Development of Therapeutic Landscape in Hospitals in the UK

doi:10.3969/j.issn.1000-0232.2023.08.001

Abstract

Abstract: A therapeutic landscape refers to a place and its surroundings that are beneficial to restore and maintain the physical, mental health, and happiness of people. The health benefits of the therapeutic landscape are fully demonstrated and widely recognized. Although the concept of therapeutic landscape has become more prominent in the contemporary era, the use of landscape to promote health has been practiced since ancient times. There are related ideas of landscape-based treatment in Ancient Egypt, Ancient Greece, Mesopotamia, and Ancient China. The origins and evolution of the landscape-based treatment idea are inextricably linked to the transformation of medical ideas and the development of hospital architecture. This study reviewed the development of the therapeutic landscape in hospitals in the UK and summarized four major development stages according to major historical events, socio-economic and scientific development, humanistic trends, medical philosophy and perceptions, and other driving factors. (1) From B.C. to the Renaissance: the passive healing stage based on natural elements. This marked the beginning and initial expansion of the therapeutic landscape. In this stage, people began to focus on the health recovery effects of the primary natural environment and gradually expanded to the cloister gardens of monasteries. As the mechanical medicine model ignored the role of spiritual comfort and many monasteries closed due to religious reform, the therapeutic landscape encountered a downturn period. (2) From the Renaissance to the first half of the 19th century: the proactive healing stage with agricultural and pastoral labor intervention. In this stage, people began to pay attention to the beautiful natural landscape environment as a response to "Pastoralism." Based on the "moral therapy" of the lunatic asylum, the development of therapeutic landscape in hospitals began to promote agricultural and pastoral labor activities, and provided planting and feeding training to mental patients. The extensive natural environment in suburbs was divided into several functional zones, including crop planting, livestock cultivation, and manual labor zones as the therapeutic landscape of the lunatic asylum. However, with the emergence of experimental medicine, medical care shifted attention to the development of medical technology, and the capital investment in landscape environment construction decreased gradually. (3) From the mid-19th century to the first half of the 20th century: the overall healing stage dominated by the physical environment. The British Industrial Revolution brought "urban diseases," and policy reforms by enlightened politicians emphasized the importance of a quality landscape environment. Due to nursing reform, high-tech materials, and the concept of the "idyllic city," hospitals began to pay attention to physical indicators, including ventilation, light, air temperature, etc. Moreover, the landscape models, such as "wide-hall hospital enclosed courtyard," "winter garden," and "garden hospital," were formed to promote comprehensive healing from physical, psychological and social aspects. As the "germ theory" denied the necessity of environmental ventilation and hospitals began to expand and concentrate, the therapeutic landscape lost its place again. (4) From the mid-20th century to the present: the refined healing stage based on multiple theories. In this stage, the interdisciplinary studies on medicine, botany, and landscape architecture became deeper and more refined. The health benefits of therapeutic landscapes were fully confirmed by theoretical studies and practices. Fine division of audiences was carried out, and perception methods were expanded continuously, accompanied by increasing diversified treatment modes. The therapeutic landscape saw unprecedented prosperity. Based on the above development contexts and characteristics, the healthcare concept based on the therapeutic landscape in hospitals in the UK changed from being one-dimensional to multi-dimensional, and audiences changed from generalization to specific groups, and then to refined division. Landscape elements generally expanded from "tangible traditional landscape elements" to "intangible physical environmental elements." Meanwhile, the development from single perception to multiple perceptions was triggered. The healing behavior patterns presented an expansion trend from "passive acceptance" to "active engagement" and from individuals to groups. This study is to provide beneficial references to the construction of the therapeutic landscape in hospitals under the "Healthy China" strategy.

Key words: therapeutic landscape in hospitals, development process, driving factors, development pattern, UK

摘要： 康复景观的健康效益已得到充分论证并被广泛认可，其起源与演进过程与医院发展密不可分。结合重大历史事件、社会经济和科学发展、人文思潮、医学理念与认知等驱动因素，梳理了英国医院康复景观的发展历程，归纳出其起伏演进的四个发展周期，总结了各时期的发展规律。表明，英国医院康复景观的疗愈健康理念由单维转向多维，受众人群类型由泛化到特定群体，再到精细划分；景观要素总体上从“有形传统景观要素”向“无形物理环境要素”拓展，并触发了感知方式由单一向多元发展；疗愈行为方式呈现出由“被动接受”到“主动参与”、自个体向群体的扩展态势。旨在为“健康中国”战略下的医院康复景观建设提供有益参考。

关键词: 医院康复景观, 发展历程, 驱动因素, 发展规律, 英国

CLC Number:

PEI Lidong, ZHAO Xiaolong, WANG Yuqin. Development of Therapeutic Landscape in Hospitals in the UK[J]. South Architecture, 2023, 0(8): 1-11.

裴立东, 赵晓龙, 王雨琴. 英国医院康复景观的“前世今生”[J]. 南方建筑, 2023, 0(8): 1-11.

References

[1] Gesler W M. Therapeutic landscape: theory and a case study of Epidauros, Greece[J]. Environment and planning, 1993(11)：171-189.
[2]刘建华．园艺疗法[J].绿化与生活，1999(1)：9.
LIU Jianhua．Horticultural therapy[J]．Greening and Life，1999(1)：9.
[3] 帕特里克•弗朗西斯•穆尼,陈进勇.康复景观的世界发展[J].中国园林，2009，25(8)：24-27.
Patrick Francis Mooney,CHEN Jinyong.The International Development of Therapeutic Landscape[J]. Chinese Landscape Architecture，2009，25(8)：24-27.
[4] Anonymous．The Epic of Gilgamesh[M]．London：Penguin Classics，1960.
[5]张登本.全注全译黄帝内经[M]．北京：新世界出版社，2008.
ZHANG Dengben．Full notes and full translations of Huangdi Neijing[M]．Beijing：New World Press，2008.
[6]赵晓龙，王敏聪，赵巍，等.公共健康和福祉视角下英国城市公园发展研究[J]．国际城市规划，2021，36(1)：47-57.
ZHAO Xiaolong，WANG Mincong，ZHAO Wei，et al．Evolution of British Urban Parks from the Perspective of Public Health and Well-being[J].Urban Planning International，2021，36(1)：47-57.
[7]姜斌．城市自然景观与市民心理健康：关键议题[J]．风景园林，2020，27(9)：17-23.
JIANG Bin．Urban Natural Landscape and Citizens' Mental Health：Key Issues[J]．Landscape Architecture，2020，27(9)：17-23.
[8]俞佳俐，李健,盛莹,等.城市绿地对居民身心健康福祉满意度影响研究[J].中国园林,2021,37(7)：95-100.
YU Jiali，LI Jian，SHENG Ying，et al.Study on the Influence of Urban Green Space on the Satisfaction of Residents[J]．Chinese Landscape Architecture，2021，37(7)：95-100.
[9]赵晓龙，董雯，程世卓，等.公共健康视角下美国社区绿道发展研究[J].南方建筑，2021(3)：8-14.
ZHAO Xiaolong，DONG Wen，CHENG Shizhuo，et al．Evolution of American Community Greenways from the Perspective of Public Health[J]．South Architecture，2021(3)：8-14.
[10]张嘉琦，龚梦柯，吴建平，等.不同森林环境对人体身心健康影响的研究[J].中国园林，2020，36(2)：118-123.
ZHANG Jiaqi，GONG Mengke，WU Jianping，et al．Effect of Different Forest Environments on People's Physical and Mental Health[J]．Chinese Landscape Architecture，2020，36(2)：118-123.
[11]向鹏天，黄秋韵，李树华．德国疗养地(Kurort)与疗养公园(Kurpark)：形成、发展、空间模式与景观设计特点[J].中国园林，2022，38(1)：118-123.
XIANG Pengtian，HUANG Qiuyun，LI Shuhua．German Health Resort(Kurort) and Spa Park(Kurpark)：The Formation, Evolvement, Space Pattern and Landscape Design Feature[J]．Chinese Landscape Architecture，2022，38(1)：118-123.
[12]王祖星，靳焕，张京生，等.基于公共健康视角的城市公园颗粒物时空分布及影响因素研究[J].中国园林，2021，37(5)：98-103.
WANG Zuxing，JIN Huan，ZHANG Jingsheng，et al.Spatiotemporal Distribution of Atmospheric Particles and Influencing Factors in Urban Park Based on the View of Public Health[J]．Chinese Landscape Architecture，2021，37(5)：98-103.
[13]熊肸，金荷仙，黄倩．盛花期常绿钩吻藤挥发物日动态变化及其对人体生理心理健康的影响[J].中国园林，2022，38(8)：117-122.
XIONG Xi，JIN Hexian，HUANG Qian．Analysis of the Daily Dynamic Changes of the Volatile Compounds of Gelsemium sempervirens in Full Bloom and Effects on Human Physiological and Psychological Health[J]．Chinese Landscape Architecture，2022，38(8)：117-122.
[14]陈睿智．城市公园景观要素的微气候相关性分析[J].风景园林，2020，27(7)：94-99.
CHEN Ruizhi．Microclimate Correlation Analysis of Landscape Elements in City Parks[J]．Landscape Architecture，2020，27(7)：94-99.
[15]刘滨谊，黄莹．上海市街道风景园林冬季微气候感受分析[J]. 城市建筑，2018(33)：53-57.
LIU Binyi，HUANG Ying．Perception Analysis Of Winter Microclimate Of Shanghai Street Landscape Architecture[J]. Urbanism and Architecture，2018(33)：53-57.
[16]陈璇，陆艳艳，李京龙，等.基于园艺疗法的康复景观设计探究[J].现代园艺，2017(18)：98.
CHEN Xuan，LU Yanyan，LI Jinglong，et al．Research on rehabilitation landscape design based on horticultural therapy[J]．Contemporary Horticulture，2017(18)：98.
[17]刘志强．芳香疗法在园林中的应用研究[J].林业调查规划，2005(6)：91-93.
LIU Zhiqiang．The Application of Therapy by means of Aromatics to Gardens[J]．Forest Inventory and Planning，2005(6)：91-93.
[18]李亨，谢辉，葛煜喆．大型综合医院室外空间声景评价[J].风景园林，2021，28(4)：71-77.
LI Heng，XIE Hui，GE Yuzhe．Evaluation of Soundscape in Outdoor Space of Large General Hospitals[J]．Landscape Architecture，2021，28(4)：71-77.
[19]王亚，曾彬．城市运动公园康复性景观设计[J]．世界林业研究，2022，35(2)：147.
WANG Ya，ZENG Bin．Rehabilitation landscape design of urban sports park[J]．World Forestry Research，2022，35(2)：147.
[20]刘博新，朱晓青．失智老人疗愈性庭园设计原则：目的、依据与策略[J].中国园林，2019，35(12)：84-89.
LIU Boxin，ZHU Xiaoqing．The Principle of Healing Gardens Design for Elderly People with Dementia:Purpose,Basis and Strategy[J].Chinese Landscape Architecture，2019，35(12)：84-89.
[21]布莱恩.E.贝森，佘美萱．美国当代康复花园设计：俄勒冈烧伤中心花园[J]．中国园林，2015，31(1)：30-34.
Brian E.Bainnson，SHE Meixuan．American Modern Healing Gardens Design：A Case Study of the Oregon Burn Center Garden[J]．Chinese Landscape Architecture，2015，31(1)：30-34.
[22]丹尼奥•温特巴顿，刘娟娟．自然与康复：为何我们需要绿色疗法[J]．中国园林，2018,34(9)：26-32.
Daniel Winterbottom，LIU Juanjuan．Healing Nature：Why We Need Green Therapy[J]．Chinese Landscape Architecture，2018，34(9)：26-32.
[23]萧蕾，林雅橙．瑞士康复花园对适老性户外环境设计的启示——以巴德-祖赫扎康复医疗中心花园为例[J]．南方建筑，2020(6)：84-90.
XIAO Lei，LIN YaCheng．Swiss Healing Garden Insights for Senior-Friendly Landscape Design:a Reha Clinic Bad Zurzach Healing Garden Case Study[J]．South Architecture，2020(6)：84-90.
[24]谢小菲．儿童医院康复景观设计浅析[J]．现代园艺，2016(23)：142-144.
XIE Xiaofei．Analysis of rehabilitation landscape design in children's hospital[J].Contemporary Horticulture，2016(23)：142-144.
[25]侯韫婧，赵晓龙，朱逊．从健康导向的视角观察西方风景园林的嬗变[J]．中国园林，2015，31(4)：101-105.
HOU Yunjing，ZHAO Xiaolong，ZHU Xun．Evolution of Western Landscape Architecture Based on Health-trend[J].Chinese Landscape Architecture，2015，31(4)：101-105.
[26] 2Roy Porter．The Cambridge History of Medicine [M]. Cambridge：Cambridge University Press，2006.
[27] Elizabeth M. Craik. The 'Hippocratic' Corpus [M]． London，Routledge，2014.
[28] G. B. Carruthers, Lesley A. Carruthers. History of Britain's Hospitals[M]. East Sussex：BOOK GUILD，2005.
[29]傅益东．中世纪英国医院浅探[J]．黑龙江史志，2014(15)：168-169.
FUYidong.An exploration of medieval English hospitals[J].Historical Records of Heilongjiang，2014(15)：168-169.
[30]李树华．尽早建立具有中国特色的园艺疗法学科体系(上)[J]．中国园林，2000(3)：15-17.
LI Shuhua.Call for Efforts to Establish the Horticultural Therapy Theory and Practice with Chinese Characteristic in the Near Future (Part One)[J]．Chinese Landscape Architecture，2000(3)：15-17.
[31]W.A.L.Bowen．Description of The Retreat[J]. Medical History，1965(9)：197-197.
[32]G. E. Mingay. The Victorian Countryside[M]. London：Routledge，1986.
[33]王广坤．19世纪中后期英国公共卫生管理制度的发展及其影响[J]．世界历史，2022(1)：59-73，154.
WANG Guangkun.Inheritance and Reform: The Development and Influence of the British Public Health Management System in the Middle and Late 1gth Century[J]．World History，2022(1)：59-73，154.
[34]严玉芳．19世纪英国“城市之肺”的概念形塑与绿色空间建设[J]．历史教学问题，2018(1)：93-98，132.
YAN Yufang．The Formation of “Lungs of City” and Green Space Construction in Nineteenth Century Britain[J].History Research and Teaching，2018(1)：93-98，132.
[35] Deborah Brunton. Health, disease and society in Europe, 1800–1930: A source book[M]. Manchester：Manchester University Press，2004.
[36] Marcus, Clare Cooper, Naomi A. Sachs and Roger S. Ulrich. Therapeutic Landscapes: An Evidence-Based Approach to Designing Healing Gardens and Restorative Outdoor Spaces[M]. Hoboken：Wiley，2013.
[37] Joseph Paxton. Sanitariums for Exercise of Invilids and Others in all Weather[N]．The Illustrated London News，1851-7-5.
[38] Richardson, Benjamin Ward. On winter palaces of health and camps of health at home: a practicable ideal[J]．Asclepiad，1884(4)：120-131.
[39] Brooke Fischer, Sarah Dash, David Berrigan. Health and community design: the impact of the built environment on physical activity[M]．Washington, DC：Island Press，2003.
[40] Ebenezer Howard.Garden Cities of Tomorrow[M]．Berlin：Nabu Press，2010.
[41] John Howard. An Account Of The Principal Lazarettos In Europe[M]. Berlin：Nabu Press, 2013.
[42] Roy Porter. The Cambridge Illustrated History of Medicine [M]. Cambridge：Cambridge University Press，2001.
[43]孙冰. 广东省医院建筑发展研究（1835年至今）[D].广州：华南理工大学，2018.
SUN Bing.Research on history and development of hospital buildings in Canton (Since 1835)[D].Guangzhou：South China University of Technology,2018.
[54]章俊华，刘玮．园艺疗法[J].中国园林，2009，25(7)：19-23.
ZHANG Junhua，LIU Wei．Horticultural Therapy[J]．Chinese Landscape Architecture，2009，25(7)：19-23.
[45]Anderson, B J. An Exploration of the Potential Benefits of Therapeutic Gardens on Veterans with PTSD[D]. Logan：Utah State University，2011.
[46]贾梅，金荷仙，王声菲．园林植物挥发物及其在康复景观中对人体健康影响的研究进展[J].中国园林，2016，32(12)：26-31.
JIA Mei，JIN Hexian，WANG Shengfei．On the Progress of Research of Landscape Plant Volatile Compounds and Their Influence on Human Health in Rehabilitation Landscape[J].Chinese Landscape Architecture，2016，32(12)：26-31.
[47]艾万峰，郑丽，代星，等.植物环境对人身心健康作用的研究进展[J]．农学学报，2017，7(2)：63-67.
AI Wanfeng，ZHENG Li，DAI Xing，et al．Plant Environment: Its Effect on Human Physical and Mental Health[J]．Journal of Agriculture，2017，7(2)：63-67.
[48] Diette GB, Lechtzin N, Haponik E, Devrotes A, Rubin HR. Distraction therapy with nature sights and sounds reduces pain during flexible bronchoscopy: a complementary approach to routine analgesia[J]. Chest，2003 Mar，123(3)：941-948.
[49] Mind. Ecotherapy: The Green Agenda for Mental Health[R]. London: Mind Publication，2007.
[50] Li Q, Morimoto K, Kobayashi M, Inagaki H, Katsumata M, Hirata Y, Hirata K, Suzuki H, Li YJ, Wakayama Y, Kawada T, Park BJ, Ohira T, Matsui N, Kagawa T, Miyazaki Y, Krensky AM. Visiting a forest, but not a city, increases human natural killer activity and expression of anti-cancer proteins[J]. Int J Immunopathol Pharmacol. 2008 Jan-Mar，21(1)：117-27.
[51] Park BJ, Tsunetsugu Y, Kasetani T, Kagawa T, Miyazaki Y. The physiological effects of Shinrin-yoku (taking in the forest atmosphere or forest bathing): evidence from field experiments in 24 forests across Japan[J]. Environ Health Prev Med．2010，15(1)：18-26.