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Biophilia Survey Results - Part Three

Survey Results – Part 3 – Influencing Factors

Part 3 presented the results regarding practice setting, practice busyness and other therapies practised. It also looked across the survey into influencing factors for prescribing nature-based activities.

Included in the third part is a summary with a call to action to prescribe and engage with nature-based activities in the light of the current health and climate crisis.

In the final set of results, the survey looks at herbal practice and possible factors that influence the extent to which participating herbal practitioners prescribe nature-based activities (N-BA) to their patients as part of their treatment plan.

Questions relating to practice setting and busyness of practice (measured by days practised and number of patients seen per week) revealed the herbal practice profile of respondents.

41% of respondents described their practices as rural, 18% described their practices as semi-rural and 41% as urban.

23% of respondents practise up to 1 day per week as a medical herbalist, 19% 1-2 days and 18% 2-3 days per week. A total of 25% practise between 3-4 (11%) and 4-5 (14%) days a week. 6% of respondents practise 5-6 days whilst 6% practise 6-7 days per week. The remaining respondents preferred not to say.

54% of survey respondents see on average of 5 or less patients per week, 23% see 6-12 patients per week, and 10% see 13-20 patients per week. 4% see 21-30 and 5% see more than 31 patients per week. The remaining respondents preferred not to say.

Practitioners were asked whether they considered their practice setting to be urban (within a town or city), semi-rural (an out-of-town suburb near countryside) or rural (village or hamlet surrounded by farmland or countryside). We were then able to consider whether setting of practice (as measured by self-perceived rural, semi-rural or urban) influenced whether someone prescribes N-BA as part of their treatment plan.

Of those that practise in a rural setting, 91% said that they do prescribe N-BA as part of a patient’s treatment plan.

Of those that practise in an urban setting, 91% said that they do prescribe N-BA as part of a patient’s treatment plan.

And of those that practise in a semi-rural setting, 92% said that they do prescribe N-BA as part of a patient’s treatment plan.

This would suggest that practice setting, whether rural, urban or semi-rural, does not influence whether a practitioner prescribes nature-based activities as part of their treatment plan.

Practitioners were then asked as to how many days a week they currently practised as a Medical Herbalist. We were able to consider whether busyness of practice (as measured by number of days practised per week) influenced whether someone prescribes N-BA as part of their treatment plan.

Of the respondents who do prescribe N-BA as part of a treatment plan, 19% worked less than 1 day per week as a Medical Herbalist, 18% 1-2 days, 19% 2-3 days, 13% 3-4 days, 14% 4-5 days and 6% and 7% worked 5-6 and 6-7 days a week respectively. The remaining respondents preferred not to say how many days per week they worked as a Medical Herbalist.

Of the respondents who do not prescribe N-BA as part of a treatment plan, 57% worked less than 1 day per week as a Medical Herbalist, with 14% working 1-2 days, 4-5 days and 5-6 days each.

This would suggest that days practised per week appears to have little influence upon those who do prescribe nature-based activities as part of a treatment plan. However, it can be seen that the majority of those who do not prescribe nature-based activities as part of a treatment plan practise less than 1 day per week.

Practitioners were asked as to how many patients they saw on average per week. We were then able to consider whether busyness of practice (as measured by number of patients seen per week) influenced whether someone prescribes N-BA as part of their treatment plan.

Of the respondents that do prescribe N-BA as part of a treatment plan, 53% see 0-5 patients per week, 24% see 6-12 patients per week, 10% 13-20 patients per week, 3% 21-30 patients per week and 6% see over 31 patients per week. The remaining respondents preferred not to say how many patients they see in a week, as a Medical Herbalist.

Of the respondents who do not prescribe N-BA as part of a treatment plan, 57% see 0-5 patients per week, 14% see 6-12 patients per week, 14% 13-20 patients per week and 14% see 21-30 patients per week. None of the respondents saw over 31 patients per week.

This would suggest that the number of patients seen per week does influence those who do prescribe nature-based activities as part of their patient treatment plan, as the majority of those that do prescribe see less than 5 patients per week. However, this echoed the findings of those who do not prescribe nature-based activities as part of a treatment plan and when cross-analysed suggested this was more of a reflection of how many patients medical herbalists, on the whole, see per week rather than an influencing factor.

­­­Finally, practitioners were asked as to whether they practised any other therapies as well as herbal medicine. We were then able to consider whether medical herbalists who practise other therapies are more or less likely to prescribe N-BA as part of their treatment plan.

41% of respondents said that they did practise other therapies with the most popular being nutrition, massage, acupuncture and reiki. Respondents also practised counselling, flower essence therapy and reflexology as part of their practice.

Of those respondents who said they did practise other therapies, 88% were also prescribing N-BA to their patients as part of their treatment plan.

Of those respondents who said they did not practise other therapies, 94% were also prescribing N-BA to their patients as part of their treatment plan.

This suggests that practising other therapies does not significantly influence whether a practitioner prescribes nature-based activities as part of a treatment plan.

Summary

The aim of Alice and Helen’s survey was to gather data to determine the extent to which practising medical herbalists use direct contact with outdoor nature as part of their clinical or self-care practice, the types of nature-based activities herbal practitioners engage in and the factors that might influence this.

They found that all respondents engaged in N-BA as part of their self-care routine with the vast majority of respondents encouraging their patients to engage in N-BA as part of their treatment plan.

Given the mounting supporting evidence that spending time in direct contact with outdoor nature has a positive and therapeutic effect upon our physical, mental, social and spiritual wellbeing it could be proposed that including nature-based activities as part of patient treatment plans will synergistically enhance therapeutic outcomes. And encouraging patients to engage with nature supports the move toward pro-environmental behaviour with the conservational ethos that those who feel they benefit from spending time in nature will be more likely to protect and care for the natural world. In these current health and climate crises, encouraging patients to engage with nature-based activities may therefore be a significant and vital element of clinical practice. Findings from the survey suggest that practitioners will be more likely to encourage patients to engage in nature-based activities that they already do themselves as part of their own self-care routine. Broadening our own interests as well as understanding the influencing factors in engaging patients in nature-based activities may be an important way forward in incorporating nature in herbal practice.

So far, there seems to be no correlation between the setting of or busyness of practice (days practised per week or number of patients) and whether practitioners do or don’t prescribe N-BA. There also seems to be no significant influence with regard to whether medical herbalists practise other therapies.

Further analysis needs to be made as to the limitations and challenges faced by practitioners asking their patients to engage with N-BA and whether this is a major influencing factor, as well as thematic analysis of why practitioners do not prescribe N-BA as part of their practice.

These results have given exciting and enlightening insights into herbal practice, and Alice and Helen would like to thank all practitioners who responded to their survey and generously gave their input. They hope to continue the work and research into this subject.