Therapeutic Nature Activities: A Step Toward the Labor Market for Traumatized Refugees.

BACKGROUND: Globally, the number of refugees is growing. For many refugees, entering the labor market in their new country of residence is challenging. Some remain forever dependent on welfare services, and this not only weakens their chances of integration, but also harms their health and well-being. METHODS: This qualitative single case study focused on a group of war-stricken refugees in Denmark. The study investigated the impact of an eight-month horticultural vocational program aimed at improving their ability to complete an education program or to work. A total of 29 interviews were conducted and analyzed using the interpretative phenomenological analysis (IPA) method. RESULTS: The natural environment in the eco-village evoked a feeling of safety as well as positive memories in the participants, in contrast to the traumatic memories they had of their flight. Horticultural activities and the positive and respectful attitude from staff initiated a recovery process. New skills were achieved at an individual pace, and feelings of isolation decreased. These findings can be implicated in future interventions.

Equine-Assisted Intervention to Improve Perceived Value of Everyday Occupations and Quality of Life in People with Lifelong Neurological Disorders: A Prospective Controlled Study.

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.

Changes in experienced value of everyday occupations after nature-based vocational rehabilitation.

OBJECTIVE: The aim of this study was to describe and assess changes in participants' experiences of everyday occupations after nature-based vocational rehabilitation (NBVR), to assess changes regarding symptoms of severe stress and the rate of return to work and possible association with experiencing the occupational value of everyday occupations. METHODS: The NBVR was carried out by a transdisciplinary rehabilitation team and took place in a specially designed rehabilitation garden. The study had a longitudinal and mixed-method approach. Data concerning experiences of everyday occupations (Oval-pd), self-assessed occupational competence (OSA-F), health status (EQ-VAS, SCI-93), and sense of coherence (SOC-13) were collected before and after the intervention, and a one-year follow-up was carried out regarding returning to work. Semi-structured interviews were performed 12 weeks after the intervention. RESULTS: Significant changes were measured regarding perceived occupational values in daily life, symptoms of severe stress, and returning to work. Both the return to work rate and symptoms of severe stress were significantly associated with changed experience of everyday occupation. CONCLUSIONS: In the interviews, participants explained that they now had a slower pace of everyday life and that everyday occupations were more often related to nature and creativity. This could be interpreted as nature-based rehabilitation inducing changes through meaningful occupations in restorative environments, leading to a positive change in perceived values of everyday occupations.