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Ever more research results demonstrate that human health and wellbeing are positively affected by stays in and/or exposure to natural areas, which leads, among other things, to a reduction in high stress levels. However, according to the studies, these natural areas must meet certain qualities. The qualities that are considered to be most health promoting are those that humans perceive in a positive way. Theories about how natural areas can reduce people’s stress levels and improve their coping skills have mainly focused on how certain natural areas that are perceived as safe reduce the activity of the hypothalamic-pituitary-adrenal axis and consequent reduction of cortisol levels. This article discusses studies containing descriptions of how participants in rehabilitation perceive and react to natural phenomena. The common core variable in the analyzed studies was the experience of calm and connection, and this experience was associated with a reduction in stress levels and with being able to develop health and coping skills. We suggest that this experience provides a possible role for the oxytocinergic system to act as a physiological mediator for the positive and health-promoting effects in humans caused by nature. The theory is mainly based on analogies framed by theories and data from the fields of environmental psychology, horticulture, landscape architecture, medicine, and neuroscience. Oxytocin promotes different kinds of social interaction and bonding and exerts stress-reducing and healing effects. We propose that oxytocin is released by certain natural phenomena experienced as positive to decrease the levels of fear and stress, increase levels of trust and wellbeing, and possibly develop attachment or bonding to nature. By these effects, oxytocin will induce health-promoting effects. In situations characterized by low levels of fear and stress in response to release of oxytocin, the capacity for “growth” or psychological development might also be promoted. Such an instorative effect of nature, i.e., the capacity of nature to promote reorientation and the creation of new coping strategies, might hence represent an additional aspect of the oxytocin-linked effect profile, triggered in connection with certain nature phenomena. We conclude by proposing that the stress-relieving, health-promoting, restorative, and instorative effects of nature may involve activation of the oxytocinergic system.
Patrik Grahn; Johan Ottosson; Kerstin Uvnäs-Moberg. The Oxytocinergic System as a Mediator of Anti-stress and Instorative Effects Induced by Nature: The Calm and Connection Theory. Frontiers in Psychology 2021, 12, 1 .
AMA StylePatrik Grahn, Johan Ottosson, Kerstin Uvnäs-Moberg. The Oxytocinergic System as a Mediator of Anti-stress and Instorative Effects Induced by Nature: The Calm and Connection Theory. Frontiers in Psychology. 2021; 12 ():1.
Chicago/Turabian StylePatrik Grahn; Johan Ottosson; Kerstin Uvnäs-Moberg. 2021. "The Oxytocinergic System as a Mediator of Anti-stress and Instorative Effects Induced by Nature: The Calm and Connection Theory." Frontiers in Psychology 12, no. : 1.
Natural environments have been shown to promote health, and are, therefore, important for achieving social sustainability in cities. As cities grow and become denser, it is important to develop knowledge about the characteristics of natural environments that work to promote health. Perceived Sensory Dimensions (PSDs) is a tool that defines eight different cultural ecosystem services. They correspond to different human needs (rest, exercise, socialising, pleasure, or security) resulting in rehabilitation and health and well-being promotion. An experiment was conducted to study the potential of PSDs to restore people who experienced stressful accidents. One hundred and fifty-seven participants were recruited and asked first to watch a film clip of serious accidents, then to look at the pictures, depicting one particular type of PSDs, while listening to its respective audio recording. Their stress levels were measured before exposure to the stressor (baseline), after exposure to the stressor (pre-test), and after exposure to a particular type of PSDs (post-test). The results show that all eight PSDs effectively provide mental recovery, but there are statistical differences in their potentials. As such, it is proposed that the combined potential of the PSDs is needed, and should be used to increase the capacity and supply of health-promoting urban green areas.
Sanaz Memari; Mahdieh Pazhouhanfar; Patrik Grahn. Perceived Sensory Dimensions of Green Areas: An Experimental Study on Stress Recovery. Sustainability 2021, 13, 5419 .
AMA StyleSanaz Memari, Mahdieh Pazhouhanfar, Patrik Grahn. Perceived Sensory Dimensions of Green Areas: An Experimental Study on Stress Recovery. Sustainability. 2021; 13 (10):5419.
Chicago/Turabian StyleSanaz Memari; Mahdieh Pazhouhanfar; Patrik Grahn. 2021. "Perceived Sensory Dimensions of Green Areas: An Experimental Study on Stress Recovery." Sustainability 13, no. 10: 5419.
Green spaces and infrastructures offer multiple ways to tackle challenges associated with increased urbanisation and densification. Greenspace aesthetics have long been pointed out as an important aspect to support human health and wellbeing. There is however a need for evidence-based approaches in order to aid practitioners, such as, e.g. landscape architects and urban planners/designers, to best meet people’s needs. Here we summarize a comprehensive study, conducted since the early 1980s, with the intention to identify the most important perceived qualities of urban green spaces. We compile evidence collected between 1984 and 2018 suggesting eight key qualities, or perceived sensory dimensions, as particularly important to support people’s needs. A summary interpretation of our collected evidence suggests that they can be related to each other in a model with four axes of opposing qualities, 1) a Natural – Cultural axis, 2) a Cohesive – Diverse axis, 3) a Sheltered – Open axis, and 4) a Serene – Social axis. Synergies and tensions between qualities are suggested based on their relations in the model, as well as some possible implications for greenspace planning and design. In general, simultaneous support for three closely related qualities is suggested as a simple heuristic for strong aesthetic function. We believe our model to account for equally important but complementary aesthetic needs that people seek support for in their close-by outdoor environment. As such, it could aid the inclusion of an evidence-based perspective on greenspace aesthetics in various design and planning practises, as well as in trans- and interdisciplinary research settings.
Jonathan Stoltz; Patrik Grahn. Perceived sensory dimensions: An evidence-based approach to greenspace aesthetics. Urban Forestry & Urban Greening 2021, 59, 126989 .
AMA StyleJonathan Stoltz, Patrik Grahn. Perceived sensory dimensions: An evidence-based approach to greenspace aesthetics. Urban Forestry & Urban Greening. 2021; 59 ():126989.
Chicago/Turabian StyleJonathan Stoltz; Patrik Grahn. 2021. "Perceived sensory dimensions: An evidence-based approach to greenspace aesthetics." Urban Forestry & Urban Greening 59, no. : 126989.
Do people classify nature in ways that can be described as archetypes? Could it be that these can be interpreted as health promotive? More and more researchers today suggest that archetypes can be used to analyze, describe, and develop green spaces. In parallel, an increasing number of research results since the 1980s have shown that human health and well-being are positively affected by stays in certain nature areas. The qualities in these nature areas which stand out to be most health-promoting are interpreted to be properties of nature that humans through evolution are prepared to perceive in a positive way. In this study, 547 respondents in southern Sweden answered a questionnaire on properties in natural areas. Through cluster analysis, these properties have been grouped into 10 types of nature and landscape. The 10 clusters are related to specific phenomena and places in Scandinavian nature, which could be described as archetypal. These natural phenomena and places are discussed, partly based on references to archaic Scandinavian mythology, Scandinavian lifestyle, and cultural canon, and partly on research on evolution, human preferences, and how nature can affect human health. We discuss how these nature archetypes evoke anxiety, fear, and distancing as well as calmness, tranquility, and connection. However, researchers have so far focused on how visits to natural environments have affected the sympathetic nervous system, and not realized the possibility of including the calm and connection system as well as the oxytocin in their explanatory models. In a follow-up article, we intend to develop a model for how the nature archetypes can interact with the calm and connection system.
Johan Ottosson; Patrik Grahn. Nature Archetypes – Concepts Related to Objects and Phenomena in Natural Environments. A Swedish Case. Frontiers in Psychology 2021, 11, 1 .
AMA StyleJohan Ottosson, Patrik Grahn. Nature Archetypes – Concepts Related to Objects and Phenomena in Natural Environments. A Swedish Case. Frontiers in Psychology. 2021; 11 ():1.
Chicago/Turabian StyleJohan Ottosson; Patrik Grahn. 2021. "Nature Archetypes – Concepts Related to Objects and Phenomena in Natural Environments. A Swedish Case." Frontiers in Psychology 11, no. : 1.
Many men have poor mental health and need help to recover. However, designing a rehabilitation intervention that appeals to men is challenging. This study protocol aims to describe the ‘Wildman Programme’, which will be a nature-based rehabilitation programme for men on long-term sick leave due to health problems such as stress, anxiety, depression, post-cancer and chronic cancer, chronic obstructive pulmonary disease (COPD), cardiovascular disease, or diabetes type II. The programme will be a nature-based rehabilitation initiative combining nature experiences, attention training, body awareness training, and supporting community spirit. The aim of the study will be to examine whether the ‘Wildman Programme’ can help to increase quality of life and reduce stress among men with health problems compared to treatment as usual. The study will be a matched control study where an intervention group (number of respondents, N = 52) participating in a 12-week nature-based intervention will be compared to a control group (N = 52) receiving treatment as usual. Outcomes are measured at baseline (T1), post-treatment (T2), and at follow up 6 months post-intervention (T3). The results of this study will be important to state whether the method in the ‘Wildman Programme’ can be implemented as a rehabilitation offer in the Danish Healthcare System to help men with different health problems.
Simon Høegmark; Tonny Elmose Andersen; Patrik Grahn; Kirsten Kaya Roessler. The Wildman Programme. A Nature-Based Rehabilitation Programme Enhancing Quality of Life for Men on Long-Term Sick Leave: Study Protocol for a Matched Controlled Study In Denmark. International Journal of Environmental Research and Public Health 2020, 17, 3368 .
AMA StyleSimon Høegmark, Tonny Elmose Andersen, Patrik Grahn, Kirsten Kaya Roessler. The Wildman Programme. A Nature-Based Rehabilitation Programme Enhancing Quality of Life for Men on Long-Term Sick Leave: Study Protocol for a Matched Controlled Study In Denmark. International Journal of Environmental Research and Public Health. 2020; 17 (10):3368.
Chicago/Turabian StyleSimon Høegmark; Tonny Elmose Andersen; Patrik Grahn; Kirsten Kaya Roessler. 2020. "The Wildman Programme. A Nature-Based Rehabilitation Programme Enhancing Quality of Life for Men on Long-Term Sick Leave: Study Protocol for a Matched Controlled Study In Denmark." International Journal of Environmental Research and Public Health 17, no. 10: 3368.
People with neurological disorders suffer from poor mobility, poor balance, fatigue, isolation and monotonous everyday activities. Studies show that equine-assisted interventions can improve their mobility and balance, but could these kinds of interventions also increase participants’ activity repertoire and self-assessed health, and reduce their fatigue? The study was conducted as a prospective, controlled study with three cohorts followed for one year: intervention group (n = 14), control group Passive (n = 29), and control group Active (n = 147). Participants in the study were affected by neurological disease or injury that limited their opportunities for an active everyday life. The intervention group lacked regular activities outside the home before the intervention, which consisted of riding once a week, led by a certified therapist. Control group Passive lacked regular activities outside the home, while control group Active had several activities outside the home per week. Primary outcome measures were activity repertoire measured with Occupational Value Assessment questionnaire. Secondary outcome measures were global self-assessed health measured with EuroQol-VAS and fatigue measured with Shirom-Melamed Burnout Questionnaire. The intervention group’s activity repertoire and self-assessed health increased significantly compared to both baseline and the control groups. Equine-assisted interventions could help to improve the perceived value of everyday occupations and quality of life, as well as break isolation and increase the activity repertoire of people with neurological disorders.
Anna María Pálsdóttir; Marie Gudmundsson; Patrik Grahn. Equine-Assisted Intervention to Improve Perceived Value of Everyday Occupations and Quality of Life in People with Lifelong Neurological Disorders: A Prospective Controlled Study. International Journal of Environmental Research and Public Health 2020, 17, 2431 .
AMA StyleAnna María Pálsdóttir, Marie Gudmundsson, Patrik Grahn. Equine-Assisted Intervention to Improve Perceived Value of Everyday Occupations and Quality of Life in People with Lifelong Neurological Disorders: A Prospective Controlled Study. International Journal of Environmental Research and Public Health. 2020; 17 (7):2431.
Chicago/Turabian StyleAnna María Pálsdóttir; Marie Gudmundsson; Patrik Grahn. 2020. "Equine-Assisted Intervention to Improve Perceived Value of Everyday Occupations and Quality of Life in People with Lifelong Neurological Disorders: A Prospective Controlled Study." International Journal of Environmental Research and Public Health 17, no. 7: 2431.
Nature-based interventions have been proposed to promote physical and mental health and give stress reduction. Little attention has been given to the potential of zoos for human health and wellbeing. A disadvantaged group in Sweden regarding access to nature are individuals with disabilities who consequently do not have the same access to these health benefits as other groups. To increase awareness and knowledge regarding spending time in nature and with animals, courses directed at caretakers for persons with disabilities and their users were held at Nordens Ark, a zoo in Sweden. To explore if the courses had led to increased nature activities, and if participating in the courses had affected caretakers’ and their users’ health and wellbeing, questionnaires and interviews for evaluating the courses were used. The results showed improved quality in nature visits because of course participation as well as positive effects for the wellbeing, sustainability for the caregivers and users in their working lives, and relationships were positively affected. The conclusion from this study is that nature and animal-based education should be more frequent to provide opportunities for a disadvantaged group to have the positive effects of nature of which most other groups have obvious access to.
Eva Sahlin; Björn Johansson; Per-Olof Karlsson; Jenny Loberg; Mats Niklasson; Patrik Grahn. Improved Wellbeing for Both Caretakers and Users from A Zoo-Related Nature Based Intervention—A Study at Nordens Ark Zoo, Sweden. International Journal of Environmental Research and Public Health 2019, 16, 4929 .
AMA StyleEva Sahlin, Björn Johansson, Per-Olof Karlsson, Jenny Loberg, Mats Niklasson, Patrik Grahn. Improved Wellbeing for Both Caretakers and Users from A Zoo-Related Nature Based Intervention—A Study at Nordens Ark Zoo, Sweden. International Journal of Environmental Research and Public Health. 2019; 16 (24):4929.
Chicago/Turabian StyleEva Sahlin; Björn Johansson; Per-Olof Karlsson; Jenny Loberg; Mats Niklasson; Patrik Grahn. 2019. "Improved Wellbeing for Both Caretakers and Users from A Zoo-Related Nature Based Intervention—A Study at Nordens Ark Zoo, Sweden." International Journal of Environmental Research and Public Health 16, no. 24: 4929.
Animals are increasingly included in treatment for children with autism, and research has shown positive effects, such as increased social initiatives, decreased typical autistic behaviors, and decreased stress. However, there are still knowledge gaps, for example, on underlying mechanisms and effects from longer treatment duration. The purpose of this study is to contribute to these gaps and ask questions about the ways in which animals and nature can improve conditions for psychological development through support from therapists. The method is based on grounded theory. Data comes from a treatment model (duration 1½ years, a total of nine children), from environmental psychology and developmental psychology, both typical and atypical as in autism. The results consist of three key categories; reduce stress and instill calm, arouse curiosity and interest, and attract attention spontaneously. These three key categories are related to an underlying core variable, vitality forms, which was described by Daniel Stern and, according to him, is important in forming overall experiences. The starting point is the brain’s way of encoding many internal and external events based on movement perception. Here it is argued that the vitality forms from nature and animals are particularly favorable for effecting development-promoting interactions with a therapist.
Kristina Byström; Patrik Grahn; Caroline Hägerhäll. Vitality from Experiences in Nature and Contact with Animals—A Way to Develop Joint Attention and Social Engagement in Children with Autism? International Journal of Environmental Research and Public Health 2019, 16, 4673 .
AMA StyleKristina Byström, Patrik Grahn, Caroline Hägerhäll. Vitality from Experiences in Nature and Contact with Animals—A Way to Develop Joint Attention and Social Engagement in Children with Autism? International Journal of Environmental Research and Public Health. 2019; 16 (23):4673.
Chicago/Turabian StyleKristina Byström; Patrik Grahn; Caroline Hägerhäll. 2019. "Vitality from Experiences in Nature and Contact with Animals—A Way to Develop Joint Attention and Social Engagement in Children with Autism?" International Journal of Environmental Research and Public Health 16, no. 23: 4673.
The global burden of depression and stress-related mental disorders is substantial, and constitutes a major need for effective rehabilitation. Can nature-based rehabilitation help people return to work? Objective: To study if the length of a nature-based rehabilitation program affects the outcome with regard to return to work one year after the onset of the program, in a group of patients with long-term reactions to severe stress and/or depression. Methods: A prospective, quasi-experimental study comparing results from 8-, 12-, and 24-week periods of rehabilitation. The rehabilitation of 106 participants was carried out by a multimodal rehabilitation team in a specially designed rehabilitation garden. Return to work data were collected before the intervention and one year after the start of rehabilitation. In addition, data were collected regarding self-assessed occupational competence, personal control, and sense of coherence. As many as 68% of the participants returned to work or participated in job training or work-oriented measures, full- or part-time, after one year. Participants with a longer period of rehabilitation reported better results on occupational competence, and were more likely to participate in paid work, full-time or part-time, one year after rehabilitation. Study outcomes indicate that a longer rehabilitation period in a rehabilitation garden increases the possibility of a return to paid work.
Patrik Grahn; Anna María Pálsdóttir; Johan Ottosson; Ingibjörg H. Jonsdottir. Longer Nature-Based Rehabilitation May Contribute to a Faster Return to Work in Patients with Reactions to Severe Stress and/or Depression. International Journal of Environmental Research and Public Health 2017, 14, 1310 .
AMA StylePatrik Grahn, Anna María Pálsdóttir, Johan Ottosson, Ingibjörg H. Jonsdottir. Longer Nature-Based Rehabilitation May Contribute to a Faster Return to Work in Patients with Reactions to Severe Stress and/or Depression. International Journal of Environmental Research and Public Health. 2017; 14 (11):1310.
Chicago/Turabian StylePatrik Grahn; Anna María Pálsdóttir; Johan Ottosson; Ingibjörg H. Jonsdottir. 2017. "Longer Nature-Based Rehabilitation May Contribute to a Faster Return to Work in Patients with Reactions to Severe Stress and/or Depression." International Journal of Environmental Research and Public Health 14, no. 11: 1310.
In this study, we assess how the Scania Green Score (SGS5), and the five distinct perceived neighbourhood green dimensions within this area-aggregated index (1km squares), is associated with self-reported physical activity and general health, and if perceived safety and social coherence has a moderating effect. Two independent surveys, both conducted in Scania, Sweden, was used for data on SGS5 and health outcomes (N=28 198 and N=23 693), respectively. SGS5 was more clearly associated with physical activity (OR 1.06; 95% CI 1.02-1.10) than with general health (OR 1.02; 95% CI 1.00-1.04). This association was moderated by safety (p for interaction <0.001); SGS5 was positively associated with physical activity only among individuals who perceived high safety in their neighbourhood (OR 1.07; 95% CI 1.02-1.11). No moderating effect was seen for social coherence. Among specific dimensions, cultural history was positively associated with both physical activity and general health. Our results suggest that perception of safety is a prerequisite for the positive effects of neighbourhood green qualities.
Hanna Weimann; Lars Rylander; Matilda Annerstedt Van Den Bosch; Maria Albin; Erik Skärbäck; Patrik Grahn; Jonas Björk. Perception of safety is a prerequisite for the association between neighbourhood green qualities and physical activity: Results from a cross-sectional study in Sweden. Health & Place 2017, 45, 124 -130.
AMA StyleHanna Weimann, Lars Rylander, Matilda Annerstedt Van Den Bosch, Maria Albin, Erik Skärbäck, Patrik Grahn, Jonas Björk. Perception of safety is a prerequisite for the association between neighbourhood green qualities and physical activity: Results from a cross-sectional study in Sweden. Health & Place. 2017; 45 ():124-130.
Chicago/Turabian StyleHanna Weimann; Lars Rylander; Matilda Annerstedt Van Den Bosch; Maria Albin; Erik Skärbäck; Patrik Grahn; Jonas Björk. 2017. "Perception of safety is a prerequisite for the association between neighbourhood green qualities and physical activity: Results from a cross-sectional study in Sweden." Health & Place 45, no. : 124-130.
Green spaces are recognized for improving mental health, but what particular kind of nature is required is yet not elucidated. This study explores the effect of specific types of recreational nature qualities on mental health. Longitudinal data (1999/2000 and 2005) from a public health survey was distributed to a stratified sample (n = 24,945) of a Swedish population. People from rural or suburban areas (n = 9230) who had moved between baseline and follow-up (n = 1419) were studied. Individual geographic residence codes were linked to five predefined nature qualities, classified in geographic information systems (GIS). Any change in the amount of or type of qualities within 300 m distance between baseline and follow-up was correlated to any change in mental health (as measured by the General Health Questionnaire) by logistic regression models. On average, the population had limited access to nature qualities both pre- and post-move. There was no significant correlation between change in the amount of qualities and change in mental health. However, the specific quality “serene” was a significant determinant with a significantly decreased risk for women of change to mental ill-health at follow-up. The objective definition of the potentially health-promoting quality may facilitate implication in landscape practice and healthy planning.
Matilda Annerstedt Van Den Bosch; Per-Olof Östergren; Patrik Grahn; Erik Skärbäck; Peter Währborg. Moving to Serene Nature May Prevent Poor Mental Health—Results from a Swedish Longitudinal Cohort Study. International Journal of Environmental Research and Public Health 2015, 12, 7974 -7989.
AMA StyleMatilda Annerstedt Van Den Bosch, Per-Olof Östergren, Patrik Grahn, Erik Skärbäck, Peter Währborg. Moving to Serene Nature May Prevent Poor Mental Health—Results from a Swedish Longitudinal Cohort Study. International Journal of Environmental Research and Public Health. 2015; 12 (7):7974-7989.
Chicago/Turabian StyleMatilda Annerstedt Van Den Bosch; Per-Olof Östergren; Patrik Grahn; Erik Skärbäck; Peter Währborg. 2015. "Moving to Serene Nature May Prevent Poor Mental Health—Results from a Swedish Longitudinal Cohort Study." International Journal of Environmental Research and Public Health 12, no. 7: 7974-7989.
Freezing of Gait (FOG) is a common condition in people with Parkinson’s disease (PD). FOG entails suddenly experiencing difficulties moving or feeling that one’s feet are as glued to the ground. It is triggered, e.g., when passing through doorways. Earlier studies suggest that being in natural environments affects FOG in a positive way. Five subjects were recruited to serve as five single subject cases. We used interviews, observations, questionnaires and collected gait pattern data with aid of an accelerometer. A special designed outdoor setting was used, where we investigated whether passing through hedge openings with or without built elements triggered FOG. We found that no one experienced a FOG reaction when they passed through hedge openings without built elements. However, FOG was triggered when a doorframe was inserted into a hedge opening, and/or when peripheral vision was blocked. We interpret the results such that the doorframe triggered a phobic reflex, causing a freezing reaction. Passing through hedge openings does not trigger FOG, which we interpret as a biophilic reaction. Our results, if repeated in future studies, may have significance to everyday lives of PD patients, who could get a simpler life by consciously prioritizing stays in natural surroundings.
Johan Ottosson; Lillian Lavesson; Stefan Pinzke; Patrik Grahn. The Significance of Experiences of Nature for People with Parkinson’s Disease, with Special Focus on Freezing of Gait—The Necessity for a Biophilic Environment. A Multi-Method Single Subject Study. International Journal of Environmental Research and Public Health 2015, 12, 7274 -7299.
AMA StyleJohan Ottosson, Lillian Lavesson, Stefan Pinzke, Patrik Grahn. The Significance of Experiences of Nature for People with Parkinson’s Disease, with Special Focus on Freezing of Gait—The Necessity for a Biophilic Environment. A Multi-Method Single Subject Study. International Journal of Environmental Research and Public Health. 2015; 12 (7):7274-7299.
Chicago/Turabian StyleJohan Ottosson; Lillian Lavesson; Stefan Pinzke; Patrik Grahn. 2015. "The Significance of Experiences of Nature for People with Parkinson’s Disease, with Special Focus on Freezing of Gait—The Necessity for a Biophilic Environment. A Multi-Method Single Subject Study." International Journal of Environmental Research and Public Health 12, no. 7: 7274-7299.
Note: In lieu of an abstract, this is an excerpt from the first page. The authors wish to make the following corrections to their paper published in the International Journal of Environmental Research and Public Health [1]:
Eva Sahlin; Jr. Gunnar Ahlborg; Artur Tenenbaum; Patrik Grahn. Correction: Sahlin, E., et al. Using Nature-Based Rehabilitation to Restart a Stalled Process of Rehabilitation in Individuals with Stress-Related Mental Illness. Int. J. Environ. Res. Public Health 2015, 12, 1928–1951. International Journal of Environmental Research and Public Health 2015, 12, 6946 -6947.
AMA StyleEva Sahlin, Jr. Gunnar Ahlborg, Artur Tenenbaum, Patrik Grahn. Correction: Sahlin, E., et al. Using Nature-Based Rehabilitation to Restart a Stalled Process of Rehabilitation in Individuals with Stress-Related Mental Illness. Int. J. Environ. Res. Public Health 2015, 12, 1928–1951. International Journal of Environmental Research and Public Health. 2015; 12 (6):6946-6947.
Chicago/Turabian StyleEva Sahlin; Jr. Gunnar Ahlborg; Artur Tenenbaum; Patrik Grahn. 2015. "Correction: Sahlin, E., et al. Using Nature-Based Rehabilitation to Restart a Stalled Process of Rehabilitation in Individuals with Stress-Related Mental Illness. Int. J. Environ. Res. Public Health 2015, 12, 1928–1951." International Journal of Environmental Research and Public Health 12, no. 6: 6946-6947.
Forests play an important role, contributing to human health and well-being as environments for recreation and rehabilitation. Stress has become a significant problem in modern societies, and the importance of forests as environments for stress relief has been recognized in recent years. To maintain and create forests for rehabilitation, consideration of their rehabilitation value needs to be incorporated into forest management planning and to do this, we need to define and quantify the characteristics of good rehabilitation forests. This study presents an approach for including rehabilitation value as an aspect of forest management planning. This approach is applied to three case study areas in northern, middle and southern Sweden to identify trade-offs between maintaining high wood production while creating forest areas suitable for rehabilitation from stress-related diseases. The results show that quite large areas of rehabilitation forest (10–15 % of total forest area) can be maintained at a relatively small loss in economic net present value (NPV) of wood production (ca 2 % of maximum NPV). When using the rehabilitation value indicator defined in this study, age and spatial variables (distance to roads and water) seem to be the most limiting factors.
Eva-Maria Nordström; Ann Dolling; Erik Skärbäck; Jonathan Stoltz; Patrik Grahn; Ylva Lundell. Forests for wood production and stress recovery: trade-offs in long-term forest management planning. European Journal of Forest Research 2015, 134, 755 -767.
AMA StyleEva-Maria Nordström, Ann Dolling, Erik Skärbäck, Jonathan Stoltz, Patrik Grahn, Ylva Lundell. Forests for wood production and stress recovery: trade-offs in long-term forest management planning. European Journal of Forest Research. 2015; 134 (5):755-767.
Chicago/Turabian StyleEva-Maria Nordström; Ann Dolling; Erik Skärbäck; Jonathan Stoltz; Patrik Grahn; Ylva Lundell. 2015. "Forests for wood production and stress recovery: trade-offs in long-term forest management planning." European Journal of Forest Research 134, no. 5: 755-767.
Green neighbourhood environments have been associated with physical and psychological wellbeing in adults. Access to greenness is potentially more important in vulnerable subgroups. In this study based on longitudinal survey data from southern Sweden the cohort was divided into prognostic groups for good self-reported general (n=8891) and mental (n=9444) health. We used independent survey data to assess perceived neighbourhood greenness in 1km(2) areas, and estimated effects of changing exposure longitudinally stratified by prognostic group. The overall effect on health was small and statistically uncertain (for general health OR 1.04, 95% CI 0.98-1.10, for mental health OR 1.07, 95% CI 1.00-1.14). A more beneficial effect of increased greenness was indicated among subjects with lowest prognostic of good general health (OR 1.24, 95% CI 1.01-1.52). The study provided only weak evidence for beneficial effects of increased neighbourhood greenness triggered by changing residence. It seems that altered life circumstances, e.g. changed civil or socioeconomic status that often trigger a decision to move, are also the key determinants of the health consequences of changing residence.
Hanna Weimann; Lars Rylander; Maria Albin; Erik Skärbäck; Patrik Grahn; Per-Olof Östergren; Jonas Björk. Effects of changing exposure to neighbourhood greenness on general and mental health: A longitudinal study. Health & Place 2015, 33, 48 -56.
AMA StyleHanna Weimann, Lars Rylander, Maria Albin, Erik Skärbäck, Patrik Grahn, Per-Olof Östergren, Jonas Björk. Effects of changing exposure to neighbourhood greenness on general and mental health: A longitudinal study. Health & Place. 2015; 33 ():48-56.
Chicago/Turabian StyleHanna Weimann; Lars Rylander; Maria Albin; Erik Skärbäck; Patrik Grahn; Per-Olof Östergren; Jonas Björk. 2015. "Effects of changing exposure to neighbourhood greenness on general and mental health: A longitudinal study." Health & Place 33, no. : 48-56.
After a period of decrease, sick leave in Sweden due to psychiatric diagnoses is on the increase. The lack of established rehabilitation programmes for patients with stress-related mental disorders (SRMD) has opened up for the use of garden/nature in a multimodal rehabilitation context (Nature-Based Rehabilitation, NBR). Region Västra Götaland (VGR) started an NBR to offer additional rehabilitation for its employees on long-term sick leave due to SRMD, where initial care had not been sufficient. The aim was to explore whether the mental health and well-being of NBR participants had improved at the end of the NBR and at three follow-ups, and to explore the development of sick leave and health care utilization according to the NBR model (n = 57) and an occupational health service (OHS) model (n = 45). Self-assessment instruments for measuring burnout, depression, anxiety and wellbeing, and data from regional and national registers were used. Results showed decreased scores on burnout, depression and anxiety, and increased well-being scores and significantly reduced health care utilization in the NBR group. A large movement from ordinary sickness benefit to rehabilitation benefit was observed, which was not observed in the OHS group. The two groups were in different rehabilitation phases, which limited comparisons. The results point to beneficial effects of using NBR for this patient group and for enhancing a stalled rehabilitation process.
Eva Sahlin; Jr. Gunnar Ahlborg; Artur Tenenbaum; Patrik Grahn. Using Nature-Based Rehabilitation to Restart a Stalled Process of Rehabilitation in Individuals with Stress-Related Mental Illness. International Journal of Environmental Research and Public Health 2015, 12, 1928 -1951.
AMA StyleEva Sahlin, Jr. Gunnar Ahlborg, Artur Tenenbaum, Patrik Grahn. Using Nature-Based Rehabilitation to Restart a Stalled Process of Rehabilitation in Individuals with Stress-Related Mental Illness. International Journal of Environmental Research and Public Health. 2015; 12 (2):1928-1951.
Chicago/Turabian StyleEva Sahlin; Jr. Gunnar Ahlborg; Artur Tenenbaum; Patrik Grahn. 2015. "Using Nature-Based Rehabilitation to Restart a Stalled Process of Rehabilitation in Individuals with Stress-Related Mental Illness." International Journal of Environmental Research and Public Health 12, no. 2: 1928-1951.
Eva Sahlin; Agneta Lindegård; Emina Hadzibajramovic; Patrik Grahn; Josefa Vega Matuszczyk; Gunnar Ahlborg. The Influence of the Environment on Directed Attention, Blood Pressure and Heart Rate—An Experimental Study Using a Relaxation Intervention. Landscape Research 2014, 41, 7 -25.
AMA StyleEva Sahlin, Agneta Lindegård, Emina Hadzibajramovic, Patrik Grahn, Josefa Vega Matuszczyk, Gunnar Ahlborg. The Influence of the Environment on Directed Attention, Blood Pressure and Heart Rate—An Experimental Study Using a Relaxation Intervention. Landscape Research. 2014; 41 (1):7-25.
Chicago/Turabian StyleEva Sahlin; Agneta Lindegård; Emina Hadzibajramovic; Patrik Grahn; Josefa Vega Matuszczyk; Gunnar Ahlborg. 2014. "The Influence of the Environment on Directed Attention, Blood Pressure and Heart Rate—An Experimental Study Using a Relaxation Intervention." Landscape Research 41, no. 1: 7-25.
This paper presents findings from real life situations, a longitudinal single case study on the role of natural environments in nature-based rehabilitation (NBR) for individuals with stress-related mental disorders, at the Alnarp Rehabilitation Garden in Sweden. A sample of 43 former clients voluntarily participated in semi-structured interview, and the data were analyzed according to interpretative phenomenological analysis (IPA). Three main superordinate themes were identified as the three phases of NBR—Prelude, Recuperating and Empowerment—explaining and illuminating the role of the natural environments in each phase. An explanatory model of NBR in this context is presented including the three phases of NBR, IRP supportive occupations and a pyramid of supporting environments. A new component of supportive environments was identified and herby named, Social quietness, an important component facilitating personal and intimate engagement with the natural environments.
Anna María Pálsdóttir; Dennis Persson; Birgitta Persson; Patrik Grahn. The Journey of Recovery and Empowerment Embraced by Nature — Clients’ Perspectives on Nature-Based Rehabilitation in Relation to the Role of the Natural Environment. International Journal of Environmental Research and Public Health 2014, 11, 7094 -7115.
AMA StyleAnna María Pálsdóttir, Dennis Persson, Birgitta Persson, Patrik Grahn. The Journey of Recovery and Empowerment Embraced by Nature — Clients’ Perspectives on Nature-Based Rehabilitation in Relation to the Role of the Natural Environment. International Journal of Environmental Research and Public Health. 2014; 11 (7):7094-7115.
Chicago/Turabian StyleAnna María Pálsdóttir; Dennis Persson; Birgitta Persson; Patrik Grahn. 2014. "The Journey of Recovery and Empowerment Embraced by Nature — Clients’ Perspectives on Nature-Based Rehabilitation in Relation to the Role of the Natural Environment." International Journal of Environmental Research and Public Health 11, no. 7: 7094-7115.
Sick leave due to stress-related disorders is increasing in Sweden after a period of decrease. To avoid that individuals living under heavy stress develop more severe stress-related disorders, different stress management interventions are offered. Self-assessed health, burnout-scores and well-being are commonly used as outcome measures. Few studies have used sick-leave to compare effects of stress interventions. A new approach is to use nature and garden in a multimodal stress management context. This study aimed to explore effects on burnout, work ability, stress-related health symptoms, and sick leave for 33 women participating in a 12-weeks nature based stress management course and to investigate how the nature/garden activities were experienced. A mixed method approach was used. Measures were taken at course start and three follow-ups. Results showed decreased burnout-scores and long-term sick leaves, and increased work ability; furthermore less stress-related symptoms were reported. Tools and strategies to better handle stress were achieved and were widely at use at all follow-ups. The garden and nature content played an important role for stress relief and for tools and strategies to develop. The results from this study points to beneficial effects of using garden activities and natural environments in a stress management intervention.
Eva Sahlin; Jr. Gunnar Ahlborg; Josefa Vega Matuszczyk; Patrik Grahn. Nature-Based Stress Management Course for Individuals at Risk of Adverse Health Effects from Work-Related Stress—Effects on Stress Related Symptoms, Workability and Sick Leave. International Journal of Environmental Research and Public Health 2014, 11, 6586 -6611.
AMA StyleEva Sahlin, Jr. Gunnar Ahlborg, Josefa Vega Matuszczyk, Patrik Grahn. Nature-Based Stress Management Course for Individuals at Risk of Adverse Health Effects from Work-Related Stress—Effects on Stress Related Symptoms, Workability and Sick Leave. International Journal of Environmental Research and Public Health. 2014; 11 (6):6586-6611.
Chicago/Turabian StyleEva Sahlin; Jr. Gunnar Ahlborg; Josefa Vega Matuszczyk; Patrik Grahn. 2014. "Nature-Based Stress Management Course for Individuals at Risk of Adverse Health Effects from Work-Related Stress—Effects on Stress Related Symptoms, Workability and Sick Leave." International Journal of Environmental Research and Public Health 11, no. 6: 6586-6611.
Translating policies about sustainable development as a social process and sustainability outcomes into the real world of social–ecological systems involves several challenges. Hence, research policies advocate improved innovative problem-solving capacity. One approach is transdisciplinary research that integrates research disciplines, as well as researchers and practitioners. Drawing upon 14 experiences of problem-solving, we used group modeling to map perceived barriers and bridges for researchers’ and practitioners’ joint knowledge production and learning towards transdisciplinary research. The analysis indicated that the transdisciplinary research process is influenced by (1) the amount of traditional disciplinary formal and informal control, (2) adaptation of project applications to fill the transdisciplinary research agenda, (3) stakeholder participation, and (4) functional team building/development based on self-reflection and experienced leadership. Focusing on implementation of green infrastructure policy as a common denominator for the delivery of ecosystem services and human well-being, we discuss how to diagnose social–ecological systems, and use knowledge production and collaborative learning as treatments.
Per Angelstam; Kjell Andersson; Matilda Annerstedt; Robert Axelsson; Marine Elbakidze; Pablo Garrido; Patrik Grahn; K. Ingemar Jönsson; Simen Pedersen; Peter Schlyter; Erik Skärbäck; Mike Smith; Ingrid Stjernquist. Solving Problems in Social–Ecological Systems: Definition, Practice and Barriers of Transdisciplinary Research. Ambio 2013, 42, 254 -265.
AMA StylePer Angelstam, Kjell Andersson, Matilda Annerstedt, Robert Axelsson, Marine Elbakidze, Pablo Garrido, Patrik Grahn, K. Ingemar Jönsson, Simen Pedersen, Peter Schlyter, Erik Skärbäck, Mike Smith, Ingrid Stjernquist. Solving Problems in Social–Ecological Systems: Definition, Practice and Barriers of Transdisciplinary Research. Ambio. 2013; 42 (2):254-265.
Chicago/Turabian StylePer Angelstam; Kjell Andersson; Matilda Annerstedt; Robert Axelsson; Marine Elbakidze; Pablo Garrido; Patrik Grahn; K. Ingemar Jönsson; Simen Pedersen; Peter Schlyter; Erik Skärbäck; Mike Smith; Ingrid Stjernquist. 2013. "Solving Problems in Social–Ecological Systems: Definition, Practice and Barriers of Transdisciplinary Research." Ambio 42, no. 2: 254-265.