Study design of an interdisciplinary and participatory nature-based palliative rehabilitation intervention in a Danish nursing home for people with severe dementia.

BACKGROUND: A limited amount of research has examined how nature-based palliative rehabilitation can be implemented in nursing homes for people with dementia, even though evidence suggests that these gardens are underused. This paper will present the study protocol of an intervention study co-designed in an interdisciplinary collaboration with a nursing home for people with dementia, to develop a tailored nature-based palliative rehabilitation program to increase qualified use of garden with the purpose of promoting a range of health outcomes. METHODS: The study is a single-cased quasi-experimental mixed methods study. The intervention will be developed, designed, and implemented in collaboration with the nursing home, using different co-design tools and methods. The effect of the intervention will be evaluated using the The Neuropsychiatric Inventory Nursing Home version in combination with medication use, a survey on staff burnout, and cameras in the garden to register garden use. A process evaluation with single- and focus group interviews consisting of various stakeholders in the study will be used to gain knowledge on the intervention processes and implementation. DISCUSSION: The paper presents new approaches in the field of palliative rehabilitation for people with dementia using nursing home gardens, through interdisciplinary collaboration, participatory co-design approach and mixed methods design. Using both effect and process evaluation, the study will provide unique insights in the role and importance of participatory process, interdisciplinary collaboration, and tailoring palliative rehabilitation activities in gardens at nursing homes to local needs and wishes. These results can be used to guide other nursing homes and renewal projects in the future. TRIAL REGISTRATION: ISRCTN, ISRCTN14095773 . Registered 15 July 2022-Retrospectively registered.

Perspectives on Accessibility and Its Users Amongst Practicing Danish Landscape Architects.

This paper presents findings from 15 interviews of randomly selected Danish landscape architectural offices focusing on how these work with and understand accessibility. The paper finds that Danish landscape architects mostly understand accessibility and its users in relation to existing building regulations. Moreover, in finding that the informants possessed a limited professional vocabulary for understanding accessibility, the paper discusses the type of knowledge requested and by, and necessary for, Danish landscape architects to gain a more reflective understanding of accessibility and its users. Towards such ends, universal design can help the profession. However, with only a few informants mentioning ideas related to universal design, this indicates that more education is needed for universal design to provide a different perspective on accessibility and its users amongst Danish landscape architects.

Psycho-Physiological Stress Recovery in Outdoor Nature-Based Interventions: A Systematic Review of the Past Eight Years of Research.

BACKGROUND: In modern, urban daily life, natural environments are increasingly recognized as an important resource for stress recovery and general well-being. AIM: the present review aims to provide an overview and synthesis of the past eight years' research into the psycho-physiological effects of outdoor nature-based interventions, related to stress recovery. METHOD: a structured search was performed in seven databases, returning 5618 articles. Removal of duplicates and initial screening gave a total of 95 studies. After full text reading, 36 studies were included in the assessment. RESULTS: most of the psychological outcomes were related to different emotional measures. The synthesis of the results points towards outdoor, nature-based exposure having a positive effect on different emotional parameters, related to stress relief. The studies into physiological measures showed more equivocal results. CONCLUSION: the research, conducted over the past eight years, into outdoor, nature-based exposure has now attained a sound evidence base for psychological and especially emotional effects, but the evidence base for physiological effects within this timeframe shows a great degree of heterogeneity. LIMITATIONS: interpretation of the results is limited by the review only covering the past eight years' research on the subject.