Evidence

Despite the wealth of scientific research on the health-promoting values of nature in space, incorporating indoor plants in the design of healthcare facilities has significant challenges. Given the dispersion of studies spanning several disciplines and lack of evidence, healthcare building designers often ignore beneficial impacts in favour of preventing nosocomial infections, resulting in indoor plants being used conservatively or substituted for artificial ones. Via a cross-disciplinary approach, this scoping review aimed to provide an overview of scholarly works that have examined the risks and benefits of integrating natural indoor plants in the design of healthcare facilities as one of the prime biophilic design elements commonly used for creating restorative environments. Twenty-eight peer-reviewed articles were selected through a systematic process in accordance with the eligibility criteria (studies examining the impacts of indoor plants on health risks and benefits for healthcare users) for final analysis. Health risks of the presence of natural indoor plants were explored concerning poor indoor air quality caused by pathogenic fungal/bacterial components released from potting soils. Benefits of physical and/or visual access to indoor plants were discussed in relation to improved non-light visual comfort and air quality, resulting in reduced emotional stress/anxiety, as well as enhanced general health, subjective wellbeing, and cognitive performance. This paper argues that multidisciplinary research is warranted on the application of biophilic design principles, particularly the use of natural elements, in the design of healthcare facilities. The finding of this research provides significant evidence that the use of natural indoor plants in the biophilic design of healthcare facilities is an efficient, low-cost, highly effective, and sustainable strategy for creating healing and therapeutic environments.

The soils of five potted plants cultivated within a hospital were investigated for the presence of fungal opportunistic pathogens of humans. A total of 16 potentially pathogenic species were isolated, including Aspergillus fumigatus at up to 53.5 colony-forming units (CFU) per gram dry soil and Scedosporium apiospermum (Pseudallescheria boydii) at up to 97.0 CFU/g. Other common species included Phialophora verrucosa and Fusarium solani. Scedosporium inflatum, a recently described emerging pathogen, is reported for the first time from an environmental source. The results of this study, in combination with previous case reports linking mycoses to potted plants and available information on the establishment and dispersal of fungal opportunistic pathogens in indoor habitats, indicate that indoor plant soils constitute a serious mycotic hazard to the immunosuppressed patient.

The ‘Garden for the Future’ project aimed to redesign an outdated, inaccessible and underused outdoor play area at the Great North Children’s Hospital in Newcastle. The project was sparked by a young patient who wrote a letter to the directorate asking for ‘a garden area where staff and patients can play and grow vegetables’. Green spaces contribute to physical and mental health, as well as helping to cool urban environments and reduce the health impacts of air pollution. They are also important spaces for children’s play, learning and development.

Urban green spaces play a vital role in mitigating heat-related health risks, offering a potential strategy for urban planning to address climate change and enhance public health. Additional research is required to thoroughly comprehend the magnitude of urban greenery’s impact on heat-related morbidity and mortality, as well as its interplay with other variables, including air pollution, socioeconomic status, among others.

Urban tree canopy is associated with lower dementia risk, but no mediation analysis has been attempted to reveal potential mechanisms. We examined 3,639 dementia diagnoses in 109,688 participants of the Sax Institute’s 45 and Up Study. Adjusted models indicated ≥20% tree canopy lowered the odds of developing dementia by 14% over 11 years (Odds Ratio = 0.86, 95%CI = 0.79-0.93). Association between tree canopy and dementia was partially mediated by physical activity (4.5%) and absences of psychological distress (5.7%), social support (2.9%), sleep duration (2.3%) and diabetes (1.8%). Social loneliness and absence of heart disease or hypertension did not mediate the tree canopy-dementia association.

Amid the COVID-19 pandemic, many therapists and their clients found it uncomfortable being indoors with others for extended periods. As a result, some mental health counselors pivoted to having their sessions outdoors, referred to as “Walk and talk therapy”. This qualitative phenomenological study aimed to understand adult clients’ (n = 7) lived experiences of walk and talk therapy.

There is a lack of systematic research on the effectiveness of outdoor arts therapies. This article presents a systematic, qualitative evaluation of an outdoors arts therapies intervention for adults with mental health problems in the United Kingdom.

This paper aims to provide an overview of the lived experience of a group of individuals who participated in an adventure therapy project, as an adjunct to their routine clinical care with an Early Intervention Service (EIS) for psychosis.

Nature-based solutions (NbS), including green social prescribing (GSP), are sustainable ways to address health and wellbeing, especially since the COVID-19 pandemic exacerbated the strain on healthcare. NbS require national and local cross-sector coordination across complex, interrelated systems, but little is known about the specific challenges this poses for community-led NbS.