This diploma thesis deals with the theme of horticultural therapy in the Czech Republic. The thesis is especially focused on the utilization of this therapy with seniors. The theoretical part contains chapters dealing with age, needs, and horticultural therapy, which is an effective way of meeting the needs of the elderly. The horticultural therapy is presented from the historical point of view. In addition the state of the horticultural therapy in Czech Republic is described in general. Furthermore this chapter describes the usage of the horticultural therapy abroad. Key features of the horticultural therapy are presented in order to ensure effectiveness of this method. Therapeutic gardens are defined in this part, as well as key differences between horticultural therapy and other generally used therapeutic approaches. The research is based on semi-structured interviews with relevant persons in the Czech Republic. The interviews were conducted with three groups of people. The first group consists from individuals who are mainly oriented in the theoretical level of horticultural therapy. For example they have an overview of the state of horticultural therapy in the Czech Republic, especially in the realization of horticultural therapy or legislative issues. The second group are those who practice...

Trädgårdsterapi är en behandlingsmetod där deltagarna genomgår ett program baserat på upplevelser och arbete i en terapeutisk trädgård med stöd av ett multidisciplinärt team med syftet att behandla olika sjukdomstillstånd. I Sverige tillämpas trädgårdsterapi främst vid vård av psykisk ohälsa som depression, utmattningssyndrom och schizofreni.  Syftet med detta arbete var att undersöka vilken effekt trädgårdsterapi har visats ha vid olika sjukdomstillstånd. Därför genomfördes en litteraturöversikt med systematisk ansats. Sökningar utfördes i databaserna PubMed, APA Psychinfo samt Swemed+ vilket resulterade i tio experimentella studier. Dessa har kvalitetsgranskats och deras resultat har bedömts och sammanställts. Studierna undersöker: cancer i palliativ vård, schizofreni, demens, stroke, smärta, depression och utmattningssyndrom samt hjärt- och kärlsjukdomar. Många av studierna har metodologiska problem som sänker deras kvalitet och bevisvärde.  Det finns inget stöd för att trädgårdsterapi skulle kunna användas för att öka livskvaliteten i palliativ vård för patienter med cancer. Det har inte heller visats fungera bättre än konventionell behandling vid stroke-rehabilitering eller för att förbättra stämningsläget hos personer med demens. Däremot har trädgårdsterapi visats ha gynnsamma effekter på symptomen vid schizofreni, depression och långvarig smärta samt bidra till rehabilitering av depression och utmattningssyndrom. De positiva effekterna på flera av sjukdomstillstånden visar att behandlingen kan ha potential att öka hälsa och lindra sjukdom. Detta kan motivera till ytterligare studier och en fortsatt utveckling av trädgårdsterapin. / Horticultural Therapy is an activity where the participants are working in and experiencing a therapeutic garden with the support of a multidisciplinary team with the aim to treat various illnesses. In Sweden the method is mainly used to treat mental health problems such as depression, fatigue and schizophrenia. The objective of this paper was to examine the effects of horticultural therapy on different illnesses. To reach the objective a review with a systematic approach was performed. A key word search was made in the databases PubMed, APA Psychinfo and Swemed+ which resulted in ten experimental studies that has been used for analyses in this paper. The quality of the studies has been examined and the results have been evaluated and compiled. The included publications examine palliative care, schizophrenia, dementia, stroke, pain, depression, fatigue and cardiopulmonary diseases. Several of the studies have methodological shortcomings which limits their quality and evidential value.  There is no evidence that horticultural therapy could be used to improve the quality of life in cancer patients in palliative care. Neither has it been shown to perform better than conventional treatments in the rehabilitation of stroke or to improve the mood of persons with dementia.  However, horticultural therapy had significant positive effects on the symptoms of schizophrenia, depression and chronic pain and contributed to the rehabilitation of depression and fatigue. The positive effects indicate that horticultural therapy could potentially contribute to promoting health and treating disease. This could motivate further studies and a continued development of the treatment.

L’objectif de cette recherche est double. Etudier les causes et conséquences du Burnout des soignants, dans un premier temps, et comprendre l’effet de la présence d’un jardin dans un secteur gériatrique hospitalier dans un second temps. Les infirmiers et aides-soignants de neuf services de gériatrie ont répondu à un questionnaire construit à partir des théories et échelles de Karasek et Theorell (1990), Siegrist (1996), Shirom (2004) et Kurorinka (1987). Ainsi, le Burnout est confronté aux facteurs psychosociaux, à la Vigueur (bien être) et aux douleurs physiques pour extraire les causes et conséquences de ce trouble psychologique. Ces mêmes équipes ont également participé à des entretiens de type « focus groups » et à des entretiens individuels semi-dirigés afin de s’exprimer sur leurs conditions de travail, ainsi que sur leur vécu et leur ressenti de la présence ou l’absence d’un jardin aménagé ou non aménagé dans leur environnement de travail. Ces équipes de soins appartenaient à trois types de services gériatriques : unité cognitivo-comportementale, soins palliatifs, soins de réadaptation. Les résultats principaux du questionnaire mettent en cause le manque de soutien de la hiérarchie comme aspect augmentant les risques de Burnout. Ce résultat est par la suite confirmé par les entretiens. De plus, le Burnout semble moins présent dans les services avec jardin que sans jardin, et il existe également une amplification de ce bénéfice dans les jardins thérapeutiques. On observe une sensation de Vigueur, tant physique que psychologique, plus importante dans les services avec jardin, et une tendance à l’augmentation des T.M.S. dans les services avec jardin thérapeutique. Cette constatation amène à s’interroger sur l'ergonomie du travail dans ce type d'environnement. En conclusion, le jardin apparaît comme un dispositif systémique favorable aux interactions de travail dans un lieu spécifiquement aménagé, permettant par là-même de combattre les sources de Burnout et de défendre la Vigueur. Il favorise l’épanouissement des soignants et la réduction du Burnout mettant tout de même en lumière un principe de précaution sur la charge physique et l’ergonomie de ce lieu à explorer / The aim of this research was twofold. Study the causes and consequences of Burnout caregivers, initially, and understand the effect of the presence of a garden in a hospital geriatric sector in a second time. Nurses and caregivers of nine geriatric services answered a questionnaire constructed from the theories and scales of Karasek and Theorell (1990), Siegrist (1996), Shirom (2004) and Kuorinka (1987). So, the Burnout is faced with psychosocial factors, the vigor (wellness) and physical pain to extract the causes and consequences of this psychological disorder. These same teams also participated in such conversations "focus groups" and semi-structured individual interviews to speak about their working conditions, as well as their experience and felt the presence or absence a arranged garden or undeveloped in their work environment. These care teams belonged to three types of geriatric services: cognitive behavioral unit, palliative care, rehabilitation care. The main results of the questionnaire involve lack of support from the hierarchy appearance as increasing the risk of Burnout. This result is confirmed by interviews. In addition, Burnout was a lesser incidence of Burnout in care services with a garden that those without a garden, and and there is also with an amplification of the benefit with specially-designed gardens. The feeling of strength, both physical and psychological, was less present when the care services did not have a therapeutic garden. A trend toward an increase in musculoskeletal disorders in services with a therapeutic garden versus no garden was observed. Upon analyzing the results, the authors recommend particular attention in the designing of hospital gardens in order to facilitate the ergonomics of nursing work. In conclusion, the overall results advocate the use of the garden as a systemic structure conducive to work interactions in a specially designed area by allowing the same to combat the sources of Burnout and defend Vigor. It encourages the development of nursing and reducing Burnout highlighting a precautionary principle on the physical load and ergonomics of this place to explore.