英国医院康复景观的“前世今生”

Development of Therapeutic Landscape in Hospitals in the UK

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。

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 multidimensional,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.