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Participants with a range of mental health issues were recruited to the study only if they were deemed to have the ability to understand and follow the survey instructions. The survey collected data on the effectiveness of outdoor programmes from participants through end-of-activity surveys and the Health Education Impact Questionnaire heiQ survey on health literacy Osborne et al , The heiQ is a user-friendly, relevant and psychometrically sound instrument.

It is designed to be applied across a broad range of chronic conditions to evaluate programme participation Osborne et al , Four specific subscales of the heiQ were used, measuring: positive and active engagement in life; self-monitoring and insight; constructive attitudes and approaches; and social integration and support. Data were analysed using the STATA data analysis and statistical software package and were either descriptive in nature means, standard deviations, frequencies or involved t -tests independent samples or paired to determine whether there were any statistically significant changes in the heiQ constructs over time.

One hundred and sixty-two participants were recruited. However, caution is required when interpreting the results as there were no statistically significant findings. In addition to surveying participants, a sub-sample of 17 older adults were recruited for a focus group, where the researchers further explored perceptions of the benefits of participating in outdoor programmes.

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The findings demonstrated that spending time outdoors resulted in a range of mental health benefits. For example, many participants mentioned experiencing relaxation, stress relief and rejuvenation as a result of attending outdoor programmes. Additionally, some participants mentioned how spending time in nature alleviated their symptoms of depression, as indicated by the following statements:.

This study was set in a hospital in an outer suburb of Melbourne. Seventy-two users of the hospital gardens were interviewed to record their experiences. The phenomenological study reflected the hermeneutic process of enquiry.

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The data collected were thematically coded and the findings were compared and contrasted to contextualise the evidence. A majority of the findings from the phenomenological study reflected global evidence outlining psychological, emotional, social and spiritual benefits from accessing hospital gardens. Findings indicated that the hospital gardens provided patients, staff and visitors with a range of mental health and well-being benefits.

The following statements highlight this theme:.

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I think everyone who comes here feels that partly through the garden, you know, partly through the opportunity that the people who live here have to work in the garden and the consideration that the garden can have therapeutically and emotionally on their sense of well-being. Anyone who comes into this environment feels that they are in a place of calm, peace, healing and relaxation, which is a contrast to how our modern society works, which is busy, crazy, fast and noisy. The findings of this study have important consequences for the evidence-based design of healthcare settings aimed at supporting and empowering users to maintain and enhance their health and well-being.


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Case study 1. Perceptions of contact with nature in relation to mental health

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