The newly built Dell Children’s Medical Center in Austin, Texas was designed with an understanding of the healing power of nature. A perspective randomized design with pre-post measures Post-Occupancy Evaluation (POE) was conducted to test whether the hospital’s Healing Garden had an effect on the stress levels of parents of pediatric hospital patients. Participants were asked to sit and relax in the Healing Garden for ten-minutes. Two differing interior spaces, one with views to nature and one without views to nature, were tested as comparisons. Data was collected in the form of surveys and behavioral observation. Results indicate that the Healing Garden reduced the stress of parents at a greater rate than the two interior spaces included in the study. However, the two interior spaces did not differ in their stress reducing effects despite one having views to nature. Comments from parents indicated a slight stress relieving effect by simply leaving their patient’s room. These research findings should be used to encourage parents and other adult family members to use the hospital’s gardens to reduce stress felt from their patient’s medical treatment. Further studies need to be conducted to provide more conclusive data.

The newly built Dell Children’s Medical Center in Austin, Texas was designed with an understanding of the healing power of nature. A perspective randomized design with pre-post measures Post-Occupancy Evaluation (POE) was conducted to test whether the hospital’s Healing Garden had an effect on the stress levels of parents of pediatric hospital patients. Participants were asked to sit and relax in the Healing Garden for ten-minutes. Two differing interior spaces, one with views to nature and one without views to nature, were tested as comparisons. Data was collected in the form of surveys and behavioral observation. Results indicate that the Healing Garden reduced the stress of parents at a greater rate than the two interior spaces included in the study. However, the two interior spaces did not differ in their stress reducing effects despite one having views to nature. Comments from parents indicated a slight stress relieving effect by simply leaving their patient’s room. These research findings should be used to encourage parents and other adult family members to use the hospital’s gardens to reduce stress felt from their patient’s medical treatment. Further studies need to be conducted to provide more conclusive data.

Researchers have studied the positive effect of healing outdoor environments on hospitalized children, their family members and staff's health and mood. Consequently many modern hospitals dedicate portions of their space to healing outdoor environments. However, these amenities are underutilized due to various design barriers. This research aimed to identify barriers to garden visitation and introduce design guidelines that encourage garden visitation in pediatric hospitals for all groups. Five Texas pediatric hospital gardens were selected to examine the impact of availability of shade, quality and availability of seats, and presence of the healing nature on user satisfaction and garden use. Behavioral observation, surveys, interviews, and site evaluations were conducted. Gardens were ranked based on design qualities, user satisfaction, and frequency and duration of garden visitation. The primary conclusion of this study was that garden visitors' satisfaction with design is positively correlated with presence and quality of hypothesis variables. Duration and frequency of garden visitation also increased in gardens with better shading, seating options, and planting. Other factors identified as influential in increasing garden use included availability of amenities for children and playfulness of design layout. The research findings were instrumental in introducing new design guidelines for future hospital garden design projects. In addition, they served to statistically support design guidelines suggested by previous researchers.

The main objective of this study was to investigate the possible design of a horticultural therapy program in Swedish correctional treatment facilities. In the USA the use of horticultural therapy in offender rehabilitation is much more frequent compared with Sweden. The aim of these programs typically contains education for inmates. Research has been made indicating that these programs can have positive effects on psychosocial behavior and on vulnerability to substance abuse among incarcerated offenders. In this study the examples of these programs was categorized and analyzed from three perspectives; Vocational, social and therapeutic horticultural programs. This information, combined with knowledge on the Swedish correctional treatment system, their clients, and information on therapeutic horticulture used in the rehabilitation garden at Alnarp in Sweden, was the information used when discussing a possible design of a horticultural therapy program in Swedish prisons and jails. The gathered information resulted in a hypothetical theory concluding that instead of having separate activities for work, education and substance abuse treatment, horticultural therapy can combine these three components and meet many of the needs that inmates have.

Syfte: Att undersöka om riktlinjer för hälsofrämjande trädgårdar och takträdgårdar kan mötas i ett gestaltningsförslag till en atriumgård på ett sjukhustak, riktad till patienter och personal i anslutning till en avdelning för personer med bipolär sjukdom. Bakgrund: Hälsofrämjande trädgårdar anses kunna vara ett komplement till traditionell vård och kan främja den fysiska, psykiska och emotionella hälsan. Många städer har under de senaste årtiondena blivit mer kompakta och gröna ytor har försvunnit. Med takträdgårdar kan man utnyttja platser som redan finns i staden genom att omvandla dem till gröna ytor. Sjukhus är ofta byggda på höjden, inte sällan finns tak och atriumgårdar inritade i arkitekturen, dessa platser har potential att nyttjas av patienter, personal och närstående om de utformas för att bli gröna hälsofrämjande miljöer. Metod: Vetenskapliga artiklar, böcker och annan litteratur inom områdena hälsofrämjande trädgård, bipolär sjukdom och takodling, takträdgård, tillsammans med enkät till avdelningen och inspirationsresor till atriumgård och takodling har använts som stöd för att skapa ett gestaltningsförslag. Resultat: Detta arbete visar på vilka komponenter som bidragit till att det går att förena riktlinjer för hälsofrämjande trädgårdar med riktlinjer för takträdgårdar. Ett gestaltningsförslag har utformats efter dessa riktlinjer, platsens förutsättningar och delvis efter målgrupperna. Med arbetet har det också framkommit att det finns lite forskning kring takträdgårdar och hälsofrämjande trädgårdar för personer med bipolär sjukdom. Slutsats: Hälsofrämjande takträdgårdar är ett nytt outforskat område, ett växande intresse finns för både takträdgårdar och hälsofrämjande trädgårdar. Detta kommer troligtvis medföra att mer litteratur, forskning och erfarenhet tillkommer inom området.

This thesis takes as its focus the Maggie’s Cancer Centres exploring for the first time the impact of their designed gardens. This research is situated within the immediate context of Maggie’s ambitions as an organisation and looks closely at their design process. It is also set within the wider debates about the effects of green space on health and the historical context of the restorative garden. By exploring both historical and contemporary examples, it argues that a healthcare garden may be a space for transformation. Using four different Maggie’s gardens as case studies, the research seeks to investigate the role of these outdoor spaces and their impact on users. Through ethnographic and sensory methods, each garden is considered and mapped. It looks at the design brief and the intentions of the designers’, but the core work is an exploration of the experiences of staff and visitors. The focus is on the everyday use of these gardens as well as the design historiography. The experiences of gardens within healthcare are examined in order to expose the ways in which gardens, people, health and care are entwined. Through the qualitative research process this thesis develops a new hypothesis as to how healthcare gardens may operate – offering a new definition for them as “resilient places”. Careful analysis of the data reveals the specific networks and affordances presented by these gardens. The thesis argues, based on the evidence of users, that healthcare gardens can uniquely embrace certain “essences” where essence is defined as conveying a quality or attribute. These garden essences are identified as thresholds, sensory richness, the density of time and homeliness. The thesis also argues that a healthcare garden can provide specific and unique opportunities for care and this, in turn, can enhance the healing ethos of an organisation such as Maggie’s.

Landscape architects design healing gardens at healthcare facilities to support patients, visitors, caregivers, and staff. Many acknowledge that medical staff regularly visit healing gardens to escape work-related stress (Marcus and Sachs, 2014). Rarely, however, are healing gardens on medical campuses designed specifically to support physicians' well-being. There is a void in healing garden design theory. Reports on the prevalence of physician burnout, warn of a widespread crisis and dismal reality within the medical community (T. D. Shanafelt et al., 2015). Researchers pronounce an urgent need for evidence-based interventions, which address individual contributing factors to burnout (Christina Maslach, Jackson, and Leiter, 1986). By investigating the Mindfulness-Based Stress Reduction program, an evidence-based therapy, clinically proven to cultivate emotional healing, for physicians suffering burnout, this research reveals how a therapeutic garden could meld mindfulness-based practices with environmental theory; healing garden design precedents; and healthcare design typologies. Finally, mindfulness-based landscape design guidelines describe how a private, restorative, healing garden could help maintain physicians' well-being and rehabilitate physicians experiencing burnout due to emotional exhaustion within the workplace. / Master of Landscape Architecture / Healing gardens have been proven successful as a therapeutic approach to reduce emotional distress. This thesis argues that therapeutic gardens, designed for medical facilities, are not suitable for physicians struggling with burnout. This research seeks to understand how a private healing garden in a medical setting could help build and maintain physicians’ emotional resilience while rehabilitating physicians experiencing burnout. Through an in-depth review of therapeutic garden design theory and mindfulness-based stress reduction (MBSR) therapy, this research highlights the shared values between the two methods used to alleviate emotional distress. Characteristics of physicians’ emotional exhaustion, social isolation, and workplace environment are teased out and organized for design intent. Elements of mindfulness-based therapy are related to existing healing garden design programs. Relationships found enhance healing garden design theory and serve as guidelines for Mindfulness-Based Landscape Design specifically for physicians in healthcare settings. Correlations between design and wellness also address the need for landscape architects who contribute to a dynamic, active, and participatory design process.

Ce travail de thèse de psychologie est issu d’une collaboration entre le Groupe de recherche sur les communications du laboratoire InterPsy de l’Université de Lorraine et le CHRU de Nancy. Il a pour objectif principal de circonscrire les vertus d'étayage psychologique de l'art chez des personnes atteintes de la maladie d’Alzheimer lors de promenades accompagnées dans un à jardin à visée thérapeutique, aménagé de références régionales naturelles et culturelles. Les conversations entre un sujet Alzheimer et une expérimentatrice lors de plusieurs promenades dans le jardin ont été soumises à une analyse pragmatico-dialogique afin d'explorer en profondeur l'expérience vécue par le sujet et d’établir les relations scientifiques entre jardin, art, mémoires, jugements artistiques et émotions. Les investigations ont été complétées à l’aide d’une évaluation neuropsychologique standard et des outils psychométriques. Les capacités à s’inscrire dans le contexte temporo-spatial, les processus thymiques, les jugements esthétiques dans le domaine de l’art et du design et les processus cognitifs liés à la reconnaissance d’œuvres artistiques sont étudiés tout au long de leur participation. Les principaux résultats sont que l’utilisation répétée du jardin, dans une relation sociale médiatisée par la conversation, favorise un apprentissage de la reconnaissance d’œuvres de formes d’art et de design spécifiques. Les promenades dans le jardin contribuent à l’acquisition de nouveaux souvenirs personnels sans impacter les préférences artistiques qui restent stables chez les sujets Alzheimer comme chez les Témoins. / This doctorate of psychology thesis work is the result of a collaboration between the Research Group on Communications of the InterPsy Laboratory of the University of Lorraine and the University Hospital (CHRU) of Nancy. Its main objective is to delineate the psychological scaffolding virtues of artwork in patients with Alzheimer's disease during accompanied walks in a healing garden adorned with regional natural and cultural references. In order to study these scaffolding virtues, conversations between a participant and an experimentalist during several walks in this garden were subjected to a pragmatic-dialogical analysis (Batt & Trognon, 2012, Trognon & Batt, 2007) allowing an in-depth exploration of the perceived experiences of the subject and establishing the scientific relationships between garden, art, memories, artistic judgments and emotions. The investigations were supplemented by psychometric tools of thymic evaluation, of aesthetic judgment (the beauty criteria and appreciations) and cognitive processing (recall of artworks of the garden). The principal results are that the repeated use of the garden, in the setting of a social relationship mediated by conversation, favours learning of the recognition of specific art forms and design. The walks in the garden and the interactions with art, contribute to he acquisition of new personal memories without impacting the artistic preferences which remain stable in both Alzheimer's disease patients and control subjects

L’originalité de cette recherche est de s’intéresser aux caractéristiques de l’environnement physique et à leur impact sur les capacités de navigation et de mémoire spatiale. Ce domaine jusqu’alors peu investigué, représente pourtant un enjeu sociétal pour l’autonomie et le bien-être de la personne. Des difficultés de navigation ont notamment été décrites dans le vieillissement normal et la maladie d’Alzheimer (MA) dès le stade débutant. Or, l’environnement physique peut soutenir les capacités/compétences spatiales des individus, ou au contraire les perturber. L’objectif de cette recherche est d’évaluer l’effet structurant des éléments d’un environnement réel riche en repères, le jardin thérapeutique « art, mémoire et vie » du CHRU de Nancy, sur l’apprentissage d’un trajet et l’acquisition des connaissances spatiales, chez une population de sujets atteints de MA. En effet l'organisation spatiale de ce jardin a été conçue pour contribuer entre autres, à atténuer les difficultés de ces personnes en termes de cognition spatiale.L’ensemble des éléments du jardin a été répertorié et intégré dans une classification inspirée des travaux de Lynch (1960) et Zeisel et Tyson (1999). Trente sujets à un stade léger à modéré de la MA et 30 sujets âgés sains appariés ont réalisé le protocole suivant : (1) un apprentissage de trajet (aller et retour), durant lequel leur description verbale du parcours était enregistrée ; (2) une série de tâches évaluant l’acquisition des connaissances spatiales ; (3) des tests cognitifs standards. Le discours a été retranscrit verbatim et soumis à une analyse de contenu. Les résultats montrent une capacité d’apprentissage de trajet résiduelle significative chez les sujets du groupe MA, tant à l’aller qu’au retour. La répétition du trajet et la richesse de l’environnement en termes de repère semblent avoir contribué à ce résultat. Les performances aux tâches expérimentales ont été croisées avec l’analyse du discours et avec les tests cognitifs standards. Les résultats mettent en évidence un rôle prépondérant de certaines caractéristiques des éléments de l’environnement, telles que la saillance et l’affordance, sur les performances d’apprentissage de trajet et de mémoire spatiale et ceci de manière encore plus marquée chez les sujets du groupe MA. L’effet structurant des éléments de l’environnement est discuté d'une part chez les sujets âgés sains au regard des processus cognitifs impliqués dans la navigation et l’acquisition des connaissances spatiales et d'autre part des processus préservés et dysfonctionnels au cours de la MA / The originality of this research is to focus on the characteristics of the physical environment and their impact on navigation and spatial memory capabilities. This field, until then little investigated, represents a societal stake for the autonomy and the well-being of the person. In particular, navigation difficulties have been described in normal aging and Alzheimer's disease (AD) in the early stage. However, the physical environment can support individuals' spatial abilities/skills, or, on the contrary, disrupt them.The aim of the present study is to assess the structuring effect of the elements of a real environment rich in landmarks, the “art, memory and life” healing garden of the CHRU of Nancy, on route learning, and on the acquisition of the spatial knowledge, in a population of subjects with AD. Indeed, the spatial organization of this garden has been designed to contribute, among other things, to alleviate the difficulties of these people in terms of spatial cognition.All the elements of the garden have been listed and integrated into a classification inspired by the works of Lynch (1960) and Zeisel and Tyson (1999). Thirty subjects with mild to moderate AD and 30 matched healthy subjects underwent the following protocol: (1) route learning (forward and return trips), during which the verbal description of the route was recorded; (2) a series of tasks assessing the acquisition of spatial knowledge of the garden as well as (3) standard cognitive tests. The speech was transcribed verbatim and subjected to a content analysis.The results show a significant residual route learning ability in the MA group, both on the forward and return trips. The repetition of the route and the richness of the environmental landmarks seem to have contributed to this result. Experimental task performances were cross-checked with discourse analysis and standard cognitive tests. The results highlight a preponderant role of certain characteristics of environmental elements, such as saliency and affordance, on the learning performances of route and spatial memory, and this even more markedly in the subjects of the MA group.The structuring effect of the elements of the environment is discussed on the one hand in healthy older subjects with regard to cognitive processes involved in the navigation and acquisition of spatial knowledge and on the other hand preserved and dysfunctional processes in the course of Alzheimer’s disease

I essäns form utforskar jag i den här uppsatsen gränser och förhållningssätt för arbete och privatliv.  Jag reflekterar kring hur arbete tar plats i min yrkespraktik där jag lever och verkar till stora delar på samma ställe, Färentuna Hälsoträdgård, en tillrättalagd mötesplats för hälsofrämjande, förebyggande och läkande för främst psykosocial och existentiell hälsa. Genom mitt skrivande undersöker jag också hur min riktning att sammanlänka de olika delarna i livet kan påverka de möten som uppstår med människor jag arbetar för. I essän låter jag gestaltande berättelser från mitt yrkesliv, genom min egen röst, gå i dialog med bland annat R Paulsen, A Gorz i tankar rörande arbete, H Arendt om människans villkor och E Fromm och M Buber med resonemang om livsvärldar och möten. Eftersom en del av mitt arbete och liv innebär att ta hjälp av natur och konstuttryck lyssnar jag också på forskare och skribenter inom dessa områden för att fördjupa reflektionen. Undersökningens resultat uttrycker ett behov av en alternerande rörelse mellan olika definitioner för arbete och roller. / In the form of an essay I explore, in this text, limits and approach for work and private life. I reflect on how the work takes place in my professional practice where I live and work, most of the time, in the same place, Färentuna Hälsoträdgård, a prearranged garden, an area, for health promotion, disease prevention an healing for psychosocial and existential health. Through my writing I also examines how my direction to link the different parts of life can affect the meetings that occur with people I work for. In the essay I let the stories from my professional life, by my own voice, go to dialog with for example R Paulsen, A Gorz and thoughts concerning work, H Arendt about human conditions and E Fromm and M Buber with reasoning about life-worlds and meetings. As part of my work and life means taking the help of nature and art expressions, I also listen to researchers and writers in these areas to deepen the reflection. The survey results are expressing a need for an alternating movement between different definitions of work and roles.