题名

森林療育對復健期燒傷者生心理影響與作用機制探討

并列篇名

Physical and Psychological Effects of Forest Therapy and Related Working Mechanisms on Burn Survivors During their Rehabilitation Phases

DOI

10.6130/JORS.202006_33(2).0004

作者

洪詩媛(Shih-Yuan Hung);湯幸芬(Hsing-Fen Tang);曠裕蓁(Yuh-Jen Kuang)

关键词

自然療法 ; 遊憩治療 ; 體適能 ; 創傷後恢復 ; Nature therapy ; Recreational therapy ; Fitness ; Posttraumatic recovery

期刊名称

戶外遊憩研究

卷期/出版年月

33卷2期(2020 / 06 / 01)

页次

97 - 132

内容语文

繁體中文

中文摘要

森林療育於生心理健康之正向影響已有豐富實證支持,然甚少研究同時從量性與質性角度探討。本研究以具高度生心理重建需求之復健期燒傷者為研究對象,採實驗法結合問卷調查、焦點團體及個別訪談,探討其生心理影響與作用機制。以滿月圓森林遊樂區為實驗場域,招募五位燒傷者進行四次森林療育活動,每次約4.5小時。研究結果發現燒傷者的肌耐力與柔軟度有改善之趨勢,團體動力、自我覺察增加及去醫療化環境可帶動生理層面的正向改變;整體心理健康尤其自卑與失眠構面有改善之趨勢,森林環境、隱匿又開放的特性、社交互動與同儕支持、自我效能增加為帶動心理正向改變的機制。本研究結果可作為從業人員規畫森林療育與燒傷者生心理重建輔助療法之參考。

英文摘要

The positive effect of forest therapy on physical and psychological well-being has been proven by empirical evidence; however, few studies have discussed both quantitative and qualitative perspectives. In this study, the burn survivors with rehabilitation needs who have a high degree of physical and psychological reconstruction are taken as the research object. Experimental methods are combined with questionnaire surveys, focus groups and individual interviews to discuss their physical and psychological impact and mechanism of action. Taking the Manyueyuan Forest Recreation Area as an experimental field, five burn survivors were recruited for four times, each time about 4.5 hours of forest therapy activities. The results of the study showed improvements in the participants' cmuscle endurance and body flexibility; moreover, group dynamics, the increase of self-awareness, and nonmedical environments could be the influential factors of these positive changes. The trends of psychological improvements were observed, especially inferiority and insomnia. These improvements could also be related to the factors such as forest environment, secure and open feature of the forest, social interactions and peer support, and self-efficacy. The findings of this study could help in the future design of forest therapy and complementary interventions for burn survivors.

主题分类 人文學 > 地理及區域研究
社會科學 > 體育學
参考文献
  1. 周煌智, H. C.(2016)。重大災難後燒傷病人的心理重建。護理雜誌,63(1),36-41。
    連結:
  2. Ajoudani, F.,Jasemi, M.,Lotfi, M.(2018).Social participation, social support, and body image in the first year of rehabilitation in burn survivors: A longitudinal, three-wave cross-lagged panel analysis using structural equation modeling.Burns,44(5),1141-1150.
  3. Appleton, J.(1996).The experience of landscape.Chichester, UK:Wiley.
  4. Appleton, J.(1975).Landscape evaluation: the theoretical vacuum.Transactions of the Institute of British Geographers,66,120-123.
  5. Attoe, C.,Pounds-Cornish, E.(2015).Psychosocial adjustment following burns: An integrative literature review.Burns,41(7),1375-1384.
  6. Badger, K.,Royse, D.(2010).Adult burn survivors’ views of peer support: A qualitative study.Social Work in Health Care,49(4),299-313.
  7. Baillie, S. E.,Sellwood, W.,Wisely, J. A.(2014).Post-traumatic growth in adults following a burn.Burns,40(6),1089-1096.
  8. Barnett, B. S.,Mulenga, M.,Kiser, M. M.,Charles, A. G.(2017).Qualitative analysis of a psychological supportive counseling group for burn survivors and families in Malawi.Burns,43(3),602-607.
  9. Berto, R.(2014).The role of nature in coping with psycho-physiological stress: A literature review on restorativeness.Behavioral Sciences,4(4),394-409.
  10. Bosmans, M. W.,Hofland, H. W.,De Jong, A. E.,Van Loey, N. E.(2015).Coping with burns: The role of coping self- efficacy in the recovery from traumatic stress following burn injuries.Journal of behavioral medicine,38(4),642-651.
  11. Caspersen, C. J.,Powell, K. E.,Christenson, G. M.(1985).Physical activity, exercise, and physical fitness: Definitions and distinctions for health-related research.Public Health Reports,100(2),126-131.
  12. Celis, M. M.,Suman, O. E.,Huang, T. T.,Yen, P.,Herndon, D. N.(2003).Effect of a supervised exercise and physiotherapy program on surgical interventions in children with thermal injury.Journal of Burn Care & Research,24(1),57-61.
  13. Chun, M. H.,Chang, M. C.,Lee, S. J.(2017).The effects of forest therapy on depression and anxiety in patients with chronic stroke.International Journal of Neuroscience,127(3),199-203.
  14. Corry, N.,Pruzinsky, T.,Rumsey, N.(2009).Quality of life and psychosocial adjustment to burn injury: social functioning, body image, and health policy perspectives.International Review of Psychiatry,21(6),539-548.
  15. Dalal, P. K.,Saha, R.,Agarwal, M.(2010).Psychiatric aspects of burn.Indian Journal of Plastic Surgery,43(S 01),S136-S142.
  16. Dauber, A.,Osgood, P. F.,Breslau, A. J.,Vernon, H. L.,Carr, D. B.(2002).Chronic persistent pain after severe burns: A survey of 358 burn survivors.Pain Medicine,3(1),6-17.
  17. Davis, T.,Gorgens, K.,Shriberg, J.,Godleski, M.,Meyer, L.(2014).Making meaning in a burn peer support group: Qualitative analysis of attendee interviews.Journal of Burn Care & Research,35(5),416-425.
  18. Difede, J.,Cukor, J.,Lee, F.,Yurt, R.(2009).Treatments for common psychiatric conditions among adults during acute, rehabilitation, and reintegration phases.International Review of Psychiatry,21(6),559-569.
  19. Disseldorp, L. M.,Nieuwenhuis, M. K.,Van Baar, M. E.,Mouton, L. J.(2011).Physical fitness in people after burn injury: A systematic review.Archives of Physical Medicine and Rehabilitation,92(9),1501-1510.
  20. Dolling, A.,Nilsson, H.,Lundell, Y.(2017).Stress recovery in forest or handicraft environments – An intervention study.Urban Forestry & Urban Greening,27,162-172.
  21. Elliot, A. J.,Maier, M. A.(2014).Color psychology: Effects of perceiving color on psychological functioning in humans.Annual Review of Psychology,65,95-120.
  22. Fauerbach, J. A.,McKibben, J.,Bienvenu, O. J.,Magyar-Russell, G.,Smith, M. T.,Holavanahalli, R.,Lezotte, D.(2007).Psychological distress after major burn injury.Psychosomatic Medicine,69(5),473-482.
  23. Frumkin, H.,Bratman, G. N.,Breslow, S. J.,Cochran, B.,Jr, P. H. K.,Lawler, J. J.,Wood, S. A.(2017).Nature contact and human health: A research agenda.Environmental Health Perspectives,125(7)
  24. Grisbrook, T. L.,Wallman, K. E.,Elliott, C. M.,Wood, F. M.,Edgar, D. W.,Reid, S. L.(2012).The effect of exercise training on pulmonary function and aerobic capacity in adults with burn.Burns,38(4),607-613.
  25. Hammitt, W. E.(1982).Cognitive dimensions of wilderness solitude.Environment and Behavior,14(4),478-493.
  26. Hammitt, W. E.,Brown, G. F., Jr(1984).Functions of privacy in wilderness environments.Leisure Sciences,6(2),151-166.
  27. Hansen, M. M.,Jones, R.,Tocchini, K.(2017).Shinrin-Yoku (Forest bathing) and nature therapy: A state-of-the-art review.International Journal of Environmental Research & Public Health,14(8),851.
  28. Hartig, T.,Evans, G. W.,Jamner, L. D.,Davis, D. S.,Gärling, T.(2003).Tracking restoration in natural and urban field settings.Journal of Environmental Psychology,23(2),109-123.
  29. Hiroko, O.,Harumi, I.,Chorong, S.,Maiko, K.,Takashi, M.,Takahide, K.,Yoshifumi, M.(2015).Physiological and psychological effects of a forest therapy program on middle-aged females.International Journal of Environmental Research & Public Health,12(12),15222.
  30. Hong, M. A.,Lee, H. G.,Han, E. K.,Kwon, Y. K.(2010).A states about forest therapy program in Korean and the prospect for the fusion of Korean medicine with forestry.Korean Journal of Oriental Medicine,16(3),95-105.
  31. Jung, W. H.,Woo, J. M.,Ryu, J. S.(2015).Effect of a forest therapy program and the forest environment on female workers’ stress.Urban Forestry & Urban Greening,14(2),274-281.
  32. Kaplan, R.,Kaplan, S.,Brown, T.(1989).Environmental preference: A comparison of four domains of predictors.Environment and Behavior,21(5),509-530.
  33. Kaplan, S.(1995).The restorative benefits of nature: Toward an integrative framework.Journal of Environmental Psychology,15(3),169-182.
  34. Kaplan, S.(2001).Meditation, restoration, and the management of mental fatigue.Environment and Behavior,33(4),480-506.
  35. Kim, W.,Lim, S. K.,Chung, E. J.,Woo, J. M.(2009).The effect of cognitive behavior therapy-based psychotherapy applied in a forest environment on physiological changes and remission of major depressive disorder.Psychiatry Investigation,6(4),245-254.
  36. Laumann, K.,Gärling, T.,Stormark, K. M.(2001).Rating scale measures of restorative components of environments.Journal of Environmental Psychology,21(1),31-44.
  37. Lee, I.,Choi, H.,Bang, K. S.,Kim, S.,Song, M.,Lee, B.(2017).Effects of forest therapy on depressive symptoms among adults: A systematic review.International Journal of Environmental Research and Public Health,14(3),321.
  38. Lee, M. B.,Liao, S. C.,Lee, Y. J.,Wu, C. H.,Tseng, M. C.,Gau, S. F.,Rau, C. L.(2003).Development and verification of validity and reliability of a short screening instrument to identify psychiatric morbidity.Journal of the Formosan Medical Association,102(10),687-694.
  39. Levinson, P.,Ousterhout, D. K.(1980).Art and play therapy with pediatric burn patients.Journal of Burn Care & Research,1(1),42-47.
  40. Li, Q.(2010).Effect of forest bathing trips on human immune function.Environmental Health Preventive Medicine,15(1),9-17.
  41. Li, Q.,Kobayashi, M.,Wakayama, Y.,Inagaki, H.,Katsumata, M.,Hirata, Y.,Miyazaki, Y.(2009).Effect of phytoncide from trees on human natural killer cell function.International Journal of Immunopathology and Pharmacology,22(4),951-959.
  42. Li, Q.,Morimoto, K.,Kobayashi, M.,Inagaki, H.,Katsumata, M.,Hirata, Y.,Wakayama, Y.(2008).A forest bathing trip increases human natural killer activity and expression of anti- cancer proteins in female subjects.Biological Regulators & Homeostatic Agents,22(1),45-55.
  43. Lung, F.,Lee, M. B.(2008).The five-item Brief-Symptom Rating Scale as a suicide ideation screening instrument for psychiatric inpatients and community residents.BMC Psychiatry,8(1),53.
  44. Mao, G. X.,Cao, Y. B.,Lan, X. G.,He, Z. H.,Chen, Z. M.,Wang, Y. Z.,Yan, J.(2012).Therapeutic effect of forest bathing on human hypertension in the elderly.Journal of Cardiology,60(6),495-502.
  45. McCallie, M. S.,Blum, C. M.,Hood, C. J.(2006).Progressive muscle relaxation.Journal of Human Behavior in the Social Environment,13(3),51-66.
  46. Nakau, M.,Imanishi, J.,Imanishi, J.,Watanabe, S.,Imanishi, A.,Baba, T.,Morimoto, Y.(2013).Spiritual care of cancer patients by integrated medicine in urban green space: A pilot study.Explore: The Journal of Science and Healing,9(2),87-90.
  47. Neugebauer, C. T.,Serghiou, M.,Herndon, D. N.,Suman, O. E.(2008).Effects of a 12-week rehabilitation program with music & exercise groups on range of motion in young children with severe burns.Journal of Burn Care & Research,29(6),939-948.
  48. Pallua, N.,Künsebeck, H. W.,Noah, E. M.(2003).Psychosocial adjustments 5 years after burn injury.Burns,29(2),143-152.
  49. Paratz, J. D.,Stockton, K.,Plaza, A.,Muller, M.,Boots, R. J.(2012).Intensive exercise after thermal injury improves physical, functional, and psychological outcomes.Journal of Traumatic Acute Care Surgery,73(1),186-194.
  50. Park, B. J.,Tsunetsugu, Y.,Kasetani, T.,Hirano, H.,Kagawa, T.,Sato, M.,Miyazaki, Y.(2007).Physiological effects of shinrin-yoku (taking in the atmosphere of the forest)—using salivary cortisol and cerebral activity as indicators—.Journal of Physiological Anthropology,26(2),123-128.
  51. Porter, C.,Hardee, J. P.,Herndon, D. N.,Suman, O. E.(2015).The role of exercise in the rehabilitation of patients with severe burns.Exercise and Sport Sciences Reviews,43(1),34-40.
  52. Poulsen, D. V.,Stigsdotter, U. K.,Djernis, D.,Sidenius, U.(2016).‘Everything just seems much more right in nature’: How veterans with post-traumatic stress disorder experience nature-based activities in a forest therapy garden.Health Psychology Open,3(1)
  53. Prensner, J. D.,Yowler, C. J.,Smith, L. F.,Steele, A. L.,Fratianne, R. B.(2001).Music therapy for assistance with pain and anxiety management in burn treatment.The Journal of Burn Care & Rehabilitation,22(1),83-88.
  54. Procter, F.(2010).Rehabilitation of the burn patient.Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India,43(Suppl),S101.
  55. Robinson, E.,Ramsey, N.,Partridge, J.(1996).An evaluation of the impact of social interaction skills training for facially disfigured people.British journal of Plastic Surgery,49(5),281-289.
  56. Rosenbach, C.,Renneberg, B.(2008).Positive change after severe burn injuries.Journal of Burn Care & Research,29(4),638-643.
  57. Shridharani, S. M.,Magarakis, M.,Manson, P. N.,Rodriguez, E. D.(2010).Psychology of plastic and reconstructive surgery: A systematic clinical review.Plastic and Reconstructive Surgery,126(6),2243-2251.
  58. Snaith, R. P.,Zigmond, A. S.(1994).The hospital anxiey and depression scale with the irritability- depression-anxiety scale and the leeds situational anxiety scale: Manual.Slough, UK:Nfer- Nelson.
  59. Sonntag-Öström, E.,Nordin, M.,Dolling, A.,Lundell, Y.,Nilsson, L.,Slunga Järvholm, L.(2015).Can rehabilitation in boreal forests help recovery from exhaustion disorder? The randomised clinical trial ForRest.Scandinavian Journal of Forest Research,30(8),732-748.
  60. Sonntag-Öström, E.,Stenlund, T.,Nordin, M.,Lundell, Y.,Ahlgren, C.,Fjellman-Wiklund, A.,Dolling, A.(2015).“Nature’s effect on my mind” – Patients’qualitative experiences of a forest-based rehabilitation programme.Urban Forestry & Urban Greening,14(3),607-614.
  61. Specified Nonprofit Corporation Forest Therapy Society. (2020). Forest therapy. Retrieved January 19, 2020, from https://www.fo-society.jp/therapy/cn45/index_en.html
  62. Stigsdotter, U. K.,Corazon, S. S.,Sidenius, U.,Refshauge, A. D.,Grahn, P.(2017).Forest design for mental health promotion—Using perceived sensory dimensions to elicit restorative responses.Landscape and Urban Planning,160,1-15.
  63. St-Pierre, D. M.,Choinière, M.,Forget, R.,Garrel, D. R.(1998).Muscle strength in individuals with healed burns.Archives of Physical Medicine and Rehabilitation,79(2),155-161.
  64. Su, Y. J.,Chow, C. C.,Yen, C. I.,Chuang, S. S.(2019).Posttraumatic growth among burn survivors 2 years after the 2015 Formosa Fun Coast Water Park explosion in Taiwan.Psychological Trauma: Theory, Research, Practice, and Policy
  65. Sung, J.,Woo, J. M.,Kim, W.,Lim, S. K.,Chung, E. J.(2012).The effect of cognitive behavior therapy-based “Forest Therapy” program on blood pressure, salivary cortisol level, and quality of life in elderly hypertensive patients.Clinical and Experimental Hypertension,34(1),1-7.
  66. Thurber, C. A.,Martin-Herz, S. P.,Patterson, D. R.(2000).Psychological principles of burn wound pain in children. I: Theoretical Framework.Journal of Burn Care & Research,21(4),376-387.
  67. Tsunetsugu, Y.,Park, B. J.,Miyazaki, Y.(2010).Trends in research related to “Shinrin-yoku” (taking in the forest atmosphere or forest bathing) in Japan.Environmental Health and Preventive Medicine,15(1),27.
  68. Ulrich, R. S.(1983).Aesthetic and affective response to natural environment.Behavior and the natural environment,Boston, MA:
  69. Ulrich, R. S.,Simons, R. F.,Losito, B. D.,Fiorito, E.,Miles, M. A.,Zelson, M.(1991).Stress recovery during exposure to natural and urban environments.Journal of Environmental Psychology,11(3),201-230.
  70. Upton, D.,Penn, F.,Richardson, C.,Rippon, M.(2014).Psychological management of wound pruritus.Journal of Wound Care,23(6),291-299.
  71. Varvani, F. P.,Hekmatpou, D.,Shamis, K. S.(2013).Effectiveness of muscle relaxation on pain, pruritus and vital signs of patients with burns.Iranian Journal of Critical Care Nursing,6(2),87-94.
  72. Westin, A. F.(1967).Privacy and freedom.New York:Atheneum.
  73. Wiechman, S.,Saxe, G.,Fauerbach, J. A.(2017).Psychological outcomes following burn injuries.Journal of Burn Care & Research,38(3),e629-e631.
  74. Willis, C. E.,Grisbrook, T. L.,Elliott, C. M.,Wood, F. M.,Wallman, K. E.,Reid, S. L.(2011).Pulmonary function, exercise capacity and physical activity participation in adults following burn.Burns,37(8),1326-1333.
  75. Wilson, E. O.(1993).Biophilia and the Conservation Ethic.Washington, DC:Island Press.
  76. Zigmond, A. S.,Snaith, R. P.(1983).The hospital anxiety and depression scale.Acta Psychiatrica Scandinavica,67(6),361-370.
  77. 上原巖, Y.,姚巧梅(譯), Q. M.(Trans.)(2013).療癒之森:進入森林療法的世界.臺北市=Taipei:張老師文化事業股份有限公司=Zhang lao shi.
  78. 余家斌, C. P.,趙彥琛, Y. C.,陳薇如, W. J.(2015)。森林環境對生心理狀態效益之研究。中華林學季刊,48(4),363-375。
  79. 吳佳儀, C. Y.,李明濱, M. B.,吳其炘, C. Z.(2015)。燒傷之身心問題與全人照護。臺灣醫界,58(8),9-14。
  80. 林一真, Y. J.(2016)。進入療癒綠天地-森林益康。林業研究專訊,23(5),5-10。
  81. 林一真, Y. J.,申永順, Y. S.,廖天賜, T. T.,王歆慈, S. T.(2011)。,台北=Taipei:行政院農業委員會林務局=Forestry Bureau, Council of Agruiculture, Executive Yuan。
  82. 紀佳汝, C. J.,蔡明哲, M. J.,蘇大成, T. C.,郭宇修, Y. H.,曹崇銘, T. M.(2017)。森林環境中空氣負離子濃度研究之文獻探討。中華林學季刊,50(2),103-116。
  83. 約瑟夫.柯內爾, J.,達娃(2017).共享自然、珍愛世界:適用全年齡層的自然覺察活動.張老師文化事業股份有限公司.
  84. 張碧凰, B. H.,戎瑾如, J. R.,楊翠媛, T. Y.,洪芬芳, F. F.,李恭賢, K. H.(2011)。慢性精神分裂症病患自然體驗活動指引之研發。精神衛生護理雜誌,6(1),11-20。
  85. 教育部(2018)。國民體適能檢測實施辦法。下載日期:2019年6月12日。取自:https://law.moj.gov.tw/LawClass/LawAll.aspx?pcode=H0120013 Ministry of Education. (2018). Citizen Physical Fitness Exam Implementation method. Retrieved June 12, 2019, from https://law.moj.gov.tw/LawClass/LawAll.aspx?pcode=H0120013
  86. 勞勃.殷恩, Robert K.,李政賢, C. H.(2014).質性研究:從開始到完成.台北=Taipei:五南圖書=Wunan Book.
  87. 蔡明哲, M. Z.,楊智凱, Z. K.,吳采諭, C. Y.,陳婉玲, W. L.,林麗貞, L. Z.(2016)。療育之森–臺大實驗林的新使命。林業研究專訊,23(5),16-19。
  88. 衛生福利部=Ministry of Health and Welfare(2014)。衛生福利部(2014)。自殺防治系列12—心情溫度計。臺北:社團法人臺灣自殺防治學會暨全國自殺防治中心。Ministry of Health and Welfare. (2014). Suicide prevention series 12 - brief symptom rating scale. Taipei: Taiwanese Society of Suicidology Suicide Prevention Center.。
  89. 簡慶德, C. D.(2016)。接觸森林增進身體健康—以一些研究成果為例。林業研究專訊,23(5),1-4。
被引用次数
  1. 謝偉民,蔡怡玟(2023)。反景入深林:以大學通識教育「環境、地理與心理」課程「走入森林」體驗為初探。地理研究,77,135-176。