People undergoing rehabilitation must cope with a difficult life situation (Becker, 1997; Charmaz, 1997; Normann et al., 2004). The underlying health challenge may make it harder to carry out routine activities and may also arouse considerable stress, whereas the rehabilitation program itself may impose new demands. To promote rehabilitation, patients need not only the appropriate medical treatment and guidance, but also support in coping with the associated stress (Normann et al., 2004).
One widely applied approach to helping people cope with rehabilitation involves having them move temporarily to a residential rehabilitation center. The social and physical environment of the center may reduce the stress of illness and rehabilitation in several ways (Rubin et al., 1998). The patient can withdraw for a time from demands and daily routines at home and also interact with potentially supportive others who face similar health challenges (Genth, 1995). Rehabilitation centers are often located in natural surroundings, and these may offer positive distractions, tranquility, and opportunities for reflection that contrast with the usual circumstances of everyday life (Cooper Marcus and Barnes, 1999; Gerlach-Spriggs et al., 1998; Van den Berg, 2005). If well designed and furnished, the indoor environment of the center can promote feelings of comfort and aesthetic satisfaction (Ulrich, 1992).
In the present study, the focus is on the effects of indoor plants in a rehabilitation center. Our focus follows from research on the benefits of contact with nature, in healthcare contexts, and more generally. Long believed to serve therapeutic goals, contact with nature became a subject for structured empirical research and psychological theorizing only relatively recently. Studies with hospital patients have reported diverse beneficial outcomes with window views of nature (Ulrich, 1984), pictures of nature (Diette et al., 2003; Verderber, 1986), indoor plants (Park and Mattson, 2008, 2009), and other nature-related environmental stimuli (for a review, see Dijkstra et al., 2006). Experiments in simulated and actual healthcare settings have also shown an increase in pain tolerance while viewing plants (Lohr and Pearson-Mims, 2000; Park et al., 2004). Outside of a healthcare context, experiments with young adults have shown that viewing relatively natural environments better promotes psychophysiological recovery from acute stress than viewing built environments lacking in vegetation (e.g., Hartig et al., 2003; Parsons et al., 1998; Ulrich et al., 1991). Other experiments suggest that having indoor plants present enhances the reduction of acute stress (Dijkstra et al., 2008; Kim and Mattson, 2002; Liu et al., 2003; Lohr et al., 1996), although these findings are not entirely consistent (Bringslimark et al., 2009). Finally, a number of studies have shown that occupants of various settings, including healthcare settings, evaluate them more positively after the introduction of indoor plants (Bringslimark, 2007). The most commonly cited theoretical account for the effects listed accords a fundamental role to a biologically prepared tendency to respond positively to some natural environmental features such as vegetation (Kellert et al., 2008; Ulrich, 1983, 1992). In addition, positive symbolic values and personal associations may also contribute to beneficial effects of indoor plants (Bringslimark, 2007).
Despite the potential for informing practical applications, to our knowledge, research has not yet assessed the effects of indoor plants in a residential rehabilitation context. The present intervention study helps to fill this gap. We assessed the effect on patients of adding plants to common areas at a rehabilitation center. The outcomes of interest included self-reported health, subjective well-being, emotions, and satisfaction with the interior environment at the center.
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