Master of Science / Department of Horticulture, Forestry, and Recreation Resources / Candice A. Shoemaker / Educational opportunities in horticultural therapy at colleges and universities are currently experiencing a minimal level as compared to the time of their development in the early 1970’s. While there is an education decline in horticultural therapy, there is a rebirth of interest in this therapeutic modality taking place within the medical profession. Due to the lack of availability of university introductory-level horticultural therapy courses throughout the United States, it is important to ascertain what topics are needed for inclusion in an introductory course. A survey was sent to 13 horticultural therapy practitioners, 11 university instructors, and 8 students. Overall, responses of practitioners and professors were varied in their opinions. The one topic of importance in which they agreed was horticultural therapy definitions, as definitions for horticultural therapy, horticultural therapist, and horticultural therapy programs. A majority of horticultural therapy practitioners indicated that horticultural therapy history and theories are important topics for an introductory horticultural therapy course. A majority of the professors reported that horticultural therapy settings are a somewhat important topic. Topics of interest to students who had taken an introduction to horticultural therapy course included interaction with special populations (for example, elders, children, patients in physical rehabilitation), the use of adaptive gardening techniques and tools, and measuring the benefits of horticultural therapy. Topics of interest about which students wanted to learn more were ways in which to help each population through planned activities and how to reach horticultural therapy goals planned for patients and clients. Results of a literature search was conducted in which sources of information indicated that there have been declines in educational opportunities over time and a lack of growth in these opportunities. Based on the survey results and literature review, an introductory horticultural therapy course was developed. An introduction-type course is one that briefly introduces most, if not all, topics that will be studied in depth in more advanced courses. It should be designed in such a way that interests students and encourages them to continue their studies in the program. At the same time, the concerns and interests of the practitioners and professors need to be considered in the design of the course. As a result, the course was planned and includes the topics that are of interest to the participants in the surveys. The topics include horticultural therapy history, theories, definitions, program types, client/patient groups, settings, and the people-plant relationship.

Previous studies suggest there are numerous benefits of horticultural therapy programs. The current study explored the benefits of a horticultural therapy program with elderly populations at two facilities in Bowling Green, Kentucky. Fifteen participants attended a 2-hour session on horticulture techniques once a week for four weeks. Using a pretest to posttest study design, changes in participants’ cognition, quality of life, and loneliness were assessed. The pretest was administered verbally by the researcher before the first session and the posttest, including a series of questions about satisfaction with the program, was administered after the last session. Items on each assessment included the Mini-Mental State Exam, the Assessment of Quality of Life, and the Revised UCLA Loneliness Scale. Findings suggest that participants’ cognitive ability significantly improved after participation in the program while quality of life and loneliness perception did not significantly improve. Participants perceived the program as positive and enjoyable.

Contexte : L’annonce du passage de soins curatifs à des soins palliatifs précipite la personne sur son dernier chemin, avec l’angoisse qui surgit. Cette annonce amorce un processus de déliaison à l’origine de la souffrance. Au-delà d’une chronique d’une mort annoncée, comment accompagner ceux qui se trouvent à la dernière étape de leur vie afin qu’ils continuent à être sujet de désir, si ce n’est en soutenant leur force créatrice. Objectif: Mettre en place un dispositif hortithérapique standardisé et manuélisé spécifique à l’accompagnement de fin de vie ; et d’évaluer les processus mobilisés et les effets hortithérapiques.Méthode: L’échantillon est composé de 106 sujets dont l’âge moyen est de 81,9 ans (σ = 8,33: extrêmes : de 57 à 97 ans).Principaux résultats: Les principaux résultats révèlent un effet bénéfique de l’hortithérapie ainsi que des différentes techniques sur les états de base, les attitudes et les processus de création.Nous retrouvons un maintien des états de base et l’intention pour l’ensemble des techniques malgré l’évolution de la maladie.Conclusion : A partir des résultats obtenus dans ce travail de recherche, des recommandations pour les bonnes pratiques en fonction des populations rencontrées ont été élaborées. / Background: The announcement of the passage of curative to palliative care precipitates person on his last path with the anxiety that arises. This announcement begins a process of unbinding the origin of suffering. Beyond a chronicle of a death, how to support those who are in the last stage of their lives so they continue to be subject of desire if not supporting their creative force.Objective: Establish a standardized and specific tool to support end of life, and to evaluate the process and effects.Method: The sample consisted of 106 subjects with a mean age of 81.9 years (σ = 8.33 : range, 57 to 97 years).Main results: The main results show a beneficial effect of horticultural therapy as well as different techniques on the basis states, attitudes and creative process.We find a continuation of basic states and intent for all technical despite the evolution of the disease.Conclusion: From the results obtained in this research, recommendations for good practice based on populations encountered were developed.

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.

<p>Hälsans Trädgård is a project which is going to start in Gamla Linköping, Sweden. The authors were commissioned by Arbetslivsresurs, a company working with work rehabilitation, to select, define and make job analyses on five work tasks at Hälsans Trädgård in Gamla Linköping. A job analysis means an analysis of the demands the job make of the individual. The job analysis used in this study is called The Revised Handbook for Analyzing Jobs (RHAJ) and is from the US Department of Labor (DOL). As RHAJ is an American instrument, the authors produced a form where the concepts are translated into Swedish to make the analysis easier. The areas that were analyzed according to the RHAJ were: worker functions, general educational development, specific vocational preparation, aptitudes, temperaments, and physical demands and environmental conditions. The five work tasks that were analyzed at Hälsans Trädgård were: “Raking”, “Planting flowers”, “Weeding”, “Shoveling snow” and “Portraying Lisa”. The result shows that the five work tasks make low demands on the individual and that none of the tasks demand mathematical development. The task “Portraying Lisa” was the task which, in most cases, made the most demands on the individual. The discussion proposes how the work tasks can be more complex. The authors suggest investigations that test the RHAJ for validity and reliability and that the RHAJ in full be translated into Swedish and tested under Swedish circumstances in future research.</p>

Hälsans Trädgård is a project which is going to start in Gamla Linköping, Sweden. The authors were commissioned by Arbetslivsresurs, a company working with work rehabilitation, to select, define and make job analyses on five work tasks at Hälsans Trädgård in Gamla Linköping. A job analysis means an analysis of the demands the job make of the individual. The job analysis used in this study is called The Revised Handbook for Analyzing Jobs (RHAJ) and is from the US Department of Labor (DOL). As RHAJ is an American instrument, the authors produced a form where the concepts are translated into Swedish to make the analysis easier. The areas that were analyzed according to the RHAJ were: worker functions, general educational development, specific vocational preparation, aptitudes, temperaments, and physical demands and environmental conditions. The five work tasks that were analyzed at Hälsans Trädgård were: “Raking”, “Planting flowers”, “Weeding”, “Shoveling snow” and “Portraying Lisa”. The result shows that the five work tasks make low demands on the individual and that none of the tasks demand mathematical development. The task “Portraying Lisa” was the task which, in most cases, made the most demands on the individual. The discussion proposes how the work tasks can be more complex. The authors suggest investigations that test the RHAJ for validity and reliability and that the RHAJ in full be translated into Swedish and tested under Swedish circumstances in future research.

The aim of the study was to explore the methods used in horticultural therapy gardens in rehabilitating people suffering from fatigue syndrome. Nine horticultural therapy gardens were contacted of wich three chose to participate. Using case study as method e-mail interviews was carried out with the participants about their establishment and what kind of theories they based their methods upon. The material collected from the interviews was complemented with additional data from the establishments web pages and information pamphlets. Collected data was processed trough content analysis and then formed as background for the development of a program theory for horticultural therapy. The results show some variations in how the different establishments practice horticultural therapy and how they assess and follow up their work. The program theory of horticultural therapy contains gardening and residing in the garden, conversational therapy, autogenic exercise and stress managment. These activities are expected to lead to a higher degree of self perception, a reevaluation of one´s conceptions and higher self esteem. Through these activities the participants are given an increased ability to handle their lives, which in turn is thought to make it possible for them to return to work or studies. The abcense of clearly defined goals with the rehabilitation makes it difficult to determine how effective it is in bringing people with fatigue syndrome back to work. / Syftet med studien var att undersöka hur trädgårdsrehabilitering tillämpas av några verksamheter för att göra en jämförelse i syfte att påvisa likheter och skillnader. Nio verksamheter kontaktades varav tre valde att delta. En fallstudie utfördes där de tre verksamhetsansvariga intervjuades via e-post om sina verksamheters organisation och grundfilosofi samt hur verksamheten utväderades och följdes upp. Som komplement till intervjuerna granskades även verksamheternas presentationer av sig själva på hemsidor och i broschyrer. Resultatet ger en bild av hur tre verksamheter som bedriver trädgårdsrehabilitering för utmattningsdrabbade är utformade, samt i vilken utsträckning de gör utvärderinga och uppföljningar. Gemensamma inslag i rehabiliteringen var trädgårdsvistelse/aktiviteter, hantverksaktiviteter, samtal, stresshantering och avslappningsövningar. Utvärderingar och uppföljningar skedde i varierande grad och med olika mätinstrument. Som en del i att försöka tydliggöra de tänkta verkningsmekanismerna i trädgårdsrehabiliteringen och ge en översiktlig bild av metoden, utformades även en programteori. Den utgår från verksamheternas metoder samt vetenskaplig evidens inom området. Programteorin visar hur de tänkta aktiviteterna förväntas leda fram till slutresultatet. Den, för trädgårdsrehabilitering, utformade programteorin innehåller vistelse i trädgård och trädgårdsarbete, samtalsterapi, avslappningsövningar och stresshantering. Aktiviteterna förväntas leda till en ökad självinsikt, ett ändrat förhållningssätt och en bättre självkänsla, och genom det en ökad förmåga att hantera sin livssituation. Detta antas ge de förutsättningar som behövs för att kunna återgå till arbetsliv eller studier, alternativt fortsätta rehabiliteringen med arbetsträning. Avsaknaden av tydliga, mätbara mål med rehabiliteringen gör det svårt att värdera hur effektiv rehabiliteringsformen egentligen är på att återinföra utmattningsdrabbade i arbetslivet.

Doctor of Philosophy / Department of Horticulture, Forestry, and Recreation Resources / Richard H. Mattson / Medical and psychological responses of patients recovering from surgery were evaluated in hospital rooms with ornamental indoor plants. Three clinical studies were conducted in two hospitals with 80 thyroidectomy patients, 90 appendectomy patients, and 90 hemorrhoidectomy patients. Patients in each surgical procedure were randomly assigned to either control or plant rooms. Eight species of foliage and flowering plants were placed in the hospital rooms during the recovery period following surgery until discharge. Data collected from each patient included length of hospitalization, analgesics used for postoperative pain control, vital signs (blood pressure, temperature, heart rate, and respiratory rate), ratings of pain intensity, pain distress, anxiety and fatigue (PPAF), the State-Trait Anxiety Inventory Form Y-1 (STAI-Y1), the Environmental Assessment Scale (EAS), and the Patient’s Room Satisfaction Questionnaire (PRSQ). Effects were assessed by analysis of covariance and the exact chi-square test. Patients in the plant rooms had significantly more positive health outcomes than those in the control group with no plants. Patients exposed to plants experienced shorter hospitalizations, fewer intakes of postoperative analgesics, more positive physiological responses, and less pain, anxiety, and fatigue than patients in the control group. Patients with plants also felt more positively about their rooms and evaluated them with higher satisfaction as compared to those in the control group. Based on patients’ comments, plants brightened up the room environment, reduced stress, and also conveyed positive messages of the hospital caring for patients. Findings of this study confirmed the therapeutic value of plants in the hospital environment as a noninvasive, inexpensive, and effective intervention for surgical patients in a general hospital ward. Outcomes of this study will substantially affect patients’ and hospital administrators’ decisions that indoor plant intervention can foster improved medical outcomes, increase satisfaction with providers, and be acceptably cost effective as compared to other alternatives.

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.