Psychological impacts of intervention to improve a therapeutic garden for older adults with dementia: a case study conducted at a care facility

Introduction

Exposure to nature is known to support psychological wellbeing, and can support People with Dementia (PwD). Here we describe a case study conducted at a care facility for PwD to examine the effect of their exposure to nature after intervention to renovate an existing Therapeutic Garden (TG). Changes in frequency of attendance and behavior in the TG were examined. A single case was also considered to assess individual benefits.

Materials and methods

Twenty-one PwD participated in the study. Their behavior in the TG was observed for 4 weeks before and after the intervention (using behavioral mapping), and measures of individual characteristics (general cognitive functioning, behavioral/neuropsychiatric symptoms, depression, and quality of life) were administered.

Results

Ten of the 21 PwD visited the TG more often after the intervention, their social behaviors (e.g., talking to others) increased, and their active isolated behavior in the garden (e.g., smelling, touching flowers) tended to increase. The increase in social behavior related to less severe baseline depressive symptoms. Passive isolated behaviors related to more impaired baseline cognitive functioning. The case of Mrs. A extended the findings for the whole sample: although her dementia symptoms (apathy, motor disturbances) worsened, she visited the TG more often after the intervention, her social exchanges and active isolated actions increased, and her agitation and wandering decreased.

Discussion

These results support the benefits of exposure to nature for PwD, and underscore the importance of considering users' profiles to optimize their use of a TG.

Playing in 'The Backyard': Environmental Features and Conditions of a Natural Playspace Which Support Diverse Outdoor Play Activities among Younger Children

Outdoor play in nature-rich spaces has been associated with healthy development among young children. The diverse play opportunities afforded to children by natural playspaces can scaffold health benefits, appreciation of nature, and pro-environmental behaviors into adulthood. Environmental features and conditions of outdoor playspaces significantly influence the diversity and quality of play opportunities. Understanding how the physical environment can support high-quality play experiences can inform the design of stimulating, health-promoting playscapes for children. An observational behavior mapping framework was utilized to examine the environmental features of The Backyard, a large natural playscape, associated with play activities among young children. The Tool for Observing Play Outdoors was used to capture outdoor play types OPT), along with associated behavioral and environmental data, during seven days of field observation. While the playspace supported most OPTs, Physical and Exploratory play were most prevalent. Associations with activity intensity and risk play are also presented. Loose parts, particularly natural loose parts, were highly involved in most OPTs, but especially associated with Exploratory play. Ground topography showed some association with several OPTs and warrants further investigation. The environmental features of The Backyard supported an abundant and diverse range of outdoor play activities for young children and families.

Mapping Healthcare Spaces: A Systematic Scoping Review of Spatial and Behavioral Observation Methods

OBJECTIVE

To provide a taxonomy of spatial observation methods that are commonly used in healthcare environments research and to describe their relative success.

BACKGROUND

Spatial observation is a valuable but resource intensive research method that is often used in healthcare environments research, but which frequently fails to deliver conclusive results. There is no existing catalog of the different spatial and behavioral observation methods that are used in healthcare design research and their benefits or limitations.

METHODS

The review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Ten key databases were searched, and articles were screened by both authors.

RESULTS

Across 67 included studies, 79 observation methods were reported. We categorized those into four, distinct methodological approaches, outlining the benefits, limitations, and suitability of each for obtaining different types of results. Common limitations included difficulty generalizing to other contexts and a lack of detailed description during data collection which led to key environment variables not being recorded. More concrete conclusions were drawn when observation methods were combined with complimentary methods such as interview.

CONCLUSIONS

The relative success of spatial observation studies is dependent on the fit of the method selected relative to the research question, approach, and healthcare setting; any complimentary methods delivered alongside it; and the analysis model employed. This article provides researchers with practical advice to guide the appropriate selection of spatial observation methods.

An Observational Study of Park Attributes and Physical Activity in Neighborhood Parks of Shanghai, China

Evidence shows that neighborhood parks provide opportunities for urban residents to participate in physical activity, but little is known about the space–behavior relationship of physical settings. This study explored the patterns of use in neighborhood parks, and focused particularly on visitors’ levels of activity supported by the specific landscape features and attributes. Behavior mapping data, including the users’ characteristics, their behaviors and activity levels, and the landscape characteristics, were obtained in three neighborhood parks of Shanghai, China. A total of 6126 park users were documented during the observations, and most of them were involved in sedentary activity. This study found that different environmental settings such as water, plaza, lawn, and architecture supported different types and levels of activity. Although more men than women visited the neighborhood parks, women were more active than men in park-based physical activity. In this Chinese sample, the findings demonstrate behavior mapping is a promising tool to measure park-based physical activity. As this study associated the levels of use with the landscape features, the results are expected to be useful in design practice for promoting regular physical activity.

Early Steps in Automated Behavior Mapping via Indoor Sensors

Behavior mapping (BM) is a spatial data collection technique in which the locational and behavioral information of a user is noted on a plan layout of the studied environment. Among many indoor positioning technologies, we chose Wi-Fi, BLE beacon and ultra-wide band (UWB) sensor technologies for their popularity and investigated their applicability in BM. We tested three technologies for error ranges and found an average error of 1.39 m for Wi-Fi in a 36 m² test area (6 m × 6 m), 0.86 m for the BLE beacon in a 37.44 m² test area (9.6 m × 3.9 m) and 0.24 m for ultra-wide band sensors in a 36 m² test area (6 m × 6 m). We simulated the applicability of these error ranges for real-time locations by using a behavioral dataset collected from an active learning classroom. We used two UWB tags simultaneously by incorporating a custom-designed ceiling system in a new 39.76 m² test area (7.35 m × 5.41 m). We considered 26 observation points and collected data for 180 s for each point (total 4680) with an average error of 0.2072 m for 23 points inside the test area. Finally, we demonstrated the use of ultra-wide band sensor technology for BM.