外部空间：提高护理机构中老年人对户外空间的使用

External Space: Increasing Outdoor Usage of Residential Facilities for the Elderly

为了解环境设计是如何鼓励或阻碍那些长期居住在护理机构中的老年人对户外环境的使用,随机挑选美国休斯敦、芝加哥和西雅图3个不同气候区域下的68所辅助生活机构进行研究。共有1 560名居民和工作人员参与关于户外环境使用情况及偏好的调查问卷,并向相应的员工提问以确认居民回答的有效性。每所护理机构的户外环境评价都涵盖63项环境评价条目,涉及7个核心设计原则,这些原则都来源于以往的研究和实践经验。在对调查样本的性别和移动能力等变量进行控制后,结果显示出若干条能够显著影响居民户外活动时长的环境特征。提升户外环境使用率的相关环境特征包括:较高的可达性、明确的室内外连接、安全的铺装、良好的维护、循环的走道和风景宜人且舒适的休憩区。经调查,居民对户外空间的使用、散步、身体活动、环境满意度和对健康状况的自我评价息息相关。这项研究的意义在于揭示精心设计的户外环境可以对长期居住在护理机构中的老年人的健康行为产生重大影响,并可能为他们带来实质性的康复效益。如果风景园林师能更好地理解户外环境使用率的具体特征,今后可能会给日渐增多的体弱老年居民的健康和福祉带来重大影响。

The purpose of this study was to learn how the designed environment can encourage or discourage elderly residents from spending time outdoors in long-term care settings.The research was conducted at 68 randomly-selected assisted living facilities in three diverse climate regions of the US(Houston,Chicago and Seattle).Residents and staff(N=1560)filled in written surveys on outdoor usage and preferences,with corresponding staff questions to confirm the validity of resident responses.The outdoor areas at each facility were evaluated with a 63-item environmental audit tool,testing seven core design principles derived from previous research and practical experience.After controlling for factors such as gender and mobility,the study found several environmental features that significantly influenced how much time residents spent outdoors.Features associated with increased outdoor usage were:high accessibility,clear indoor-outdoor connections,safe paving,good maintenance,round-trip walkways and a choice of comfortable sitting areas with appealing views.There was strong correlation between outdoor usage,walking,physical activity,environmental satisfaction and self-reported health of the residents surveyed.The implications of this study are that welldesigned outdoor environments can have a major impact on healthrelated behavior in long-term care settings,potentially leading to substantial therapeutic benefits.By better understanding specific features that promote outdoor usage,environmental design will have a major impact on the health and well-being of the growing number of frail elderly residents.