Functioning and environment: Exploring outdoor activity-friendly environments for older adults with disabilities in a Chinese long-term care facility

Older adults with disabilities are very dependent on the physical environment, but evidence concerning outdoor activity-friendly environments is limited. This study developed the functioning and environment model to analyse the interactions among body functions and structures (physiological or psychological functions of body systems and anatomical parts of the body), outdoor environments, and outdoor activities in older adults with disabilities. Demographic and health surveys of older adults (N = 95), interviews with older adults (N = 95) and staff members (N = 28), and behavioural observations of older adults (N = 12) were conducted at a typical Chinese long-term care facility. Environmental needs were revealed by thematic analysis in five themes: natural environments with positive sensory stimuli, accessible and personalized gardening spaces, safe and comfortable walking environments, spaces and equipment for playful exercise, and gathering spaces mixing diverse people. The results showed that the outdoor environment could facilitate outdoor activities by compensating for impairments and utilizing remaining body functions and structures, which could further improve body functions and structures. This study enriches understanding of the relationship between functioning and the environment, providing a new perspective for interdisciplinary cooperation between medical and design fields on environments for healthy ageing.