Impact of horticultural therapy on patients admitted to psychiatric wards, a randomised, controlled and open trial.

Psychiatric inpatients often endure anxiety. This randomized trial assessed the impact of horticultural therapy on anxiety in adult psychiatric inpatients over four weeks, compared to standard care. Recruiting 211 inpatients from six units were randomized into control (n = 105) and experimental (n = 106) groups. Control received usual care; the experimental group had horticultural therapy alongside usual care. Anxiety, measured using HADS-A scale at four weeks, aimed to establish horticultural therapy's superiority. After four weeks, horticultural therapy significantly reduced anxiety compared to standard care (P < 0.001). These results argue in favor of integrating horticultural therapy into psychiatric nursing practices.Trial registration: No Clinical Trail: NCT02666339 (1st registration: 28/01/2016).

Horticultural Therapy for Individuals Coping with Dementia: Practice Recommendations Informed by Related Non-Pharmacological Interventions.

Dementia care currently presents a challenge to healthcare providers on many levels. The rapid increase in the number of people with dementia and the costs of care certainly contribute to these challenges. However, managing the behavioral and psychological symptoms of dementia (BPSDs) has become one of the most significant tasks in providing care and can lead to poor health and well-being outcomes, not only for the people living with dementia (PLWD) but also for those providing their care. Cost-effective, easily implemented, highly adaptable, empirically based alternatives are needed. Interventions such as Horticultural Therapy (HT), which is naturally informed by Montessori-Based Methods for Dementia and sensory reminiscence therapies, meets these qualifying factors. This article, based on a review of current best practices and clinical experience, hopes to provide recommendations for such an intervention along with special considerations for PLWD and adaptations for different acuity levels. With additional safe and effective, person-centered, non-pharmacological interventions available for the complex cognitive and neuropsychiatric manifestations of this disease, a better care milieu can be provided, improving the quality of life for both patients and caregivers. This article also identifies the need for continued research into the synergistic effects of person-centered behavioral and psychosocial interventions combined with environmental approaches to provide the optimal healing environment for those coping with dementia.

Which horticultural activities are more effective for children's recovery from stress and mental fatigue? A quasi-experimental study.

Introduction: Studies have established the benefits of horticultural therapy and activities for human health and well-being. Nonetheless, limited research has been conducted on the potential restorative advantages and distinctions between different types of horticultural activities in terms of stress reduction. Methods: This study employed a quantitative research method to investigate the stress recovery benefits of five horticultural activities (flower arrangement, sowing and transplanting seeds, kokedama crafting, pressed flower card making, and decorative bottle painting with dried flowers) and one reference activity (short composition writing) for children. The experiment was conducted in a children's activity center's multi-purpose classroom with 48 elementary students aged 9-12 years. The subjects first took a stress test to induce stress and then engaged in horticultural activities for 20 min. Physiological stress was assessed using electrocardiograms and electroencephalograms as feedback indicators. Psychological and emotional changes were determined using the Positive and Negative Affect Schedule for Children and Self-Assessment Manikin scales. Results: The results demonstrated that horticultural activities greatly reduced physiological fatigue, and their recovery benefits were significantly greater than those of the reference activity. The recovery effects from different horticultural activities were similar across physiological indicators, although flower arrangement and sowing and transplanting seeds exhibited relatively robust recovery benefits. The heart rate and α-EEG-based generalized estimating equation revealed that horticultural activities offered significantly better relative recovery at each time phase of operation than the reference activity, with girls showing a 3.68% higher relative recovery value than boys. Flower arrangement and kokedama crafting offered better physiological recovery for students with prior horticultural experience, and these two activities received the highest scores in terms of positive effects and the "pleasure" dimension. Students believed that participating in horticultural activities resulted in a noteworthy increase in personal confidence and a greater sense of achievement. Conclusion: The study suggests that horticultural activities that involve real and vibrant plants or natural materials and are more attractive have more stress-relieving benefits. We conclude that horticultural activities are beneficial leisure activities that aid in stress relief for children and that it is important to consider the attributes of activities when developing horticultural programs for elementary students.

The impact of gardening on well-being, mental health, and quality of life: an umbrella review and meta-analysis.

BACKGROUND: Gardening and horticultural therapy (HT) has been widely recognised as a multicomponent approach that has affected a broad range of health and well-being outcomes. The aim of this umbrella review and meta-analysis was to compare the findings of previous reviews on the impact of multiple gardening interventions and gardening attributes on different well-being constructs. METHODS: Electronic databases including PubMed, Web of Science, Science Direct, the Cochrane Library, and Google Scholar were searched from inception to December 2022. Interventional and observational reviews were eligible for inclusion in this umbrella review. Outcome measures included mental well-being, health status and quality of life. The key exposure variables were gardening and horticultural therapy. Narrative synthesis was used to evaluate the overall impact of gardening and HT on study outcomes. For a subsample of studies with available quantitative data, a random effect meta-analysis was conducted. RESULTS: This umbrella review included 40 studies (10 interventional studies, 2 observational studies, and 28 mixed interventional and observational studies). The reviewed studies reported an overall positive impact of gardening activities on several measures of mental well-being, quality of life, and health status. Meta-analysis showed a significant and positive effect of gardening and HT activities on well-being (effect size (ES) 0.55, 95% confidence interval (CI) 0.23, 0.87, p < 0.001). CONCLUSIONS: Evidence from observational and interventional studies supports a positive role for gardening and HT activities on well-being and general health. Interventional studies with horticultural-based therapies were effective in improving well-being and quality of life both in the general population and vulnerable subgroups. The high degree of heterogeneity in the included studies cautions against any direct clinical implications of the study findings.

Health effects of green prescription: A systematic review of randomized controlled trials.

An increasing number of studies have examined the effects of green prescription on various health outcomes. The aim of this study was to systematically review published randomized controlled trial studies on the health benefits of green prescriptions. We searched PubMed, Scopus, and Web of Science for the relevant original articles published in English until June 30, 2023. Our search initially retrieved 26176 articles, of which 31 studies were included in our review after removing the duplicates and excluding ineligible articles based on their titles, abstracts, and full-text review. Consistent positive health benefits of green prescription were reported for psychological health and wellbeing (16 out of 24 studies), cardiometabolic health (five out of nine studies), physical activity (eight out of nine studies), and inflammation (two out of two studies). The reviewed studies did not report any significant benefits in orthopedic conditions, pain, and recovery from exhaustion disorder due to their implemented green prescriptions; however, the number of studies was too small to generalize the effect of green prescriptions on these outcomes. The quality of these studies was generally acceptable, with 28 studies having some concerns regarding their overall risk of bias and only three studies with a high risk of bias. All in all, this systematic review suggests that green prescriptions can be effective in improving various health outcomes, but further studies with larger sample sizes and objective measures are needed.

Effects of an outdoor horticultural activities program on cognitive and behavioral functioning, mood, and perceived quality of life in people with dementia: a pilot study.

Introduction: One of various non-pharmacological treatments for people with dementia (PwD) is horticultural therapy. The aim of this double-blind, pre- and post-test, pilot study was to examine the effects of horticultural activities (HA) for PwD at a residential and daytime care facility. Whether combining HA with elements drawn from other psychosocial interventions (cognitive stimulation) would maximize any benefits was also newly examined. Materials and methods: Twenty-four PwD were involved either in HA, alone (TG1, N = 7) or combined with some cognitive stimulation (TG2, N = 8), or in indoor treatment-as-usual activities (CG, N = 9). Benefits were assessed in terms of general cognitive functioning (for participants with mild-to-moderate dementia), mood, behavioral and psychological symptoms, and quality of life. Results: No differences emerged between TG1 and TG2 in any outcome measure, so the two groups were combined (N = 15). Compared with the CG, the TG involved in HA exhibited less frequent and severe behavioral and psychological symptoms and an improved mood after the intervention. Caregivers also reported less distress in the TG after the intervention than in the CG. Considering only PwD with mild-to-moderate dementia, the TG also showed benefits in a measure of general cognitive functioning, and self-reported quality of life, compared with the CG. Discussion: Our results further confirm that engaging PwD in participatory HA in contact with natural elements can decrease their dementia symptoms and their caregivers' distress, but also increase PwD's quality of life. Our findings also suggest the need to consider dementia severity when assessing the benefits of horticultural therapy.

Effects of horticultural therapy on health in the elderly: A review and meta-analysis.

Aim: Given the current aging population, the demand on medical facilities, facilities for elderly care, and even their high prevalence, it is crucial to investigate the advantages of older people. The purpose of our study was to systematically review the existing literature on the health effects of horticultural therapy as a treatment option for the elderly. Subject and methods: Article searches were conducted through five databases: Web of science, Science Direct, PubMed, EBSCO, and Google Scholar, according to the standard method of systematic evaluation and meta-analysis. Thirty-two published articles were included, and 27 relevant variables were meta-analyzed to assess the benefits of horticultural therapy in terms of physical and psychological functioning in the elderly. Results: Results show that horticultural therapy may be helpful in helping seniors lose weight -0.195 (95% CI -0.507,0.117), reduce their waist circumference -0.327 (95% CI -0.637, -0.017), lower their stress -0.339 (95% CI -0.610, -0.069) and cortisol -0.902 (95% CI -0.728, -0.002) levels, improve their physical flexibility 0.302 (95% CI 0.036, 0.569), social interaction 0.370, (95% CI 0.115, 0.624), and daily vegetables and fruit consumption 0.688 (95% CI: 0.287, 1.089). Conclusion: Horticultural therapy may be a useful tool for enhancing the physical, mental and social aspects of the elderly. However, there is substantial heterogeneity and wide variation in the quality of the included studies. Further high-quality studies, rigorous controls and adjustments for significant confounding variables, and larger populations are needed in the future to further our understanding of the link between horticultural therapy and elder health. Supplementary Information: The online version contains supplementary material available at 10.1007/s10389-023-01938-w.

The effect of horticultural therapy on older adults in pension institutions: a systematic review.

AIMS: To systematically evaluate the effect of horticultural therapy (HT) on older adults in pension institutions. DESIGN: Systematic review was conducted based on the checklist for PRISMA. METHODS: The searches were conducted in the Cochrane library, Embase, Web of Science, PubMed, Chinese Biomedical Database (CBM), and the China Network Knowledge Infrastructure (CNKI), from their inception until May 2022. In addition, manual screening of references of relevant studies was performed to identify potential studies. We conducted a review of quantitative studies published in Chinese or English. Experimental studies were evaluated using the Physiotherapy Evidence Database (PEDro) Scale. RESULTS: A total of 21 studies involving 1214 participants were included in this review, and the quality of the literature was good. Sixteen studies were Structured HT. The effects of HT were significant in terms of physical, physiological, and psychological aspects. In addition, HT improved satisfaction, quality of life, cognition, and social relationships, and no negative events were found. CONCLUSION: As an affordable non-pharmacological intervention with a wide range of effects, horticultural therapy is suitable for older adults in pension institutions and is worth promoting in pension institutions, communities, homes, hospitals, and other institutions that require long-term care.

Effectiveness of horticultural therapy in aged people with depression: A systematic review and meta-analysis.

Background: Depression, an increasing global crisis, has affected many people's daily life, especially for older adults. Horticultural therapy has been widely used in non-pharmacological treatment for patients with depression, with a body of studies demonstrating its therapeutic effects. However, a lack of systematic reviews and meta-analyses makes it difficult to get a holistic picture of this research field. Objectives: We aimed to evaluate the reliability of the previous studies and the effectiveness of horticultural therapy (including the intervention of environmental settings, activities, and duration) on older adults with depression. Methods: This systematic review was conducted under the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA) guidelines. We searched relevant studies in multiple databases, and the original search was finished on 25 September 2022. We included studies using randomized controlled trials (RCTs) or quasi-experimental designs. Results: We yielded a total of 7,366 studies and finally included 13 which involved 698 aged people with depression. Results from meta-analysis indicated significant effects of horticultural therapy on reducing depressive symptoms for the older adults. Besides, we found different outcomes among various horticultural interventions (such as environmental setting, activities, and duration). Depression reduction was more effective in care-providing settings than in community settings; participatory activities were more effective in reducing depression than observational activities; intervention of 4-8 weeks might represent the optimal course of treatment compared to interventions more than 8 weeks in duration. Conclusion: We came up with a comprehensive set of recommendations based on the meta-analysis: aged people in care-providing settings with depression could get the most benefit from horticultural therapy by participating in participatory activities for 4-8 weeks. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022363134, identifier CRD42022363134.

The effectiveness of group-based gardening interventions for improving wellbeing and reducing symptoms of mental ill-health in adults: a systematic review and meta-analysis.

BACKGROUND: There is increasing interest in the association between nature, health and wellbeing. Gardening is a popular way in which interaction with nature occurs and numerous gardening projects aim to facilitate wellbeing among participants. More research is needed to determine their effectiveness. AIM: To systematically evaluate the effectiveness of group-based gardening interventions for increasing wellbeing and reducing symptoms of mental ill-health in adults. METHODS: A systematic review of Randomised Controlled Trials was conducted following the protocol submitted to PROSPERO (CRD42020162187). Studies reporting quantitative validated health and wellbeing outcomes of the community residing, adult populations (18+) were eligible for inclusion. RESULTS: 24 studies met inclusion criteria: 20 completed and four ongoing trials. Meta-analyses suggest these interventions may increase wellbeing and may reduce symptoms of depression, however, there was uncertainty in the pooled effects due to heterogeneity and unclear risk of bias for many studies. There were mixed results for other outcomes. RESEARCH LIMITATIONS/IMPLICATIONS: Heterogeneity and small sample sizes limited the results. Poor reporting precluded meta-analysis for some studies. Initial findings for wellbeing and depression are promising and should be corroborated in further studies. The research area is active, and the results of the ongoing trials identified will add to the evidence base.

Terapia ocupacional desde una perspectiva ecosocial de la salud mental / Occupational therapy from an ecosocial perspective of mental health

Resumen Se describe la experiencia de un proyecto de huerta terapéutica ubicada en las inmediaciones del Servicio de psiquiatría del Hospital Guillermo Grant Benavente (HGGB) de Concepción, Chile, liderada por la Organización No Gubernamental Rebrota (ONG Rebrota) en base a la perspectiva eco-social aplicada en personas con necesidades de salud mental. Se objetiva analizar la experiencia de Terapia Ocupacional Ecosocial como herramienta práctica para la transformación de los territorios, permitiendo a los terapeutas ocupacionales comprender la interacción entre la sociedad y la naturaleza como un proceso socioecológico que impacta en diferentes esferas de los seres humanos, especialmente en la participación social y la salud mental. Utilizando la metodología descriptiva del Modelo Procesal de Emprendimiento Eco-social realizamos una orientación práctica de acciones para que las comunidades, insertas en sus entornos naturales y culturales, logren descubrirse reflexivamente generando procesos de salud colectiva. La Terapia Ocupacional Ecosocial desarrolla praxis que mejoran la salud y promueven el bienestar de las personas, grupos y/o comunidades, generando un impacto positivo en los socio-ecosistemas y construyen comunidades más saludables, inclusivas, sostenibles. La Terapia Ocupacional Ecosocial es una invitación a generar proyectos de investigación-acción para mitigar el impacto social sobre la naturaleza en un contexto de crisis climática, donde encontramos comunidades en la génesis de saberes transculturales que nos permitan desarrollar una praxis transformadora para el buen vivir en sintonía con nuestro entorno; mientras mejoran su bienestar y participación, desde una perspectiva de derechos humanos y justicia ocupacional.

Abstract It is described the experience of a therapeutic garden project located in the vicinity of the Psychiatry Service of the Guillermo Grant Benavente Hospital (HGGB) in Concepción, Chile, led by the Non-Governmental Organization Rebrota (ONG Rebrota) based on the ecosocial perspective applied in people with mental health needs. It aims to analyze this Eco-social Occupational Therapy experience as a practical tool for the transformation of territories, allowing occupational therapists to understand the interaction between society and nature as a socio-ecological process that impacts different spheres of human beings, especially in social participation and mental health. Using the descriptive methodology of the Eco-social Entrepreneurship Process Model, we carry out a practical orientation of actions so that communities, inserted in their natural and cultural environments, can discover themselves reflexively, generating collective health processes. Eco-social Occupational Therapy develops practices that improve health and promotes the well-being of individuals, groups and/or communities, generating a positive impact on socio-ecosystems and building healthier, more inclusive, and sustainable communities. Eco-social Occupational Therapy is an invitation to generate research-action projects to mitigate the social impact on nature in a context of the climate crisis, where we find communities in the genesis of transcultural knowledge that allows us to develop a transformative praxis for good living in tune with our environment; while improving their well-being and participation, from a human rights and occupational justice perspectives.

Effects of horticultural therapy on social function for elderly inpatients with cognitive dysfunction / 中华行为医学与脑科学杂志

Objective:To investigate the effect of horticultural therapy on social function of elderly inpatients with cognitive dysfunction.Methods:Ninety inpatients with cognitive dysfunction who met the diagnostic criteria of ICD-10 were randomly divided into horticultural research group and control group, with 45 patients in each group.Finally, totally 82 completed the test with 41 in each group.Patients in the two groups were both given drug therapy according to clinical symptoms.At the same time, patients in the research group were given horticultural therapy 3 times a week, 90 minutes each section, for 12 weeks.Scale of social function in psychosis inpatients(SSPI) was used to assess the social function of the patients in the two groups were at baseline, 4, 8 and 12 weekends of the treatment.SPSS 25.0 software was used to conduct chi-square test and independent sample t-test for demographic data of the two groups, and repeated measures ANOVA was performed for SSPI score. Results:The results of repeated measure analysis of variance showed that the group main effect ( F=7.226, F=13.428, F=24.817, F=19.793) and interaction effect between time and group were all statistically significant ( F=29.644, F=42.937, F=53.246, F=67.215)(all P<0.01) in daily living ability (factor Ⅰ), mobility and interaction (factor Ⅱ), social activity skills score (factor Ⅲ) and total score.Simple effect analysis showed there were no statistically significant differences in each factor score and total score between the two groups at the baseline ( P>0.05), and there were statistically significant differences in each factor scores and total score at the end of the 8th weekend ((9.95±2.41), (10.39±3.38), (6.56±3.24), (26.90±7.88) vs (8.10±2.45), (6.88±3.48), (2.81±2.50), (17.78±6.96))and 12th weekend((10.27±2.16), (11.61±3.07), (7.88±3.08), (29.76±7.40) vs (7.56±2.41), (5.78±3.21), (2.34±2.02), (15.68±6.24)) (all P<0.01). The pair-to-pair comparison within the group showed that the differences in factor Ⅱ, factor Ⅲ and total score of the research group at the end of the 12th weekend ((11.61±3.07), (7.88±3.08), (29.76±7.40)) were higher than those at the baseline((8.59±3.93), (4.56±3.32), (22.02±8.35)), 4th weekend((9.07±4.14), (5.12±3.35), (23.59±8.51)), and 8th weekend((10.39±3.38), (6.56±3.24), (26.90±7.88))(all P<0.05). Factor Ⅰ (10.27±2.16) showed a statistically significant difference compared with the baseline (8.88±2.65) and 4th weekend (9.39±2.63)(both P<0.05). All the scores showed an upward trend. Conclusion:Horticultural therapy can improve the social function of elderly inpatients with cognitive impairment.

Psychophysiological Responses of Humans during Seed-Sowing Activity Using Soil Inoculated with Streptomyces rimosus.

Electroencephalogram (EEG) responses and serum metabolite levels were used to investigate the effects of horticultural activities (seed-sowing) on the psychophysiological aspects of adults based on the presence or absence of the soil microorganism Streptomyces rimosus. In this case, 31 adults were subjected to seed-sowing activities using S. rimosus inoculated (experimental group) and medium (control group) soils. EEG was measured to analyze the resulting psychophysiological response, and blood samples (5 mL) were collected. The relative gamma power (RG), relative high beta (RHB), and SEF 50 and SEF 90 were significantly higher in the right than in the left occipital lobe (p < 0.05). In both occipital lobes, ratios of SMR to theta (RST), mid beta to theta (RMT), and SMR-mid beta to theta (RSMT) were high (p < 0.05). GC-TOF-MS-based serum metabolite analysis detected 33 metabolites. Compared to the control group, the experimental group showed a lower content of amino acids (except aspartic acid), lipids, and C6 sugar monomers after the activity (p < 0.05). Aminomalonic acid was decreased, and aspartic acid was increased (p < 0.05). This study confirmed a positive effect on improving the concentration and attention of adults when seed-sowing activity was performed using S. rimosus-inoculated soil.

Horticultural Therapy May Reduce Psychological and Physiological Stress in Adolescents with Anorexia Nervosa: A Pilot Study.

Studies in psychiatric populations have found a positive effect of Horticultural therapy (HCT) on reductions in stress levels. The main objective of the present pilot study was to evaluate the impact of the addition of HCT to conventional clinical treatment (Treatment as Usual, TaU) in a sample of six female adolescents with anorexia nervosa restricting type (AN-R), as compared to six AN-R patients, matched for sex and age, under TaU only. This is a prospective, non-profit, pilot study on patients with a previous diagnosis of AN-R and BMI < 16, recruited in 2020 in clinical settings. At enrolment (T0) and after treatment completion (TF), psychiatric assessment was performed. At T0, all the patients underwent: baseline electrocardiogram acquisition with a wearable chest strap for recording heart rate and its variability; skin conductance registration and thermal mapping of the individual's face. An olfactory identification test was administered both to evaluate the olfactory sensoriality and to assess the induced stress. One-way analyses of variance (ANOVAs) were performed to analyze modifications in clinical and physiological variables, considering time (T0, TF) as a within-subjects factor and group (experimental vs. control) as between-subjects factors. When the ANOVA was significant, post hoc analysis was performed by Paired Sample T-tests. Only in the HCT group, stress response levels, as measured by the biological parameters, improved over time. The body uneasiness level and the affective problem measures displayed a significant improvement in the HCT subjects. HCT seems to have a positive influence on stress levels in AN-R.

Effect of horticultural activities on quality of life, perceived stress, and working memory of community-dwelling older adults.

This study sampled 86 community-dwelling older adults to investigate the effect of horticultural activities on their quality of life, perceived stress, and working memory. The results demonstrated that after 8 weeks of horticultural activities, the effect sizes (Cohen's d) of their quality of life, perceived stress, and working memory were 0.92, -1.32, and 0.62, respectively. Among the four domains of quality of life, the social relationships domain improved the most. For perceived stress, the score of the experimental group decreased from 1.70 (0.48) to 1.29 (0.58). For working memory, the score increased from 3.43 (1.13) to 4.14 (1.27), whereas the score of the control group did not change substantially. Statistical analysis conducted using a generalized estimating equation revealed a significant interaction effect between group and time (P < 0.001). This study provides a reference for improving the quality of life, perceived stress, and working memory in older people.

Horticultural Therapy for Improving the Work Performance and Interpersonal Relationships of Persons with Intellectual Disabilities.

For the occupational adaptation and social integration of the intellectually disabled, it is helpful to improve their work performance and interpersonal skills. The purpose of the study was to evaluate the effectiveness of horticultural therapy (HT) programs to improve work performance and interpersonal relationships of persons with intellectual disabilities. Based on observations and analyses of how people with intellectual disabilities work, we have developed a 12-session HT program that includes upper limb movements and physical activities to improve hand function. We recruited, with the consent of their legal guardians, 14 (6 males, 8 females) participants who had intellectual disabilities and were working at a sheltered workshop in K-gu, Seoul, South Korea. The program consisted of twelve sixty-minute sessions that were conducted twice a week at a rooftop garden. For pre- and post-evaluation of the program, the survey of functional adaptive behavior (SFAB), interpersonal negotiation strategies, a horticultural job evaluation (self), hand function tests (pegboard, pinch gauge, fingertips), and blood sample tests for physiological indicators of exercise were conducted. Interpersonal negotiation strategies, functional adaptive behaviors, and physical abilities for job behaviors, including agility and grasping of the hand, improved significantly from before to after the program (p < 0.05). A positive result of VEGF (vascular endothermic growth factor) in blood sample tests implies the need for further research on cognitive changes caused by horticultural activities. This study has limitations due to the small number of participants, but the results suggest that low- to medium-intensity horticultural treatment programs using the upper body and hands could be effective for vocational rehabilitation of the intellectually disabled.

Psychophysiological and Metabolomics Responses of Adults during Horticultural Activities Using Soil Inoculated with Streptomyces rimosus: A Pilot Study.

This study compared the physiological effects at a metabolomics level with autonomic nervous system responses in adults during soil mixing activities, based on the presence or absence of Streptomyces rimosus in the soil. Thirty adult participants performed soil mixing activities for 5 min using sterilized soil with culture media and Streptomyces rimosus, respectively. Blood samples were drawn twice from each participant after each activity. Electroencephalograms were measured during the activity. Serum metabolites underwent metabolite profiling by gas chromatography, followed by multivariate analyses. Serum brain-derived neurotrophic factor and C-reactive protein levels were measured by Enzyme-Linked Immunosorbent Assay. Soil-emitted volatile organic compounds were identified via solid-phase microextraction and gas chromatography-mass spectroscopy, followed by multivariate analyses. The volatile compound analysis revealed that the terpenoid and benzoid compounds, geosmin, and 2-methylisoborneol were greater in soil with Streptomyces rimosus. Serum metabolomics revealed that the treatment group (soil inoculated with Streptomyces rimosus) possessed relatively higher levels of serotonin compared to the control group (soil mixed with culture media), and serum C-reactive protein levels were significantly lower in the treatment group. In the treatment group, the electroencephalogram revealed that alpha band activity of the occipital lobe increased. This study concludes that Streptomyces rimosus soil contact can positively affect human metabolic and autonomic reactions. Therefore, this pilot study confirmed the possible role of soil microorganisms in horticultural activities for psychophysiological effects in humans.

The effects of a combination of 3D virtual reality and hands-on horticultural activities on mastery, achievement motives, self-esteem, isolation and depression: a quasi-experimental study.

BACKGROUND: Aging societies are a public health concern worldwide. It is critical to develop strategies that harness technology to enhance older adults' mastery, achievement motives, self-esteem, isolation and depression effectively. METHODS: This study aimed to explore the effects of a combination of three-dimensional virtual reality (VR) and hands-on horticultural activities on the psychological well-being of community-dwelling older adults. We used a quasi-experimental design. A total of 62 community-dwelling older adults were recruited and assigned to the experimental (n = 32) and comparison groups (n = 30). The members of the experimental group participated in an 8-week intervention program. Participants of both groups completed before-and-after intervention measurements for outcome variables that included perceived self-esteem, depression, isolation, and mastery and achievement motives, which were analyzed using the generalized estimating equation (GEE). A baseline score of depression was used as an adjustment for the GEE analyses to eliminate the effects of depression on outcomes. RESULTS: After controlling age and gender as confounders, GEE analyses indicated that the experimental group showed significant post-intervention improvements in scores for self-esteem (ß = 2.18, P = .005) and mastery (ß = 1.23, P = .039), compared to the control group. CONCLUSIONS: This study supported a combination of three-dimensional VR and hands-on horticultural activities on community-dwelling older adults to improve self-esteem and mastery. The findings suggest that the future implementation of a similar program would be feasible and beneficial to community-dwelling older adults. TRIAL REGISTRATION: The study was posted on www. CLINICALTRIALS: gov (NCT05087654) on 21/10/2021. It was approved by the Institutional Review Board of En Chu Kong Hospital and performed in accordance with the Declaration of Helsinki.

The effect of horticultural therapy on depressive symptoms among the elderly: A systematic review and meta-analysis.

Objective: This systematic review and meta-analysis aimed to assess the effectiveness of horticultural therapy on depressive symptoms in the elderly and determine the potential moderators of the intervention effect. Methods: In early June 2022, randomized controlled trials and Quasi-experimental studies were searched on Web of Science, PsycINFO, CINAHL, EMBASE, Medline, PubMed, CNKI, WANFANG DATA, and CQVIP. Three independent authors proposed the following inclusion criterion for this study: the elderly with applied horticultural therapy intervention compared to non-HT intervention. From a total of 3,068 records, only 34 studies met the inclusion criteria. After the full-text screening, 13 studies were included in the analysis. An assessment of the risk of bias was conducted using RoBINS-I and RoB 2 tools. The comprehensive Meta-Analysis 3.3 tool was used for the meta-analysis. Results: Meta-analysis suggested that mean depression scores of elderly people who underwent horticultural therapy intervention were significantly lower than those who did not receive HT therapy. More significant effects were found for the elderly with mean age equal to or over 75 years instead of younger than 75 years, in randomized controlled trials instead of quasi-experimental studies, for studies with more than 20 participants receiving horticultural therapy at the same time and place instead of equal to or fewer than 20 horticultural therapy participants. Conclusions: This evidence supported that horticultural therapy had a significant positive effect on the depressive symptoms outcomes for the elderly. Therefore, our data revealed that horticultural therapy could be considered as a part of therapy in depressive symptoms reduction programs. Due to the high degree of heterogeneity and the limited number of studies, a future review is warranted to determine the effects of horticultural therapy on depressive symptoms reduction in the elderly. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=272464, identifier: CRD42021272464.

Psychophysiological Responses of Cut Flower Fragrances as an Olfactory Stimulation by Measurement of Electroencephalogram in Adults.

Horticultural therapy (HT) is green care that can help improve and recover the health of modern people living in cities through natural experiences. Many studies have been conducted to determine HT's therapeutic effects and underlying mechanisms, but investigation for developing readily applicable clinical techniques is insufficient. We aimed to investigate adults' brain activity and emotional state during flower arrangement (FA) with different flowers in an HT program. We recruited thirty adults and used a randomized cross-over study method to set them to participate in five FA tasks at 90-s intervals. While performing FA tasks, the participants' prefrontal cortex brain waves were measured by a wireless electroencephalography device and their emotional states between FA tasks were measured by questionnaires. Results showed that each FA task resulted in a different attention level of the participants. The participants showed the highest attention level during FA with stocks and carnations, while FA with lilies showed the lowest attention level among the five FA tasks. Instead, the participants showed the highest arousal, tension, and anxiety for emotional states during FA with lilies. Therefore, this study confirmed the differences in attention level and emotional changes according to flower types for using clinical techniques of HT for various clients.