RESEARCH
The Effects of Horticultural Therapy on Sense of Coherence among Residents of Long-Term Care Facilities: A Quasi Experimental Design
Summary
This study used a quasi-experimental design to investigate the effectiveness of horticultural therapy on the Sense of Coherence (SOC) among older residents living in long-term care facilities (LTCFs) in northeastern Taiwan. Recognizing the importance of promoting positive mental health in this population, particularly those without significant dementia who may still face loneliness and monotonous environments, the researchers implemented a 12-week horticultural intervention. A total of 86 participants were recruited using convenient sampling from 12 LTCFs, which were randomly assigned to either an experimental group (n=49) receiving the therapy or a control group (n=37) continuing with usual activities. The intervention involved weekly 40-minute sessions of indoor desktop gardening activities, designed based on the residents’ characteristics and aiming to stimulate senses, encourage interaction, and foster feelings of empowerment and reflection. SOC, a subjective perception of mental health involving comprehensibility, manageability, and meaningfulness, was measured using a validated 13-item scale at baseline and at 4, 8, and 12 weeks.
The results demonstrated a significant positive effect of the horticultural therapy on the participants’ Sense of Coherence. While there was no significant difference in SOC scores between the groups at baseline or at the 4-week mark, the experimental group showed a statistically significant increase in their mean SOC score over time. By the 8th week and maintained through the 12th week, the experimental group had significantly higher SOC scores compared to the control group. The authors attributed this improvement to the program’s ability to provide opportunities for empowerment through learning plant care skills and reflection through observing plant growth, aligning with salutogenic theory. Although the study did not find significant changes in MMSE or GDS scores in the experimental group, suggesting potential ceiling effects for those already without significant cognitive/depressive symptoms, the findings support horticultural therapy as a potential health promotion strategy to strengthen positive mental health indicators like SOC in older LTCF residents. Limitations included the quasi-experimental design, limited follow-up, and focus solely on indoor activities.
