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Nature-Based Rehabilitation for Patients with Long-Standing Stress-Related Mental Disorders: A Qualitative Evidence Synthesis of Patients’ Experiences

Author

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  • Anna Bergenheim

    (Region Västra Götaland, Research, Education, Development & Innovation, Primary Health Care, Sweden
    Department of Health and Rehabilitation, Sahlgrenska Academy, Institute of Neuroscience and Physiology, University of Gothenburg, 413 46 Gothenburg, Sweden)

  • Gunnar Ahlborg

    (Region Västra Götaland, Institute of Stress Medicine, 413 19 Gothenburg, Sweden)

  • Susanne Bernhardsson

    (Region Västra Götaland, Research, Education, Development & Innovation, Primary Health Care, Sweden
    Department of Health and Rehabilitation, Sahlgrenska Academy, Institute of Neuroscience and Physiology, University of Gothenburg, 413 46 Gothenburg, Sweden
    Region Västra Götaland, HTA-Centrum, Sahlgrenska University Hospital, 413 46 Gothenburg, Sweden)

Abstract

Stress-related mental disorders contribute to work disabilities globally and are a common cause for sick leave. Nature-based rehabilitation (NBR) is a multi-disciplinary approach offered to this patient group on a limited scale. Qualitative studies provide insight into patients’ experiences of NBR, and there is a need to synthesize and assess the certainty of evidence for patient-experienced benefits. The aim was to identify, appraise, and synthesize studies reporting experiences and perceived benefits of participation in multidisciplinary, group-based NBR of adult patients with long-standing stress-related mental disorders. PubMed, Embase, CINAHL, AMED, APA PsycInfo, and the Cochrane Library were searched from inception to December 2020. Reference lists of relevant publications were searched. After title and abstract screening, full-text articles were retrieved and assessed for inclusion. The methodological quality of the included studies was assessed, and certainty of evidence was appraised according to CERQual. The search yielded 362 unique records; 19 full-text publications were assessed for eligibility, and 5 studies were included in the synthesis. The studies were considered relevant regarding context, population, and intervention, and quality was generally assessed as moderate to high. Extracted texts were inductively coded and organized into 16 descriptive themes and 4 broad, analytical themes: Instilling calm and joy; Needs being met; Gaining new insights; and Personal growth. Experiences and perceived benefits of participating in NBR and spending time in a nature environment were described as positive for recovery. Nine of the descriptive themes were based on explicit results from at least four of the five studies. Confidence in the evidence of the qualitative findings ranged from moderate to low. Moderate-to-low certainty evidence from the included studies suggests that patients with long-standing stress-related mental disorders experience positive health effects from participating in NBR.

Suggested Citation

  • Anna Bergenheim & Gunnar Ahlborg & Susanne Bernhardsson, 2021. "Nature-Based Rehabilitation for Patients with Long-Standing Stress-Related Mental Disorders: A Qualitative Evidence Synthesis of Patients’ Experiences," IJERPH, MDPI, vol. 18(13), pages 1-14, June.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:13:p:6897-:d:583316
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    References listed on IDEAS

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    1. Eva Sahlin & 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," IJERPH, MDPI, vol. 12(2), pages 1-24, February.
    2. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
    3. Sus Sola Corazon & Ulrik Sidenius & Dorthe Varning Poulsen & Marie Christoffersen Gramkow & Ulrika Karlsson Stigsdotter, 2019. "Psycho-Physiological Stress Recovery in Outdoor Nature-Based Interventions: A Systematic Review of the Past Eight Years of Research," IJERPH, MDPI, vol. 16(10), pages 1-21, May.
    4. Simon Lewin & Claire Glenton & Heather Munthe-Kaas & Benedicte Carlsen & Christopher J Colvin & Metin Gülmezoglu & Jane Noyes & Andrew Booth & Ruth Garside & Arash Rashidian, 2015. "Using Qualitative Evidence in Decision Making for Health and Social Interventions: An Approach to Assess Confidence in Findings from Qualitative Evidence Syntheses (GRADE-CERQual)," PLOS Medicine, Public Library of Science, vol. 12(10), pages 1-18, October.
    5. Anna 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," IJERPH, MDPI, vol. 11(7), pages 1-22, July.
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    2. Eleanor Petitt & Bo Rolander & Per Johnsson, 2023. "Medical Nature-Based Rehabilitation Program for Individuals with Exhaustion Syndrome: Changes in Quality of Life, Exhaustion Symptoms and Overall Health," IJERPH, MDPI, vol. 20(17), pages 1-17, August.

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