The forest as a classroom: preparing for mental health practice

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Abstract

Background

Positive effects of physical activity, health promotion and disease prevention, in treatment of mental illnesses are well documented. Mental health practice for nursing students highlights the important connection between physical activities and mental health. This study aims to examine the outcome from nursing students’ participation using The forest as a classroom. Students’ collaboration by problem solving, theoretical discussions and performance of activities in the forest serves as a repertoire of non-medical treatment strategies in mental health.

Methods

The forest as a classroom was evaluated by means of an ad-hoc questionnaire including both standardized and open-ended questions. Data was analyzed by means of descriptive statistics and content analysis.

Results

The results indicated enhanced knowledge about physical activity and its impact on mental health. However, the nursing students’ experience challenge preserving theoretical exercises outdoor because sensory stimulation took attention away from learning.

Conclusions

For nursing students it is essential to build a repertoire of treatment activities to care for patients having mental health problems. This kind of approach is supported by the students’ learning in the forest. The pilot study highlights the importance of multiple methods of learning in nursing education.

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Most cited references 17

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A systematic review of evidence for the added benefits to health of exposure to natural environments

Diana E Bowler, Lisette Buyung-Ali, Teri M Knight … (2010)

Background There is increasing interest in the potential role of the natural environment in human health and well-being. However, the evidence-base for specific and direct health or well-being benefits of activity within natural compared to more synthetic environments has not been systematically assessed. Methods We conducted a systematic review to collate and synthesise the findings of studies that compare measurements of health or well-being in natural and synthetic environments. Effect sizes of the differences between environments were calculated and meta-analysis used to synthesise data from studies measuring similar outcomes. Results Twenty-five studies met the review inclusion criteria. Most of these studies were crossover or controlled trials that investigated the effects of short-term exposure to each environment during a walk or run. This included 'natural' environments, such as public parks and green university campuses, and synthetic environments, such as indoor and outdoor built environments. The most common outcome measures were scores of different self-reported emotions. Based on these data, a meta-analysis provided some evidence of a positive benefit of a walk or run in a natural environment in comparison to a synthetic environment. There was also some support for greater attention after exposure to a natural environment but not after adjusting effect sizes for pretest differences. Meta-analysis of data on blood pressure and cortisol concentrations found less evidence of a consistent difference between environments across studies. Conclusions Overall, the studies are suggestive that natural environments may have direct and positive impacts on well-being, but support the need for investment in further research on this question to understand the general significance for public health.

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What are the Benefits of Interacting with Nature?

Lucy Keniger, Kevin Gaston, Katherine Irvine … (2013)

There is mounting empirical evidence that interacting with nature delivers measurable benefits to people. Reviews of this topic have generally focused on a specific type of benefit, been limited to a single discipline, or covered the benefits delivered from a particular type of interaction. Here we construct novel typologies of the settings, interactions and potential benefits of people-nature experiences, and use these to organise an assessment of the benefits of interacting with nature. We discover that evidence for the benefits of interacting with nature is geographically biased towards high latitudes and Western societies, potentially contributing to a focus on certain types of settings and benefits. Social scientists have been the most active researchers in this field. Contributions from ecologists are few in number, perhaps hindering the identification of key ecological features of the natural environment that deliver human benefits. Although many types of benefits have been studied, benefits to physical health, cognitive performance and psychological well-being have received much more attention than the social or spiritual benefits of interacting with nature, despite the potential for important consequences arising from the latter. The evidence for most benefits is correlational, and although there are several experimental studies, little as yet is known about the mechanisms that are important for delivering these benefits. For example, we do not know which characteristics of natural settings (e.g., biodiversity, level of disturbance, proximity, accessibility) are most important for triggering a beneficial interaction, and how these characteristics vary in importance among cultures, geographic regions and socio-economic groups. These are key directions for future research if we are to design landscapes that promote high quality interactions between people and nature in a rapidly urbanising world.

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Is there evidence that walking groups have health benefits? A systematic review and meta-analysis

Sarah Hanson, Andy Jones (2015)

Objective To assess the health benefits of outdoor walking groups. Design Systematic review and meta-analysis of walking group interventions examining differences in commonly used physiological, psychological and well-being outcomes between baseline and intervention end. Data sources Seven electronic databases, clinical trial registers, grey literature and reference lists in English language up to November 2013. Eligibility criteria Adults, group walking outdoors with outcomes directly attributable to the walking intervention. Results Forty-two studies were identified involving 1843 participants. There is evidence that walking groups have wide-ranging health benefits. Meta-analysis showed statistically significant reductions in mean difference for systolic blood pressure −3.72 mm Hg (−5.28 to −2.17) and diastolic blood pressure −3.14 mm Hg (−4.15 to −2.13); resting heart rate −2.88 bpm (−4.13 to −1.64); body fat −1.31% (−2.10 to −0.52), body mass index −0.71 kg/m2 (−1.19 to −0.23), total cholesterol −0.11 mmol/L (−0.22 to −0.01) and statistically significant mean increases in VO2 max of 2.66 mL/kg/min (1.67–3.65), the SF-36 (physical functioning) score 6.02 (0.51 to 11.53) and a 6 min walk time of 79.6 m (53.37–105.84). A standardised mean difference showed a reduction in depression scores with an effect size of −0.67 (−0.97 to −0.38). The evidence was less clear for other outcomes such as waist circumference fasting glucose, SF-36 (mental health) and serum lipids such as high-density lipids. There were no notable adverse side effects reported in any of the studies. Conclusions Walking groups are effective and safe with good adherence and wide-ranging health benefits. They could be a promising intervention as an adjunct to other healthcare or as a proactive health-promoting activity.

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Author and article information

Contributors

Marthe Lyngås Eklund: +47 92293389 , marthe.eklund@hbv.no

Ireen Ruud: +47 92664122 , ireen.ruud@hbv.no

Ellen Karine Grov: +47 98845950 , ellen-karine.grov@hioa.no

Journal

Journal ID (nlm-ta): BMC Nurs

Journal ID (iso-abbrev): BMC Nurs

Title: BMC Nursing

Publisher: BioMed Central (London )

ISSN (Electronic): 1472-6955

Publication date (Electronic): 1 February 2016

Publication date PMC-release: 1 February 2016

Publication date Collection: 2016

Volume: 15

Electronic Location Identifier: 6

Affiliations

[ ]Institute of Nursing Science, University College of Southeast Norway, PB 7035, 3045 Drammen, Norway

[ ]Department of Nursing and Health Promotion, Oslo and Akershus University of Applied Sciences, PB 4 St. Olavs plass, 0130 Oslo, Norway

Article

Publisher ID: 128

DOI: 10.1186/s12912-016-0128-8

PMC ID: 4736658

PubMed ID: 26839512

SO-VID: 4d188766-0162-4148-a10b-1599e7ba7fc8

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 4 August 2015

Date accepted : 26 January 2016

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ScienceOpen disciplines: Nursing

Keywords: physical activities,outdoor education,mental health,nursing students

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ScienceOpen disciplines: Nursing

Keywords: physical activities, outdoor education, mental health, nursing students

The forest as a classroom: preparing for mental health practice

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Stigmatisation of mental illnesses

Most cited references 17

A systematic review of evidence for the added benefits to health of exposure to natural environments

What are the Benefits of Interacting with Nature?

Is there evidence that walking groups have health benefits? A systematic review and meta-analysis

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