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Li Y, Muschalla B. Virtual Reality Mental Health Interventions in Geriatric Care for Functional or Well-being Enhancement - A Scoping Review. DIE REHABILITATION 2024. [PMID: 38885655 DOI: 10.1055/a-2316-6541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/20/2024]
Abstract
PURPOSE It has become common to use Virtual Reality (VR) for mental health interventions; however, its use in care of the elederly is limited, especially regarding mood and well-being. In this review, we summarize the results of current VR-based mental health interventions for this population. METHODS Peer-reviewed journal articles on immersive VR mental health intervention in seniors, published until 2022, were included. RESULTS There were 2697 results found in the database search, of which 40 articles met the inclusion criteria and were included in the final analysis. Most studies did not use an experimental design with randomized controlled trials and follow-up sessions. Function-oriented and entertainment-oriented intervention studies were categorized. VR-based geriatric mental interventions have grown rapidly since 2018, especially the number of interventions that promote wellbeing. The function-oriented intervention used active interactions with varied devices. Entertainment-oriented interaction was primarily passive, seldomly using hand controllers for moving activities. Generally, VR interventions improved the mental health of older adults. CONCLUSION Geriatric rehabilitation can benefit from this innovative technology to maintain cognitive functions and to improve the well-being of seniors. They have potential for use in aging care and in retirement homes. Future VR intervention may also involve promoting social interaction to combat loneliness among seniors.
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Swami V. Associations between nature exposure and body image: A critical, narrative review of the evidence. Acta Psychol (Amst) 2024; 248:104355. [PMID: 38870689 DOI: 10.1016/j.actpsy.2024.104355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 05/14/2024] [Accepted: 06/11/2024] [Indexed: 06/15/2024] Open
Abstract
Researchers, practitioners, and policy-makers are having to deal with the negative impact of body image concerns in populations globally. One cost-effective way of promoting healthier body image outcomes is through exposure to natural environments. A growing body of research has shown that spending time in, interacting with, and even just looking at natural environments can promote healthier body image outcomes. In this narrative review, I consider the different forms of evidence documenting an association between nature exposure and body image (i.e., cross-sectional and mediational, experimental and quasi-experimental, comparative, prospective, experience sampling, and qualitative research). Beyond this, I shine a critical light on the available evidence, highlighting concerns with methodological (i.e., who research has focused on and what types of natural environments have been considered), psychometric (i.e., how body image and nature exposure are measured), and conceptual issues (how the association is explained). I conclude that, although there are issues affecting the way the existing body of research is to be understood, there are reasons to be hopeful that nature exposure can be leveraged to promote healthier body image outcomes in diverse populations.
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Affiliation(s)
- Viren Swami
- School of Psychology, Sport, and Sensory Sciences, Anglia Ruskin University, Cambridge, United Kingdom; Centre for Psychological Medicine, Perdana University, Kuala Lumpur, Malaysia.
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Girishan Prabhu V, Stanley L, Morgan R, Shirley B. Designing and developing a nature-based virtual reality with heart rate variability biofeedback for surgical anxiety and pain management: evidence from total knee arthroplasty patients. Aging Ment Health 2024; 28:738-753. [PMID: 37850735 DOI: 10.1080/13607863.2023.2270442] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 10/06/2023] [Indexed: 10/19/2023]
Abstract
OBJECTIVES Total knee arthroplasty (TKA) is one of the most common joint surgeries, with over a million procedures performed annually in the US. Over 70% of patients report moderate to high pain and anxiety surrounding TKA surgery, and 96% are discharged with an opioid prescription. This population requires special attention as approximately 90% of TKA patients are older adults and one of the riskiest groups prone to misusing opioids. This study aimed to develop and compare the efficacy of nature-based virtual reality (VR) with heart rate variability biofeedback (HRVBF) to mitigate surgical pain and anxiety. METHODS This randomized control trial recruited 30 patients (mean age = 66.3 ± 8.2 years, 23 F, 7 M) undergoing TKA surgery and randomly assigned to a control, 2D video with HRVBF, or VR with HRVBF group. A visual analog scale (VAS) was used to measure pain levels before and after the intervention. In addition, a second VAS and the State-Trait Anxiety Inventory (STAI) were used to measure anxiety before and after the intervention. Electrocardiogram (ECG) was used to continuously measure HRV and respiration rate in preoperative and postoperative settings. RESULTS VR and 2D-video with HRVBF decreased pain and anxiety post-intervention compared with the control group, p's <.01. On analyzing physiological signals, both treatment groups showed greater parasympathetic activity levels, and VR with HRVBF reduced pain more than the 2D video, p < .01. CONCLUSIONS Nature-based VR and 2D video with HRVBF can mitigate surgical pain and anxiety. However, VR may be more efficacious than 2D video in reducing pain.
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Affiliation(s)
| | - Laura Stanley
- Gianforte School of Computing, Montana State University, Bozeman, MT, USA
| | - Robert Morgan
- Department of Anesthesiology, Prisma Health, Greenville, SC, USA
| | - Brayton Shirley
- Department of Orthopaedics, Prisma Health, Greenville, SC, USA
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4
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Freymueller J, Schmid HL, Senkler B, Lopez Lumbi S, Zerbe S, Hornberg C, McCall T. Current methodologies of greenspace exposure and mental health research-a scoping review. Front Public Health 2024; 12:1360134. [PMID: 38510363 PMCID: PMC10951718 DOI: 10.3389/fpubh.2024.1360134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 02/20/2024] [Indexed: 03/22/2024] Open
Abstract
Introduction Greenspaces can provide an important resource for human mental health. A growing body of literature investigates the interaction and the influence of diverse greenspace exposures. In order to gain a comprehensive understanding of the complex connection between greenspace and mental health, a variety of perspectives and methodological combinations are needed. The aim of this review is to assess the current methodologies researching greenspace and mental health. Methods A scoping review was conducted. Four electronic databases (Pubmed, Embase, PsycInfo, Web of Science) were searched for relevant studies. A wide range of greenspace and mental health keywords were included to provide a comprehensive representation of the body of research. Relevant information on publication characteristics, types of greenspaces, mental health outcomes, and measurements of greenspace exposure and mental health was extracted and assessed. Results 338 studies were included. The included studies encompassed a multitude of methods, as well as outcomes for both greenspace and mental health. 28 combinations were found between seven categories each for greenspace and mental health assessment. Some pairings such as geoinformation systems for greenspace assessment and questionnaires investigating mental health were used much more frequently than others, implying possible research gaps. Furthermore, we identified problems and inconsistences in reporting of greenspace types and mental health outcomes. Discussion The identified methodological variety is a potential for researching the complex connections between greenspace and mental health. Commonly used combinations can provide important insights. However, future research needs to emphasize other perspectives in order to understand how to create living environments with mental health benefits. For this purpose, interdisciplinary research is necessary.
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Affiliation(s)
- Julius Freymueller
- Medical School OWL, Department of Sustainable Environmental Health Sciences, Bielefeld University, Bielefeld, Germany
| | - Hannah-Lea Schmid
- Medical School OWL, Department of Sustainable Environmental Health Sciences, Bielefeld University, Bielefeld, Germany
| | - Ben Senkler
- Medical School OWL, Department of Sustainable Environmental Health Sciences, Bielefeld University, Bielefeld, Germany
| | - Susanne Lopez Lumbi
- Medical School OWL, Department of Sustainable Environmental Health Sciences, Bielefeld University, Bielefeld, Germany
| | - Stefan Zerbe
- Faculty of Agricultural, Environmental and Food Sciences, Free University of Bozen-Bolzano, Bolzano, Italy
- Institute of Geography, University of Hildesheim, Hildesheim, Germany
| | - Claudia Hornberg
- Medical School OWL, Department of Sustainable Environmental Health Sciences, Bielefeld University, Bielefeld, Germany
| | - Timothy McCall
- Medical School OWL, Department of Sustainable Environmental Health Sciences, Bielefeld University, Bielefeld, Germany
- School of Public Health, Department of Environment and Health, Bielefeld University, Bielefeld, Germany
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5
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Patwary MM, Bardhan M, Browning MHEM, Astell-Burt T, van den Bosch M, Dong J, Dzhambov AM, Dadvand P, Fasolino T, Markevych I, McAnirlin O, Nieuwenhuijsen MJ, White MP, Van Den Eeden SK. The economics of nature's healing touch: A systematic review and conceptual framework of green space, pharmaceutical prescriptions, and healthcare expenditure associations. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 914:169635. [PMID: 38159779 DOI: 10.1016/j.scitotenv.2023.169635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 12/20/2023] [Accepted: 12/21/2023] [Indexed: 01/03/2024]
Abstract
Green spaces play a crucial role in promoting sustainable and healthy lives. Recent evidence shows that green space also may reduce the need for healthcare, prescription medications, and associated costs. This systematic review provides the first comprehensive assessment of the available literature examining green space exposure and its associations with healthcare prescriptions and expenditures. We applied Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines to search MEDLINE, Scopus, and Web of Science for observational studies published in English through May 6, 2023. A quality assessment of the included studies was conducted using the Office of Health Assessment and Translation (OHAT) tool, and the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) assessment was used to evaluate the overall quality of evidence. Our search retrieved 26 studies that met the inclusion criteria and were included in our review. Among these, 20 studies (77 % of the total) showed beneficial associations of green space exposure with healthcare prescriptions or expenditures. However, most studies had risks of bias, and the overall strength of evidence for both outcomes was limited. Based on our findings and related bodies of literature, we present a conceptual framework to explain the possible associations and complex mechanisms underlying green space and healthcare outcomes. The framework differs from existing green space and health models by including upstream factors related to healthcare access (i.e., rurality and socioeconomic status), which may flip the direction of associations. Additional research with lower risks of bias is necessary to validate this framework and better understand the potential for green space to reduce healthcare prescriptions and expenditures.
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Affiliation(s)
- Muhammad Mainuddin Patwary
- Environment and Sustainability Research Initiative, Khulna, Bangladesh; Environmental Science Discipline, Life Science School, Khulna University, Khulna, Bangladesh.
| | - Mondira Bardhan
- Environment and Sustainability Research Initiative, Khulna, Bangladesh; Department of Park, Recreation and Tourism Management, Clemson University, Clemson, SC, USA
| | - Matthew H E M Browning
- Department of Park, Recreation and Tourism Management, Clemson University, Clemson, SC, USA.
| | - Thomas Astell-Burt
- School of Architecture, Design, and Planning, University of Sydney, Australia
| | - Matilda van den Bosch
- ISGlobal, Barcelona, Spain; European Forest Institute, Biocities Facility, Rome, Italy; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Jiaying Dong
- Department of Park, Recreation and Tourism Management, Clemson University, Clemson, SC, USA; School of Architecture, Clemson University, Clemson, SC, USA
| | - Angel M Dzhambov
- Research Group "Health and Quality of Life in a Green and Sustainable Environment", Strategic Research and Innovation Program for the Development of MU - Plovdiv, Medical University of Plovdiv, Plovdiv, Bulgaria; Environmental Health Division, Research Institute at Medical University of Plovdiv, Medical University of Plovdiv, Plovdiv, Bulgaria; Department of Hygiene, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria; Institute of Highway Engineering and Transport Planning, Graz University of Technology, Graz, Austria
| | - Payam Dadvand
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Iana Markevych
- Research Group "Health and Quality of Life in a Green and Sustainable Environment", Strategic Research and Innovation Program for the Development of MU - Plovdiv, Medical University of Plovdiv, Plovdiv, Bulgaria; Environmental Health Division, Research Institute at Medical University of Plovdiv, Medical University of Plovdiv, Plovdiv, Bulgaria; Institute of Psychology, Jagiellonian University, Krakow, Poland
| | - Olivia McAnirlin
- Department of Park, Recreation and Tourism Management, Clemson University, Clemson, SC, USA
| | - Mark J Nieuwenhuijsen
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Mathew P White
- Cognitive Science Hub, University of Vienna, Vienna, Austria
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Khalil R, Demarin V. Creative therapy in health and disease: Inner vision. CNS Neurosci Ther 2024; 30:e14266. [PMID: 37305955 PMCID: PMC10915997 DOI: 10.1111/cns.14266] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 04/21/2023] [Accepted: 05/03/2023] [Indexed: 06/13/2023] Open
Abstract
Can we better understand the unique mechanisms of de novo abilities in light of our current knowledge of the psychological and neuroscientific literature on creativity? This review outlines the state-of-the-art in the neuroscience of creativity and points out crucial aspects that still demand further exploration, such as brain plasticity. The progressive development of current neuroscience research on creativity presents a multitude of prospects and potentials for furnishing efficacious therapy in the context of health and illness. Therefore, we discuss directions for future studies, identifying a focus on pinpointing the neglected beneficial practices for creative therapy. We emphasize the neglected neuroscience perspective of creativity on health and disease and how creative therapy could offer limitless possibilities to improve our well-being and give hope to patients with neurodegenerative diseases to compensate for their brain injuries and cognitive impairments by expressing their hidden creativity.
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Affiliation(s)
- Radwa Khalil
- School of Business, Social and Decision SciencesConstructor UniversityBremenGermany
| | - Vida Demarin
- International Institute for Brain HealthZagrebCroatia
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Syed A, Jacob MS. Languaging psychopathology: neurobiology and metaphor. Front Psychiatry 2024; 15:1320771. [PMID: 38374980 PMCID: PMC10875027 DOI: 10.3389/fpsyt.2024.1320771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 01/12/2024] [Indexed: 02/21/2024] Open
Abstract
Explanatory models of the mind inform our working assumptions about mental illness with direct implications for clinical practice. Neurobiological models assert that the mind can be understood in terms of genetics, chemistry, and neuronal circuits. Growing evidence suggests that clinical deployment of neurobiological models of illness may have unintended adverse effects on patient attitudes, public perception, provider empathy, and the effectiveness of psychiatric treatment. New approaches are needed to find a better language for describing (let alone explaining) the experience of mental illness. To address this gap, we draw upon interdisciplinary sources and semiotic theory to characterize the role of metaphor in the conceptualization and communication of psychopathology. We examine the metaphors recruited by contemporary neurobiological models and metaphor's role in facilitating descriptive clarity or evocative creativity, depending on intention and context. These multiple roles reveal the implications of metaphorical reasoning in clinical practice, including cognitive flexibility, personalized communication, and uncertainty tolerance. With this analysis, we propose a clinical approach that embraces the meta-process of ongoing novel metaphor generation and co-elaboration, or languaging metaphors of psychopathology. Our goal is to bring attention to the value of employing ever-evolving, shapeable metaphorical depictions of psychiatric illness: metaphors that enable a capacity for change in individuals and society, reduce stigma, and nurture recovery.
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Affiliation(s)
- Adnan Syed
- Mental Health Service, San Francisco Veterans Affairs (VA) Medical Center, San Francisco, CA, United States
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Michael S. Jacob
- Mental Health Service, San Francisco Veterans Affairs (VA) Medical Center, San Francisco, CA, United States
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
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Le Roy B, Martin-Krumm C, Poupon C, Richieri R, Malbos E, Barthélémy F, Guedj E, Trousselard M. Virtual Exercise in Medicine: A Proof of Concept in a Healthy Population. JMIR Form Res 2024; 8:e45637. [PMID: 38252484 PMCID: PMC10845022 DOI: 10.2196/45637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 05/19/2023] [Accepted: 08/31/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND Science is beginning to establish the benefits of the use of virtual reality (VR) in health care. This therapeutic approach may be an appropriate complementary treatment for some mental illnesses. It could prevent high levels of morbidity and improve the physical health of patients. For many years, the literature has shown the health benefits of physical exercise. Physical exercise in a VR environment may improve the management of mild to moderate mental health conditions. In this context, we developed a virtual environment combined with an ergocycle (the augmented physical training for isolated and confined environments [APTICE] system). OBJECTIVE This study aims to investigate the impact of physical exercise in a VR environment. METHODS A total of 14 healthy participants (11 men and 3 women; mean age 43.28, SD 10.60 years) undertook 15 minutes of immersive physical exercise using the system. Measures included mindfulness and immersion disposition, subjective perceptions of sensory information, user experience, and VR experience (ie, psychological state, flow, and presence). RESULTS First, the APTICE system appears to be a useful tool because the user experience is positive (subscales in the AttrakDiff questionnaire: pragmatic quality=0.99; hedonic quality-stimulation=1.90; hedonic quality-identification=0.67; attractiveness=1.58). Second, the system can induce a positive psychological state (negative emotion, P=.06) and an experience of flow and presence (P values ranging from <.001 to .04). Third, individual immersive and mindful disposition plays a role in the VR experience (P values ranging from <.02 to .04). Finally, our findings suggest that there is a link between the subjective perception of sensory information and the VR experience (P values ranging from <.02 to .04). CONCLUSIONS These results indicate that the device is well accepted with positive psychological and exteroceptive outcomes. Overall, the APTICE system could be a proof of concept to explore the benefits of virtual physical exercise in clinical medicine.
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Affiliation(s)
- Barbara Le Roy
- Unité neurophysiologie du stress, Institut de recherche biomédicale des armées, Brétigny-sur-Orge, France
- Adaptation, mesure et évaluation en santé. Approches interdisciplinaires, Metz, France
| | - Charles Martin-Krumm
- Unité neurophysiologie du stress, Institut de recherche biomédicale des armées, Brétigny-sur-Orge, France
- Adaptation, mesure et évaluation en santé. Approches interdisciplinaires, Metz, France
- Vulnérabilité, capabilité, rétablissement, Unité religion, culture et société, Ecole des psychologues praticiens, Paris, France
| | - Charlotte Poupon
- École nationale supérieure de création industrielle, Paris, France
| | - Raphaëlle Richieri
- Département psychiatrie, Hôpital de la Conception, Institut Fresnel, Marseille, France
| | - Eric Malbos
- Département psychiatrie, Hôpital de la Conception, Institut Fresnel, Marseille, France
| | - Fanny Barthélémy
- Département de médecine nucléaire, Centre européen de recherche en imagerie médicale, Institut Fresnel, Marseille, France
| | - Eric Guedj
- Département de médecine nucléaire, Centre européen de recherche en imagerie médicale, Institut Fresnel, Marseille, France
| | - Marion Trousselard
- Unité neurophysiologie du stress, Institut de recherche biomédicale des armées, Brétigny-sur-Orge, France
- Adaptation, mesure et évaluation en santé. Approches interdisciplinaires, Metz, France
- Service de santé des armées, Paris, France
- Réseau ABC des Psychotraumas, Montpellier, France
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Bolouki A. The impact of virtual reality natural and built environments on affective responses: a systematic review and meta-analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024; 34:73-89. [PMID: 36201684 DOI: 10.1080/09603123.2022.2130881] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 09/22/2022] [Indexed: 06/16/2023]
Abstract
This study aims to evaluate the extent to which virtual reality (VR) natural and built settings affect emotional states. Web of Science, SCOPUS, and PubMed were searched for relevant articles prior to February 2022. Of 15 articles identified for systematic review, 6 met the inclusion criteria for meta-analysis (studies with only pre- and post-condition measures of the Positive and Negative Affect Schedule (PANAS) were included). Both positive affect (g = 0.20, p = 0.001) and negative affect (g = - 0.30, p = 0.001) change scores for the VR natural environment were statistically significant. On the other hand, change scores for VR built environment were not significant in both positive affect (g = - 0.08, p = 0.355) and negative affect (g = - 0.08, p = 0.058). The findings revealed that, in addition to a VR natural environment, a VR built environment is capable of providing restorative experiences against negative mood in some circumstances.
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Affiliation(s)
- Ahmad Bolouki
- Master of urban design, Tehran University of Art, Tehran, Iran
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10
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Brambilla E, Petersen E, Stendal K, Sundling V, MacIntyre TE, Calogiuri G. Effects of immersive virtual nature on nature connectedness: A systematic review and meta-analysis. Digit Health 2024; 10:20552076241234639. [PMID: 38533309 PMCID: PMC10964443 DOI: 10.1177/20552076241234639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 01/26/2024] [Indexed: 03/28/2024] Open
Abstract
Objective This study systematically summarizes the extant literature on the impacts of immersive virtual nature (IVN) on nature connectedness in the general population. Methods Papers were considered eligible if peer-reviewed, in English language, comprising experimental or quasi-experimental trials, including at least one outcome relative to nature connectedness in the general population. Database search was conducted on Scopus, Web of Science, Google Scholar, Medline, and GreenFILE (22-28 November 2021). Risk of bias was established by the Cochrane RoB 2 tool. Data synthesis was conducted through meta-analysis according with the Cochrane Consumers and Communication Group guidelines. Results Six eligible papers (9 studies; n = 730) were selected, in which IVN was compared to (i) non-immersive virtual nature, (ii) immersive virtual built environments, (iii) non-immersive virtual built environments, and (iv) actual nature. The risk of bias was predominantly "low" or of "some concerns." Meta-analyses showed a statistically significant overall effect for the first (g = 0.26; 95% CI = 0.06-0.45; I2 = 35%) and fourth group (g = -1.98; 95% CI = -3.21 to -0.75; I2 = 96%), the former in favor of IVN and the latter in favor of actual nature. Subgroup analyses were conducted for the first and second groups of studies to explore possible sources of heterogeneity. The small number of studies available limits the validity of the outcomes of the meta-analyses. Conclusion The findings indicate that IVN may be an effective tool for the promotion of nature connectedness, although the evidence in this field is still limited and largely mixed. Recommendations for future research are discussed.
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Affiliation(s)
- Elena Brambilla
- Centre for Health and Technology, Department of Nursing and Health Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Evi Petersen
- Department of Sports, Physical Education and Outdoor Studies, University of South-Eastern Norway, Bø, Norway
- Department of Early Childhood Education, Oslo Metropolitan University, Oslo, Norway
| | - Karen Stendal
- Department of Business, Marketing and Law, University of South-Eastern Norway, Ringerike, Norway
| | - Vibeke Sundling
- Department of Optometry, Radiography and Lighting Design, University of South-Eastern Norway, Kongsberg, Norway
| | - Tadhg E MacIntyre
- All Institute, Department of Psychology, Maynooth University, Maynooth, Irlanda
| | - Giovanna Calogiuri
- Centre for Health and Technology, Department of Nursing and Health Sciences, University of South-Eastern Norway, Drammen, Norway
- Section for Public Health, Department of Public Health and Sport Sciences, Inland Norway University of Applied Science, Elverum, Norway
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11
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Reale G, Fusco A, Calciano R, Vallario N, Vagnarelli G, Caliandro P, Castelli L, Moci M, Tieri G, Iasevoli L, Padua L. The Immediate Effects of Immersive Virtual Reality on Autonomic Nervous System Function in Patients with Disorders of Consciousness after Severe Acquired Brain Injury: A Pilot Study. J Clin Med 2023; 12:7639. [PMID: 38137708 PMCID: PMC10744216 DOI: 10.3390/jcm12247639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 11/23/2023] [Accepted: 12/06/2023] [Indexed: 12/24/2023] Open
Abstract
Disorders of Consciousness (DoCs) after severe acquired brain injury involve substantial impairment of cognition and physical functioning, requiring comprehensive rehabilitation and support. Technological interventions, such as immersive Virtual Reality (VR), have shown promising results in promoting neural activity and enhancing cognitive and motor recovery. VR can induce physical sensations that may activate the Autonomic Nervous System (ANS) and induce ANS-regulated responses. This study aimed to investigate the effects of immersive VR on the ANS in patients with DoCs through the analysis of the electrodermal activity (EDA). EDA was measured with a wearable device during a single immersive VR session consisting of static and dynamic videos depicting naturalistic environments. A pilot case-control study was conducted with 12 healthy participants and 12 individuals with DoCs. Results showed higher EDA values in patients than in healthy participants (p = 0.035), suggesting stronger autonomic activation during immersive VR exposure, while healthy subjects, in turn, showed a decrease in EDA values. Our results revealed a significant interaction between conditions and groups (p = 0.003), with patients showing significantly increased EDA values from the baseline compared to dynamic video observation (p = 0.014) and final rest (p = 0.007). These results suggest that immersive VR can elicit sympathetic arousal in patients with DoCs. This study highlights the potential of immersive VR as a tool to strengthen autonomic responses in patients with impaired consciousness.
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Affiliation(s)
- Giuseppe Reale
- UOC Neuroriabilitazione ad Alta Intensità, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy (A.F.); (M.M.)
| | - Augusto Fusco
- UOC Neuroriabilitazione ad Alta Intensità, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy (A.F.); (M.M.)
| | - Rossella Calciano
- Department of Geriatrics and Orthopaedics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Noemi Vallario
- Department of Geriatrics and Orthopaedics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Gabriele Vagnarelli
- Department of Geriatrics and Orthopaedics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Pietro Caliandro
- UOC Neurologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Letizia Castelli
- UOC Neuroriabilitazione ad Alta Intensità, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy (A.F.); (M.M.)
| | - Marco Moci
- UOC Neuroriabilitazione ad Alta Intensità, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy (A.F.); (M.M.)
| | - Gaetano Tieri
- Virtual Reality and Digital Neuroscience Lab, Department of Law and Digital Society, University of Rome Unitelma Sapienza, Piazza Sassari, 4, 00161 Rome, Italy;
- IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
| | - Luigi Iasevoli
- Multiple Sclerosis Unit, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
| | - Luca Padua
- UOC Neuroriabilitazione ad Alta Intensità, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy (A.F.); (M.M.)
- Department of Geriatrics and Orthopaedics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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12
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Marvier M, Kareiva P, Felix D, Ferrante BJ, Billington MB. The benefits of nature exposure: The need for research that better informs implementation. Proc Natl Acad Sci U S A 2023; 120:e2304126120. [PMID: 37871200 PMCID: PMC10622866 DOI: 10.1073/pnas.2304126120] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2023] Open
Abstract
Concern about humanity's detachment from nature has spawned a global push to increase the availability of green spaces within cities. One impetus for this movement is a growing collection of studies documenting an association between improved human well-being and exposure to nature. The challenge lies in translating this research into pragmatic recommendations for cities. The usefulness of the existing research portfolio is diminished by the limitations of prevailing research designs. For example, most nature exposure studies (>80%) are observational. The rare randomized manipulative experiments tend to be indoors or virtual and rely on nature exposures on the order of ten to fifteen minutes. "Nature" and "biodiversity" are commonly invoked together as benefiting human well-being despite little evidence that biodiversity has particular importance for human psychological and emotional health. The most glaring gap in nature exposure research is the neglect of differences among cultures and ethnic groups with respect to the nature they prefer. In the few cases where researchers looked for differences among groups, they often found heterogeneous responses. Finally, few studies have compared greening interventions to other possible efforts to improve urban life. Thus, the utopian city of the future might be resplendent with urban parks on every block, but it is not clear whether those parks should offer basketball and pickleball courts, or small woodlands with a cornucopia of birds. We advocate for the next generation of nature exposure research that better informs the envisioning of our future sustainable cities with enhanced and equitable access to nature.
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Affiliation(s)
- Michelle Marvier
- Department of Environmental Studies and Sciences, Santa Clara University, Santa Clara, CA95053
| | | | | | - Brian J. Ferrante
- Environmental Systems Program, University of California San Diego, San Diego, CA92093
| | - Morgan B. Billington
- Department of Environmental Studies and Sciences, Santa Clara University, Santa Clara, CA95053
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13
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Nicholas M, Wittmann J, Norena M, Ornowska M, Reynolds S. A randomized, clinical trial investigating the use of a digital intervention to reduce delirium-associated agitation. NPJ Digit Med 2023; 6:202. [PMID: 37903857 PMCID: PMC10616287 DOI: 10.1038/s41746-023-00950-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 10/18/2023] [Indexed: 11/01/2023] Open
Abstract
We aimed to determine if a novel digital therapeutic intervention could reduce agitation and unscheduled medication use in an adult delirious acute care population. Delirious participants were randomly allocated (1:1) to receive standard of care plus a single 4-hour exposure to the digital intervention "MindfulGarden", which uses a screen-based delivery to display a nature landscape with dynamic adjustment of screen content in response to movement and sound or standard of care only. Between March 2021 and January 2022, 73 participants were enrolled with 70 completing the trial protocol and included in the final analysis with a mean age of 61 years and 68% being male (35 intervention, 35 control). Mean RASS was significantly lower across the 4-hour study period in the intervention arm 0.3 (0.85) vs 0.9 (0.93), p = 0.01. Exposure to a nature-based dynamic digital intervention showed benefits in agitation reduction.
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Affiliation(s)
- Michelle Nicholas
- Intensive Care Unit, Fraser Health Authority C/O Royal Columbian Hospital, New Westminster, BC, V3L 3W7, Canada
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, V5A 1S6, Canada
| | - Jessica Wittmann
- Intensive Care Unit, Fraser Health Authority C/O Royal Columbian Hospital, New Westminster, BC, V3L 3W7, Canada
| | - Monica Norena
- Centre for Health Evaluation and Outcome Sciences, Vancouver, BC, V6Z 1Y6, Canada
| | - Marlena Ornowska
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, V5A 1S6, Canada
| | - Steven Reynolds
- Intensive Care Unit, Fraser Health Authority C/O Royal Columbian Hospital, New Westminster, BC, V3L 3W7, Canada.
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, V5A 1S6, Canada.
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14
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Ríos-Rodríguez ML, Testa Moreno M, Moreno-Jiménez P. Nature in the Office: A Systematic Review of Nature Elements and Their Effects on Worker Stress Response. Healthcare (Basel) 2023; 11:2838. [PMID: 37957983 PMCID: PMC10650689 DOI: 10.3390/healthcare11212838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 10/19/2023] [Accepted: 10/25/2023] [Indexed: 11/15/2023] Open
Abstract
Work-related stress is a significant problem in many work environments and can have negative consequences for both employees and organisations. This review aimed to identify which elements of biophilic design in the workplace affect workers' stress response. To enable this, a literature search was conducted using PsycINFO, Scopus, and Medline. The search was limited to articles published from 2012 to June 2023. This review only integrated quantitative data, incorporating twelve records for qualitative synthesis. The selected studies suggest that strategies such as access to outdoor environments or the creation of outdoor areas are effective in reducing stress in the workplace. If these are not feasible, the examined research advocates the use of virtual means to recreate such relaxation or break spaces. Furthermore, aspects of interest for future research were identified, such as multisensory stimulation, including the sense of smell, the exploration of views with natural elements, the creation of shelters, or the study of biomorphic forms.
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Affiliation(s)
- María Luisa Ríos-Rodríguez
- Department of Social Psychology, Social Work, Social Services and Social Anthropology, University of Málaga, 29016 Málaga, Spain; (M.T.M.); (P.M.-J.)
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15
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Lee MJ, Pradeep A, Lobner K, Badaki-Makun O. The effect of nature exposure on pain experience and quality of life in patients with chronic pain: A systematic review and meta-analysis protocol. PLoS One 2023; 18:e0291053. [PMID: 37768931 PMCID: PMC10538778 DOI: 10.1371/journal.pone.0291053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 08/21/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND Chronic pain is a complex condition with short and long-term effects on physical and psychosocial health. Nature exposure therapy has been investigated as a potential non-pharmacological intervention to improve physical and emotional health of individuals with chronic pain. This proposed systematic review aims to examine the effects of nature exposure therapy on pain experience and quality of life in patients with chronic pain. METHODS Studies will be identified by searching the MEDLINE, Embase and Cumulative Index for Nursing and Allied Health Literature (CINAHL) databases. All included studies will be required to be interventional controlled trials comparing nature exposure therapy to placebo or standard care in patients with chronic pain. Primary outcomes for this review will be pain intensity and quality of life scores. Secondary outcomes will include self-efficacy, depression and pain-related anxiety scores. If 2 or more studies are included, results will be pooled for meta-analysis. If meta-analysis is not possible, the results will be presented in a narrative form. DISCUSSION Given the adverse effects of opioid use, non-pharmacological interventions are a necessary alternative to treat patients with chronic pain. Nature exposure therapy is an intriguing example of such an intervention. We hope that this systematic review will guide future clinical decision-making for patients with chronic pain and provide evidence for or against the need for natural spaces and improved urban planning. TRIAL REGISTRATION PROSPERO registration number: CRD42021226949.
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Affiliation(s)
- Matthew J. Lee
- Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America
| | - Aishwarya Pradeep
- Mayo Clinic Alix School of Medicine, Rochester, Minnesota, United States of America
| | - Katie Lobner
- Johns Hopkins Welch Medical Library, Baltimore, Maryland, United States of America
| | - Oluwakemi Badaki-Makun
- Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
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16
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Yang E. Implications of immersive technologies in healthcare sector and its built environment. FRONTIERS IN MEDICAL TECHNOLOGY 2023; 5:1184925. [PMID: 37799269 PMCID: PMC10548380 DOI: 10.3389/fmedt.2023.1184925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 09/04/2023] [Indexed: 10/07/2023] Open
Abstract
Objectives This research focuses on how built environment experts can contribute to the MXR-enabled digital innovation as part of the multidisciplinary team effort to ensure post-pandemic resilience in healthcare built environment. The goal of this research is to help healthcare providers, built environment experts, and policy makers respectively: (1) Advocate the benefits of MXR for innovating health and social care; (2) Spark debate across networks of expertise to create health-promoting environment; and (3) Understand the overriding priorities in making effective pathways to the implementation of MXR. Methods To highlight the novelty of this research, the study relies on two qualitative methodologies: exploratory literature review and semi-structured interviews. Based on the evaluation of prior works and cross-national case studies, hypotheses are formulated from three arenas: (1) Cross-sectional Initiatives for Post-pandemic Resilience; (2) Interoperability and Usability of Next-gen Medicines; and (3) Metaverse and New Forms of Value in Future Healthcare Ecosystems. To verify those hypotheses, empirical findings are derived from in-depth interviews with nine key informants. Results The main findings are summarized under the following three themes: (1) Synergism between Architecture and Technology; (2) Patient Empowerment and Staff Support; and (3) Scalable Health and Wellbeing in Non-hospital and Therapeutic Settings. Firstly, both built environment and healthcare sectors can benefit from the various capabilities of MXR through cross-sectional initiatives, evidence-based practices, and participatory approaches. Secondly, a confluence of knowledge and methods of HCI and HBI can increase the interoperability and usability of MXR for the patient-centered and value-based healthcare models. Thirdly, the MXR-enabled technological regime will largely affect the new forms of value in healthcare premises by fostering more decentralized, preventive, and therapeutic characteristics in the future healthcare ecosystems. Conclusion Whether it's virtual or physical, our healthcare systems have placed great emphasis on the rigor of evidence-based approach linking health outcome to a clinical environment. Henceforth, built environment experts should seek closer ties with the MXR ecosystems for the co-production of scalable health and wellbeing in non-hospital and therapeutic settings. Ultimately, this is to improve resource efficiency in the healthcare sector while considering the transition of health resources towards in silico status by increasing the implementation of MXR.
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Affiliation(s)
- Eunsil Yang
- Healthcare Facilities, Bartlett School of Sustainable Construction, University College London, London, United Kingdom
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17
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Sundermann M, Chielli D, Spell S. Nature As Medicine: The 7th (Unofficial) Pillar of Lifestyle Medicine. Am J Lifestyle Med 2023; 17:717-729. [PMID: 37711353 PMCID: PMC10498981 DOI: 10.1177/15598276231174863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023] Open
Abstract
There are 6 Official Pillars of Lifestyle Medicine, and now mounting evidence supports daily exposure to nature and fresh air as vital to optimizing overall physical and mental health. Time spent in nature has been shown to help lower blood pressure, reduce nervous system arousal, enhance immune system function, reduce anxiety and increase self-esteem. The positive effects of time spent in nature span different occupations, ethnic groups, financial status and individuals with a variety of chronic illnesses and disabilities. "Forest Bathing" is the term coined by Japanese researchers for walking in the woods. It is suspected that aerosols from trees, when inhaled during a forest walk, are one factor responsible for elevated immune system Natural Killer (NK) cells, which help fight off infections and tumor growth. In a culture of ever-increasing technology and screen time, now more than ever it is crucial to educate and empower individuals to incorporate nature into therapeutic treatment regimens. This article will demonstrate the potential benefits of nature, share evidence supporting nature as medicine and provide tools to help engage individuals to spend more time outdoors.
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18
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Alanazi MO, Patano A, Bente G, Mason A, Goldstein D, Parsnejad S, Wyatt G, Lehto R. Nature-Based Virtual Reality Feasibility and Acceptability Pilot for Caregiver Respite. Curr Oncol 2023; 30:5995-6005. [PMID: 37504309 PMCID: PMC10378650 DOI: 10.3390/curroncol30070448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 06/14/2023] [Accepted: 06/20/2023] [Indexed: 07/29/2023] Open
Abstract
Home-based informal caregivers (CGs), such as the family members and friends of cancer patients, often suffer averse emotional symptoms, such as anxiety and depression, due to the burden associated with providing care. The natural environment has been valued as a healing sanctuary for easing emotional pain, promoting calmness, relaxation, and restoration. The use of virtual reality (VR) nature experiences offers an alternative option to CGs to manage emotional symptoms and improve their quality of life. The aim of this mixed-method pilot was to evaluate the feasibility and acceptability of a nature-based VR experience for home-based CGs. Nine informal CGs participated in a 10 min nature-based VR session and completed feasibility, acceptability, and VR symptom measures in the laboratory. Semi-structured interviews with five of the CGs provided qualitative data regarding their experiences with VR. The CGs (mean age 64.78 years) were mostly female (n = 7). Our analysis showed high feasibility (15.11 ± 1.76; range 0-16) and acceptability (15.44 ± 1.33; range 0-16), as well as low VR Symptoms (1.56 ± 1.33; range 0-27). Participants primarily expressed positive perceptions regarding VR feasibility and acceptability during interviews. Our findings show promise for the use of VR nature experiences. In the next phase of the study, the intervention will be tested on home-based informal CGs of patients at end of life.
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Affiliation(s)
- Mohammed Owayrif Alanazi
- College of Nursing, Michigan State University, East Lansing, MI 48824, USA
- Department of Nursing, College of Applied Medical Sciences, University of Bisha, Bisha 61922, Saudi Arabia
| | - Arienne Patano
- College of Nursing, Michigan State University, East Lansing, MI 48824, USA
| | - Gary Bente
- College of Communication Arts & Sciences, Michigan State University, East Lansing, MI 48824, USA
| | - Andrew Mason
- College of Engineering, Michigan State University, East Lansing, MI 48824, USA
| | - Dawn Goldstein
- College of Nursing, Michigan State University, East Lansing, MI 48824, USA
| | - Sina Parsnejad
- Texas Instruments, 1001 Winstead Dr #305, Cary, NC 27513, USA
| | - Gwen Wyatt
- College of Nursing, Michigan State University, East Lansing, MI 48824, USA
| | - Rebecca Lehto
- College of Nursing, Michigan State University, East Lansing, MI 48824, USA
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19
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Theodorou A, Spano G, Bratman GN, Monneron K, Sanesi G, Carrus G, Imperatori C, Panno A. Emotion regulation and virtual nature: cognitive reappraisal as an individual-level moderator for impacts on subjective vitality. Sci Rep 2023; 13:5028. [PMID: 36977705 PMCID: PMC10043509 DOI: 10.1038/s41598-023-30287-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 02/20/2023] [Indexed: 03/30/2023] Open
Abstract
People who make habitual use of an emotion regulation strategy such as cognitive reappraisal may be more sensitive to the emotion cues coming from a surrounding natural environment and, thus, get more benefits from virtual nature exposure such as enhanced subjective vitality. However, no previous study investigated the moderating role of cognitive reappraisal in the relationship between exposure to different types of natural environments (a national park, a lacustrine environment, and an arctic environment vs. an urban environment) and subjective vitality. We designed a between-subject design (four conditions, one per type of environment) with a sample of 187 university students (Mage = 21.17, SD = 2.55). Participants were exposed to four 360° panoramic photos of the environment for one minute each with a virtual reality head-mounted display. The results of a multicategorical moderation analysis attested that there were two significant interactions, respectively between lacustrine and arctic environments and cognitive reappraisal. More specifically, for participants with low levels of habitual use of cognitive reappraisal, the effects of virtual nature (vs. urban) exposure on subjective vitality were not significant, while for participants with high levels, the effects were significant and positive. Findings show how the potential of virtual nature may be boosted with training aimed at increasing the general use of cognitive reappraisal, supports enhancing the applications of virtual nature, and demonstrates the need to take individual differences into account when determining the benefits of these applications.
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Affiliation(s)
- Annalisa Theodorou
- Department of Education, Roma Tre University, 20 Via del Castro Pretorio, 00185, Rome, Italy.
| | - Giuseppina Spano
- Department of Education, Psychology, Communication Sciences, University of Bari Aldo Moro, Bari, Italy
| | - Gregory N Bratman
- School of Environmental and Forest Sciences, University of Washington, Seattle, USA
| | - Kevin Monneron
- Geographic Research and Application Laboratory (GREAL), European University of Rome, Rome, Italy
| | - Giovanni Sanesi
- Department of Agricultural and Environmental Sciences, University of Bari Aldo Moro, Bari, Italy
| | - Giuseppe Carrus
- Department of Education, Roma Tre University, 20 Via del Castro Pretorio, 00185, Rome, Italy
| | | | - Angelo Panno
- Department of Human Science, European University of Rome, Rome, Italy.
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20
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Phillips TB, Wells NM, Brown AH, Tralins JR, Bonter DN. Nature and well‐being: The association of nature engagement and well‐being during the SARS‐CoV‐2 pandemic. PEOPLE AND NATURE 2023. [DOI: 10.1002/pan3.10433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Affiliation(s)
- Tina B. Phillips
- Cornell Lab of Ornithology Cornell University Ithaca New York USA
| | - Nancy M. Wells
- College of Human Ecology Cornell University Ithaca New York USA
| | | | | | - David N. Bonter
- Cornell Lab of Ornithology Cornell University Ithaca New York USA
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21
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Restout J, Bernache-Assollant I, Morizio C, Boujut A, Angelini L, Tchalla A, Perrochon A. Fully Immersive Virtual Reality Using 360° Videos to Manage Well-Being in Older Adults: A Scoping Review. J Am Med Dir Assoc 2023; 24:564-572. [PMID: 36758621 DOI: 10.1016/j.jamda.2022.12.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 12/20/2022] [Accepted: 12/31/2022] [Indexed: 02/08/2023]
Abstract
OBJECTIVE The development of negative behavioral and psychosocial factors (depression, anxiety, apathy, etc) is associated with poor well-being, which can contribute to health issues in ageing, especially in the context of COVID-19. Despite its relative novelty, fully immersive virtual reality (VR) interventions through 360° immersive videos are becoming more accessible and flexible and constitute an emerging method to potentially enhance well-being. The aim of this scoping review is to assess the effectiveness of 360° interventions on well-being in older adults with or without cognitive impairment, as well as cybersickness and attitudes toward this technology. DESIGN Scoping review. SETTING AND PARTICIPANTS Older adults with or without cognitive impairment. METHODS The PRISMA-SR guideline was followed. Four databases were used, and we selected articles published until April 2022. We have analyzed the effect of 360° videos on the well-being of older adults with respect to the study design, the population, the contents, the duration of intervention, and the outcomes. RESULTS A total of 2262 articles were screened, of which 10 articles were finally included in this review. Most of them are pilot studies and used mixed methods including scales and interviews. The material and content of VR are diversified. Many behavioral and psychological outcomes were assessed, including anxiety, apathy, loneliness, depression, social engagement, quality of life, and emotions. The results were positive or mixed, according to the outcomes. We recorded few adverse events, and the interviews show contrasting results concerning the participants' feelings (ie, degree of immersion, familiarity with technology, and VR content). CONCLUSIONS AND IMPLICATIONS The use of VR 360° videos seems feasible in community-dwelling older adults or residential aged care facilities, as they are safe and provide enjoyment. It constitutes an emerging and promising therapeutic tool to manage psychosocial disorders. This review provides key considerations for the design and implementation of interventions using VR 360° video in clinical practice.
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Affiliation(s)
- J Restout
- Université de Limoges, HAVAE, UR20217, Limoges, France
| | | | - C Morizio
- Université de Limoges, HAVAE, UR20217, Limoges, France
| | - A Boujut
- Université de Limoges, HAVAE, UR20217, Limoges, France; 3iL Groupe, Limoges, France
| | - L Angelini
- School of Management Fribourg, HES-SO, Fribourg, Switzerland; Humantech Institute, HES-SO, Fribourg, Switzerland
| | - A Tchalla
- CHU de Limoges, Pôle HU gérontologie clinique, Limoges, France; Laboratoire VieSanté, UR 24134 (Vieillissement, Fragilité, Prévention, e-Santé), IFR OMEGA HEALTH, Université de Limoges, Limoges, France
| | - A Perrochon
- Université de Limoges, HAVAE, UR20217, Limoges, France.
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22
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Valentine C. Health Implications of Virtual Architecture: An Interdisciplinary Exploration of the Transferability of Findings from Neuroarchitecture. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2735. [PMID: 36768106 PMCID: PMC9915076 DOI: 10.3390/ijerph20032735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 01/26/2023] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
Virtual architecture has been increasingly relied on to evaluate the health impacts of physical architecture. In this health research, exposure to virtual architecture has been used as a proxy for exposure to physical architecture. Despite the growing body of research on the health implications of physical architecture, there is a paucity of research examining the long-term health impacts of prolonged exposure to virtual architecture. In response, this paper considers: what can proxy studies, which use virtual architecture to assess the physiological response to physical architecture, tell us about the impact of extended exposure to virtual architecture on human health? The paper goes on to suggest that the applicability of these findings to virtual architecture may be limited by certain confounding variables when virtual architecture is experienced for a prolonged period of time. This paper explores the potential impact of two of these confounding variables: multisensory integration and gravitational perception. This paper advises that these confounding variables are unique to extended virtual architecture exposure and may not be captured by proxy studies that aim to capture the impact of physical architecture on human health through acute exposure to virtual architecture. While proxy studies may be suitable for measuring some aspects of the impact of both physical and virtual architecture on human health, this paper argues that they may be insufficient to fully capture the unintended consequences of extended exposure to virtual architecture on human health. Therefore, in the face of the increasing use of virtual architectural environments, the author calls for the establishment of a subfield of neuroarchitectural health research that empirically examines the physiological impacts of extended exposure to virtual architecture in its own right.
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Affiliation(s)
- Cleo Valentine
- Department of Architecture, University of Cambridge, Cambridge CB2 1PX, UK
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23
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Browning MHEM, Shin S, Drong G, McAnirlin O, Gagnon RJ, Ranganathan S, Sindelar K, Hoptman D, Bratman GN, Yuan S, Prabhu VG, Heller W. Daily exposure to virtual nature reduces symptoms of anxiety in college students. Sci Rep 2023; 13:1239. [PMID: 36690698 PMCID: PMC9868517 DOI: 10.1038/s41598-023-28070-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 01/12/2023] [Indexed: 01/24/2023] Open
Abstract
Exposure to natural environments offers an array of mental health benefits. Virtual reality provides simulated experiences of being in nature when outdoor access is limited. Previous studies on virtual nature have focused mainly on single "doses" of virtual nature. The effects of repeated exposure remain poorly understood. Motivated by this gap, we studied the influence of a daily virtual nature intervention on symptoms of anxiety, depression, and an underlying cause of poor mental health: rumination. Forty college students (58% non-Hispanic White, median age = 19) were recruited from two U.S. universities and randomly assigned to the intervention or control group. Over several weeks, anxious arousal (panic) and anxious apprehension (worry) decreased with virtual nature exposure. Participants identifying as women, past VR users, experienced with the outdoors, and engaged with the beauty in nature benefited particularly strongly from virtual nature. Virtual nature did not help symptoms of anhedonic depression or rumination. Further research is necessary to distinguish when and for whom virtual nature interventions impact mental health outcomes.
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Affiliation(s)
- Matthew H E M Browning
- Virtual Reality and Nature Lab, Clemson University, Clemson, SC, USA.
- Department of Parks, Recreation and Tourism Management, Clemson University, Clemson, SC, USA.
| | - Seunguk Shin
- Department of Natural Resources and Environmental Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Gabrielle Drong
- College of Education, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Olivia McAnirlin
- Virtual Reality and Nature Lab, Clemson University, Clemson, SC, USA
- Department of Parks, Recreation and Tourism Management, Clemson University, Clemson, SC, USA
| | - Ryan J Gagnon
- Department of Parks, Recreation and Tourism Management, Clemson University, Clemson, SC, USA
| | - Shyam Ranganathan
- School of Mathematical and Statistical Sciences, Clemson University, Clemson, SC, USA
| | | | | | - Gregory N Bratman
- School of Environmental and Forest Sciences, University of Washington, Seattle, WA, USA
| | - Shuai Yuan
- Virtual Reality and Nature Lab, Clemson University, Clemson, SC, USA
- Department of Parks, Recreation and Tourism Management, Clemson University, Clemson, SC, USA
| | - Vishnunarayan Girishan Prabhu
- Virtual Reality and Nature Lab, Clemson University, Clemson, SC, USA
- Systems Engineering and Engineering Management, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Wendy Heller
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL, USA
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24
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Zhang G, Wu G, Yang J. The restorative effects of short-term exposure to nature in immersive virtual environments (IVEs) as evidenced by participants' brain activities. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2023; 326:116830. [PMID: 36435136 DOI: 10.1016/j.jenvman.2022.116830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 11/09/2022] [Accepted: 11/17/2022] [Indexed: 06/16/2023]
Abstract
Short-term exposure to nature has excellent potential to be used as a public health intervention measure. Nevertheless, the physiological and psychological mechanisms of this health benefit are still unclear. In this study, we intend to verify the effects of short-term exposure to nature on psychological functioning and to explore the underlying mechanism through experiments conducted in immersive virtual environments (IVEs). Participants were randomly exposed to videos of an urban forest and an indoor environment in IVEs. Before and after the exposure, a participant's self-perceived stress and cognitive performance were measured using the PSS-14 form and the Stroop task, respectively. Their brain activities during the exposure were measured using the electroencephalogram (EEG). The PSS-14 and the Stroop task results confirmed the benefits of stress reduction and cognitive performance improvements from short-term nature exposure. At the same time, rhythmic brain activities during nature exposure indicated better attentional states. The electrodes around the parietal region detected significantly stronger power spectral density of the theta band than other bands. Also, participants showed high functional connectivity among different brain parts during nature exposure, which revealed better cognitive flexibility. The topographic pattern of the differences in functional connectivity overlapped well with the default mode network (DMN)-a "task-negative" network active during the resting state. The overlap indicated a lower cognitive processing load when exposing to nature. Our results support the hypothesis that nature's restorative effects mainly come from effortless processing in natural environments.
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Affiliation(s)
- Gaochao Zhang
- School of Architecture, Southeast University, Nanjing, 210096, China.
| | - Guowei Wu
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China.
| | - Jun Yang
- Department of Earth System Science, Institute for Global Change Studies, Ministry of Education Ecological Field Station for East Asian Migratory Birds, Tsinghua University, Beijing, 100084, China.
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Lau SSS, Leung SSK, Wong JWC, Lee TCP, Cartwright SR, Wong JTC, Man J, Cheung E, Choi RPW. Brief repeated virtual nature contact for three weeks boosts university students' nature connectedness and psychological and physiological health during the COVID-19 pandemic: A pilot study. Front Public Health 2023; 10:1057020. [PMID: 36711407 PMCID: PMC9878182 DOI: 10.3389/fpubh.2022.1057020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 12/19/2022] [Indexed: 01/15/2023] Open
Abstract
The COVID-19 pandemic and its associated uncertainties and restrictions have adverse impacts on university students' mental wellbeing. Evidence shows that virtual nature contact has mental health benefits. However, little is known about the potential beneficial health impacts of virtual nature contact during times of social distancing, when access to the natural environment is restricted. This pilot study aimed to examine the effectiveness of a 3-week virtual nature contact in improving nature connectedness and reducing psychophysiological stress. A sample of 56 university students in Hong Kong was randomly assigned to control and nature interventions using 2-D video played for 15 min three times a week for 3 weeks. Nature connectedness, perceived restorativeness and psycho-physiological wellbeing were measured. Our findings show significant changes in psychological stress levels after nature interventions compared with the baseline, including increased happiness and stronger emotions of comfort and relaxation. When compared with the control group, the results show the nature intervention group has significantly higher levels of nature connectedness, happiness, and positive affect, but no significant effects on other psychological and physiological variables (e.g., cardiovascular responses). Our preliminary findings highlight the potential use of virtual nature contacts in bolstering university students' wellbeing at times of pandemic or when in-person visit to the natural environment is not feasible.
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Affiliation(s)
- Sam S. S. Lau
- Research Centre for Environment and Human Health, School of Continuing Education, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China,College of International Education, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China,Multidisciplinary Research Centre, School of Continuing Education, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China,Institute of Bioresources and Agriculture, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China,*Correspondence: Sam S. S. Lau ✉
| | - Sharron S. K. Leung
- Research Centre for Environment and Human Health, School of Continuing Education, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China,Division of Nursing Education, School of Continuing Education, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China
| | - Jonathan W. C. Wong
- Institute of Bioresources and Agriculture, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China,Department of Biology, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China
| | - Terence C. P. Lee
- Research Centre for Environment and Human Health, School of Continuing Education, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China,College of International Education, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China
| | - Stephen R. Cartwright
- Research Centre for Environment and Human Health, School of Continuing Education, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China,College of International Education, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China
| | - Janet T. C. Wong
- Research Centre for Environment and Human Health, School of Continuing Education, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China
| | - Jackie Man
- Research Centre for Environment and Human Health, School of Continuing Education, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China,Multidisciplinary Research Centre, School of Continuing Education, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China
| | - Ethan Cheung
- Research Centre for Environment and Human Health, School of Continuing Education, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China,Multidisciplinary Research Centre, School of Continuing Education, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China
| | - Regene P. W. Choi
- Research Centre for Environment and Human Health, School of Continuing Education, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China
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Li H, Ding Y, Zhao B, Xu Y, Wei W. Effects of immersion in a simulated natural environment on stress reduction and emotional arousal: A systematic review and meta-analysis. Front Psychol 2023; 13:1058177. [PMID: 36698558 PMCID: PMC9869155 DOI: 10.3389/fpsyg.2022.1058177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 12/16/2022] [Indexed: 01/11/2023] Open
Abstract
Background Although the mental health benefits of exposure to simulated natural environments are well established by researchers from environmental psychology, landscape architecture, and public health, it is unclear whether and to what extent technological immersion affects these benefits. Methods Systematical literature searches were conducted in May 2022 from six databases. The risk of bias was evaluated using the Cochrane's Risk of Bias tool 2.0 and the Risk of Bias in Non-randomized Studies of Interventions tool. We performed a random-effects meta-regression to investigate the heterogeneity. The immersion levels of included studies were classified by projection devices and motion capture, and then subgroup analysis was conducted. Results Twenty-six publications were included. Exposure to simulated nature was confirmed to be associated with increased positive affect 0.40 [95% confidence interval (CI): 0.22, 0.58], vigor 0.58 (95% CI: 0.30, 0.86), calmness 0.54 (95% CI: 0.17, 0.92) and decreased perceived stress -0.38 (95% CI: -0.71, -0.06), total mood disturbance -0.87 (95% CI: -1.17, -0.57), tension -0.70 (95% CI: -0.99, -0.41), fatigue -0.60 (95% CI: -0.91, -0.28), anxiety -0.72 (95% CI: -1.43, -0.02), depression -0.33 (95% CI: -0.52, -0.14), confusion -0.79 (95% CI: -1.19, -0.40), and anger -0.54 (95% CI: -0.76, -0.31). Gender, health status, study design, mean age, and single exposure duration were not significant when entered in a meta-regression. For positive affect, medium immersion was observed to produce a larger effect than low and high immersion. All included studies had a moderate to high risk of bias. Conclusion Audio-visual exposure to simulated nature contributes to stress relief and emotional arousal. The immersion level explains the heterogeneity of positive affect triggered by simulated nature. Focusing on the technical features will open up new possibilities for combining actual and simulated nature's mental health benefits.
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Affiliation(s)
- Hongyi Li
- The College of Landscape Architecture, Nanjing Forestry University, Nanjing, China
| | - Yujun Ding
- The College of Landscape Architecture, Nanjing Forestry University, Nanjing, China
| | - Bing Zhao
- The College of Landscape Architecture, Nanjing Forestry University, Nanjing, China
| | - Yuhang Xu
- The College of Landscape Architecture, Nanjing Forestry University, Nanjing, China
| | - Wei Wei
- The College of Environmental Science, Nanjing Xiaozhuang University, Nanjing, China,*Correspondence: Wei Wei, ✉
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Bentley PR, Fisher JC, Dallimer M, Fish RD, Austen GE, Irvine KN, Davies ZG. Nature, smells, and human wellbeing. AMBIO 2023; 52:1-14. [PMID: 35849312 PMCID: PMC9289359 DOI: 10.1007/s13280-022-01760-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/15/2022] [Accepted: 06/17/2022] [Indexed: 06/12/2023]
Abstract
The link between nature and human wellbeing is well established. However, few studies go beyond considering the visual and auditory underpinnings of this relationship, even though engaging with nature is a multisensory experience. While research linking smell to wellbeing exists, it focuses predominantly on smells as a source of nuisance/offence. Smells clearly have a prominent influence, but a significant knowledge gap remains in the nexus of nature, smell, and wellbeing. Here, we examine how smells experienced in woodlands contribute to wellbeing across four seasons. We show that smells are associated with multiple wellbeing domains, both positively and negatively. They are linked to memories, and specific ecological characteristics and processes over space/time. By making the link between the spatiotemporal variability in biodiversity and wellbeing explicit, we unearth a new line of enquiry. Overall, the multisensory experience must be considered by researchers, practitioners, policy-makers and planners looking to improve wellbeing through nature.
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Affiliation(s)
- Phoebe R Bentley
- Durrell Institute of Conservation and Ecology (DICE), School of Anthropology and Conservation, University of Kent, Canterbury, CT2 8NR, UK
| | - Jessica C Fisher
- Durrell Institute of Conservation and Ecology (DICE), School of Anthropology and Conservation, University of Kent, Canterbury, CT2 8NR, UK.
| | - Martin Dallimer
- Sustainability Research Institute, School of Earth and Environment, University of Leeds, Leeds, LS9 2JT, UK
| | - Robert D Fish
- Durrell Institute of Conservation and Ecology (DICE), School of Anthropology and Conservation, University of Kent, Canterbury, CT2 8NR, UK
| | - Gail E Austen
- Durrell Institute of Conservation and Ecology (DICE), School of Anthropology and Conservation, University of Kent, Canterbury, CT2 8NR, UK
| | - Katherine N Irvine
- Social, Economic and Geographic Sciences Department, James Hutton Institute, Craigiebuckler, Aberdeen, AB15 8QH, UK
| | - Zoe G Davies
- Durrell Institute of Conservation and Ecology (DICE), School of Anthropology and Conservation, University of Kent, Canterbury, CT2 8NR, UK
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Sun Y, Li F, He T, Meng Y, Yin J, Yim IS, Xu L, Wu J. Physiological and affective responses to green space virtual reality among pregnant women. ENVIRONMENTAL RESEARCH 2023; 216:114499. [PMID: 36208780 DOI: 10.1016/j.envres.2022.114499] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 09/16/2022] [Accepted: 10/02/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Benefits of green spaces on stress reduction have been shown in previous studies. Most existing studies to date have focused on the general population. However, there is a lack of understanding of physiological mechanisms underlying the beneficial effects of green space among special populations, such as pregnant women. OBJECTIVES To examine physiological and affective responses to green space on stress recovery among pregnant women, using simulated green space exposure through virtual reality (VR). METHODS We recruited 63 pregnant women between 8 and 14 weeks' gestational age for a laboratory experiment. Participants were randomly assigned to view one of three, 5-min, VR videos of an urban scene with different green space levels (i.e., non-green, moderate, and high) after a laboratory stressor, the Trier Social Stress Test. Physiological stress responses were measured via changes in blood pressure, heart rate, skin conductance level, salivary alpha-amylase, and salivary cortisol. Affective response was measured using the Positive and Negative Affect Scale. RESULTS We found that visual exposure to a green space environment in VR was associated with both physiological and affective stress reduction among pregnant women, including lower systolic blood pressure [-4.6 mmHg, 95% confidence interval (CI): -8.8, -0.4], reduced salivary alpha-amylase concentration (-1.2 ng/ml, 95% CI: -2.2, -0.2), improved overall positive affect (score: 6.6, 95% CI: 0.3, 13.0) and decreased negative affect of anxiety (score: -2.6, 95% CI: -5.19, -0.04) compared to non-green space environment. Exposure to high green space environment in park-like setting had the strongest impacts on stress recovery. CONCLUSION This study demonstrated that virtual green space exposure could effectively ease stress and improve mental health and well-being during pregnancy. Even a short immersion in VR-based green space environment may bring health benefits, which has significant implications for pregnant women when access to an actual nature may not be possible.
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Affiliation(s)
- Yi Sun
- Department of Environmental and Occupational Health, Program in Public Health, University of California, Irvine, CA, USA; Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| | - Fu Li
- College of Architecture and Landscape Architecture, Peking University, Beijing, China
| | - Tao He
- Program in Public Health Policy, University of California, Irvine, CA, USA
| | - Yaohan Meng
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jie Yin
- College of Architecture and Urban Planning, Tongji University, Shanghai, China
| | - Ilona S Yim
- Department of Psychological Science, University of California, Irvine, CA, USA
| | - Liyan Xu
- College of Architecture and Landscape Architecture, Peking University, Beijing, China.
| | - Jun Wu
- Department of Environmental and Occupational Health, Program in Public Health, University of California, Irvine, CA, USA.
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McKinley E, Burdon D, Shellock RJ. The evolution of ocean literacy: A new framework for the United Nations Ocean Decade and beyond. MARINE POLLUTION BULLETIN 2023; 186:114467. [PMID: 36516497 DOI: 10.1016/j.marpolbul.2022.114467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 12/02/2022] [Indexed: 06/17/2023]
Abstract
First introduced in the early 2000s, the concept of ocean literacy has evolved in recent years, not least since its inclusion as a mechanism for change within the United Nations Ocean Decade's goals. Building on early definitions of ocean literacy, there has been increasing recognition of a range of additional dimensions which contribute to an individual or collective sense of 'ocean literacy'. Drawing on existing research, and parallel and supporting concepts, e.g., marine citizenship, ocean connectedness, and public perceptions research, this paper proposes ten dimensions of ocean literacy: knowledge, communication, behaviour, awareness, attitudes, activism, emotional connection, access and experience, adaptive capacity and trust and transparency, and recommends expanding previously recognised dimensions, in a bid to ensure that ocean literacy encompasses diverse knowledges, values and experiences. The paper provides a useful framework for ongoing ocean literacy research, and highlights aspects of ocean literacy which have received limited focus to date.
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Affiliation(s)
- E McKinley
- School of Earth and Environmental Sciences, Cardiff University, Cardiff, UK.
| | - D Burdon
- Daryl Burdon Ltd., Marine Research, Teaching and Consultancy, Willerby, HU10 6LL, UK
| | - R J Shellock
- Australian National Centre for the Public Awareness of Science, Australian National University, Canberra, Australia
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van Houwelingen-Snippe J, Ben Allouch S, van Rompay TJL. Designing digital nature for older adults: A mixed method approach. Digit Health 2023; 9:20552076231218504. [PMID: 38053734 PMCID: PMC10695079 DOI: 10.1177/20552076231218504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 11/16/2023] [Indexed: 12/07/2023] Open
Abstract
Objective Loneliness and social isolation are pressing issues that can seriously impact the mental health and well-being of older adults. Interacting with nature can stimulate a feeling of connectedness. However, for older adults, access to nature is often troublesome because of physical limitations and mobility restrictions. Methods In the present mixed-method study, 37 older adults (62-99 years old) with varying care needs and mobility restrictions watched a video presenting a walkthrough of a simulated digital nature landscape. Results Quantitative results show a significant increase in social connectedness scores and enhanced peacefulness after experiencing a digital nature. Qualitative results stress the importance of variations in nature scenery and highlight the influence of contextual and person-related factors including nature experiences throughout the life span and mobility constraints that older adults may face. Conclusion These findings testify to the potential of using digital nature as a complementary strategy when interactions with outdoor nature become increasingly difficult due to old age.
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Affiliation(s)
- Josca van Houwelingen-Snippe
- Department of Communication Science, Faculty of Behavioural, Management and Social Sciences, University of Twente, Enschede, The Netherlands
| | - Somaya Ben Allouch
- Digital Life, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
- Digital Interactions, Informatics Institute, University of Amsterdam, Amsterdam, The Netherlands
| | - Thomas J. L. van Rompay
- Department of Communication Science, Faculty of Behavioural, Management and Social Sciences, University of Twente, Enschede, The Netherlands
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McEwan K, Collett H, Nairn J, Bird J, Faghy MA, Pfeifer E, Jackson JE, Cook C, Bond A. The Feasibility and Impact of Practising Online Forest Bathing to Improve Anxiety, Rumination, Social Connection and Long-COVID Symptoms: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14905. [PMID: 36429623 PMCID: PMC9691063 DOI: 10.3390/ijerph192214905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/01/2022] [Accepted: 11/07/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Long-COVID affects over 144 million people globally. In the absence of treatments, there is a need to establish the efficacy of therapies that improve patient outcomes. Forest bathing has been demonstrated to improve physical and mental outcomes but there is no evidence in Long-COVID patients. Accordingly, this pilot study sought to determine the feasibility and effectiveness of online forest bathing in adults with Long-COVID. METHODS Feasibility was assessed by monitoring retention rates and participant feedback. In a waitlist controlled, repeated measures design, 22 Long-COVID patients completed weekly online surveys during a four-week waitlist control period, before engaging in four weekly online forest bathing sessions, completing post-intervention surveys following each session. RESULTS In terms of retention, 27% did not provide post-intervention data, reasons for non-adherence were: feeling too ill, having medical appointments, or having career responsibilities. Compared with the waitlist control period, there were statistically significant improvements in Anxiety (49% decrease), Rumination (48% decrease), Social Connection (78% increase), and Long-COVID symptoms (22% decrease). Written qualitative comments indicated that participants experienced feelings of calm and joy, felt more connected socially and with nature, and experienced a break from the pain and rumination surrounding their illness. CONCLUSIONS Online Forest bathing resulted in significant improvements in well-being and symptom severity and could be considered an accessible and inexpensive adjunct therapy for Long-COVID patients. Where people have limited access to in-person nature, virtual nature may offer an alternative to improve health and well-being outcomes.
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Affiliation(s)
- Kirsten McEwan
- College of Health, Psychology and Social Care, University of Derby, Kedleston Road, Derby DE22 1GB, UK
| | | | - Jean Nairn
- Woodlands Breathing, Edinburgh EH27 8BW, UK
| | - Jamie Bird
- College of Health, Psychology and Social Care, University of Derby, Kedleston Road, Derby DE22 1GB, UK
| | - Mark A. Faghy
- Biomedical Research Theme, School of Human Sciences, University of Derby, Derby DE22 1GB, UK
- Healthy Living for Pandemic Event Protection (HL–PIVOT) Network, Chicago, IL 60612, USA
| | - Eric Pfeifer
- Catholic University of Applied Sciences, Karlstr. 63, 79104 Freiburg, Germany
- Faculty of Psychotherapy Science, Sigmund Freud University Vienna, 1020 Vienna, Austria
| | - Jessica E. Jackson
- College of Health, Psychology and Social Care, University of Derby, Kedleston Road, Derby DE22 1GB, UK
| | | | - Amanda Bond
- Wild Edgewalker Forest Therapy, Jersey JE3 8AF, UK
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Tan J, Kannis-Dymand L, Jones C. Examining the potential of VR program Tilt Brush in reducing anxiety. VIRTUAL REALITY 2022; 27:1-13. [PMID: 36405877 PMCID: PMC9647245 DOI: 10.1007/s10055-022-00711-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 10/09/2022] [Indexed: 06/16/2023]
Abstract
Recent advancement in technology has made virtual reality (VR) more accessible and immersive than ever before, resulting in its increasing utility in various industries. Despite this, VR has remained an underutilised tool within clinical psychology. This study aimed to explore the potential of using VR for therapeutic benefits through examining the level of flow and anxiety-reducing effects of freeform drawing in real life (on paper) versus drawing in VR (using Tilt Brush) via a randomised-controlled trial with 40 participants. State and trait anxiety was measured using the State-Trait Anxiety Inventory, level of flow was measured using the Long Flow State Scale, and level of presence was measured using the iGroup Presence Questionnaire. Overall level of flow was not significantly different between both groups, implying drawing in VR induces as much flow as drawing in real life. Level of flow was positively correlated to level of presence experienced in the VR group (p < .01). Although there was no significant interaction effect, both groups experienced an overall decrease in state anxiety, with the VR group experiencing a significant reduction of state anxiety from pre- to post-test (p < .01).
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Affiliation(s)
- Janice Tan
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Maroochydore, QLD Australia
| | - Lee Kannis-Dymand
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Maroochydore, QLD Australia
| | - Christian Jones
- School of Law and Society, University of the Sunshine Coast, Maroochydore, QLD Australia
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Reece R, Bornioli A, Bray I, Alford C. Exposure to Green and Historic Urban Environments and Mental Well-Being: Results from EEG and Psychometric Outcome Measures. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13052. [PMID: 36293634 PMCID: PMC9603209 DOI: 10.3390/ijerph192013052] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/06/2022] [Accepted: 10/06/2022] [Indexed: 06/16/2023]
Abstract
Previous studies have identified the benefits of exposure to green or historic environments using qualitative methods and psychometric measures, but studies using a combination of measures are lacking. This study builds on current literature by focusing specifically on green and historic urban environments and using both psychological and physiological measures to investigate the impact of virtual exposure on well-being. Results from the psychological measures showed that the presence of historic elements was associated with a significantly stronger recuperation of hedonic tone (p = 0.01) and reduction in stress (p = 0.04). However, the presence of greenness had no significant effect on hedonic tone or stress. In contrast, physiological measures (EEG) showed significantly lower levels of alpha activity (p < 0.001) in occipital regions of the brain when participants viewed green environments, reflecting increased engagement and visual attention. In conclusion, this study has added to the literature by showing the impact that historic environments can have on well-being, as well as highlighting a lack of concordance between psychological and physiological measures. This supports the use of a combination of subjective and direct objective measures in future research in this field.
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Affiliation(s)
- Rebecca Reece
- Centre for Public Health and Wellbeing, University of the West of England, Bristol BS16 1QY, UK
| | - Anna Bornioli
- Erasmus Centre for Urban, Port and Transport Economics, Erasmus University Rotterdam, Burgemeester Oudlaan 50, 3062 PA Rotterdam, The Netherlands
| | - Isabelle Bray
- Centre for Public Health and Wellbeing, University of the West of England, Bristol BS16 1QY, UK
| | - Chris Alford
- Psychological Sciences Research Group, University of the West of England, Bristol BS16 1QY, UK
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Song R, Chen Q, Zhang Y, Jia Q, He H, Gao T, Qiu L. Psychophysiological restorative potential in cancer patients by virtual reality (VR)-based perception of natural environment. Front Psychol 2022; 13:1003497. [PMID: 36300069 PMCID: PMC9589456 DOI: 10.3389/fpsyg.2022.1003497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 08/31/2022] [Indexed: 12/03/2022] Open
Abstract
The positive significance of nature to human’ self-reported well-being has been widely confirmed, but less attention has been paid to the study of cancer patients, as well as the role of time on the restorative effects. Therefore, using virtual reality (VR) and the inclusion of patients with esophageal and gastrointestinal cancer as participants, this study conducted indoor experiments to explore patients’ psychophysiological recovery through the perception of five different environmental types with three to five interventions per week. There were 63 participants selected from the People’s Hospital in Shaanxi Province. Depending on their psychophysiological state, they would participate in three to five interventions in a week to compare the number of interventions needed to achieve maximum restoration. The five environmental types utilized varied in land cover, vegetation structure, and landscape characteristics, and were identified as blue space (BS), open green space (OGS), semi-open green space (SOS), closed green space (CGS), and gray space (GrS). Before and after viewing landscapes, the changes of psychophysiological indicators were measured to explore the influence of different environmental types on participants. The results showed that the participants preferred and received the highest perceived restorative potentials in BS and lastly, GrS. The green and blue spaces measurably increased positive emotions and perceived restoration while a decreasing negative emotions and the heart rate (HR) compared with the GrS. Participants had the highest level of relaxation while their eyes were closed in the EEG baseline stage. Moreover, participants received the most relaxation when they contacted with nature three times a week, which indicated that excessive natural participation may not be conducive to the sustained development of cancer patients’ psychophysiological health. Instead of field appreciation, VR could be utilized to increase the access of cancer patients to nature and then be used as an approach to landscape interaction.
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Affiliation(s)
- Rui Song
- College of Landscape Architecture and Art, Northwest A&F University, Xianyang, China
| | - Qujing Chen
- College of Landscape Architecture and Art, Northwest A&F University, Xianyang, China
| | - Ying Zhang
- Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
| | - Qing'an Jia
- Institute of Medical Research, Northwestern Polytechnical University, Xi’an, Shaanxi, China
| | - Hongyun He
- Town Planning and Designing Institute, Xi’an, Shaanxi, China
- *Correspondence: Hongyun He, ; Tian Gao, ; Ling Qiu,
| | - Tian Gao
- College of Landscape Architecture and Art, Northwest A&F University, Xianyang, China
- *Correspondence: Hongyun He, ; Tian Gao, ; Ling Qiu,
| | - Ling Qiu
- College of Landscape Architecture and Art, Northwest A&F University, Xianyang, China
- *Correspondence: Hongyun He, ; Tian Gao, ; Ling Qiu,
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Jones RJF, Littzen COR. An Analysis of Theoretical Perspectives in Research on Nature-Based Interventions and Pain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12740. [PMID: 36232042 PMCID: PMC9566272 DOI: 10.3390/ijerph191912740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/26/2022] [Accepted: 09/29/2022] [Indexed: 06/16/2023]
Abstract
Chronic pain results from a complex series of biomechanical, inflammatory, neurological, psychological, social, and environmental mechanisms. Pain and pain-related diseases are the leading causes of disability and disease burden globally. Employing nature-based interventions for the treatment of pain is an emerging field. Current theory driving the suggested mechanism(s) linking the pain reducing effects of nature-based interventions is lacking. A two-step approach was taken to complete a theoretical review and analysis. First, a literature review was completed to gather a substantive amount of research related to theoretical frameworks on the topic of nature-based interventions and pain. Secondly, a theoretical analysis as proposed by Walker and Avant was completed to explore current theoretical frameworks accepted in the literature on nature-based interventions and pain. Stress reduction theory and attention restoration theory were the most common theoretical frameworks identified. Neither theoretical framework explicitly identifies, describes, or intends to adequately measure the concept of pain, revealing a limitation for their application in research with nature-based interventions and pain. Theoretical development is needed, as it pertains to nature-based interventions and pain. Without this development, research on nature-based interventions and pain will continue to use proxy concepts for measurement and may result in misrepresented findings.
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Affiliation(s)
- Reo J. F. Jones
- School of Nursing, Oregon Health & Science University, Portland, OR 97239, USA
- School of Nursing and Health Innovations, The University of Portland, Portland, OR 97203, USA
| | - Chloé O. R. Littzen
- School of Nursing and Health Innovations, The University of Portland, Portland, OR 97203, USA
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Gladwin TE, Markwell N, Panno A. Do Semantic Vectors Contain Traces of Biophilic Connections Between Nature and Mental Health? ECOPSYCHOLOGY 2022. [DOI: 10.1089/eco.2022.0036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
| | | | - Angelo Panno
- Department of Human Science, The European University of Rome, Rome, Italy
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Reece R, Bornioli A, Bray I, Newbutt N, Satenstein D, Alford C. Exposure to Green, Blue and Historic Environments and Mental Well-Being: A Comparison between Virtual Reality Head-Mounted Display and Flat Screen Exposure. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159457. [PMID: 35954820 PMCID: PMC9368727 DOI: 10.3390/ijerph19159457] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 07/28/2022] [Accepted: 07/29/2022] [Indexed: 02/04/2023]
Abstract
Improving the mental health of urban residents is a global public health priority. This study builds on existing work that demonstrates the ability of virtual exposure to restorative environments to improve population mental health. It compares the restorative effects of green, blue and historic environments delivered by both flat screen and immersive virtual reality technology, and triangulates data from psychological, physiological and qualitative sources. Results from the subjective measure analyses showed that exposures to all the experimental videos were associated with self-reported reduced anxiety and improved mood, although the historic environment was associated with a smaller reduction of anxiety (p < 0.01). These results were supported by the qualitative accounts. For two of the electroencephalography (EEG) frequency bands, higher levels of activity were observed for historic environments. In relation to the mode of delivery, the subjective measures did not suggest any effect, while for the EEG analyses there was evidence of a significant effect of technology across three out of four frequency bands. In conclusion, this study adds to the evidence that the benefits of restorative environments can be delivered through virtual exposure and suggests that virtual reality may provide greater levels of immersion than flat screen viewing.
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Affiliation(s)
- Rebecca Reece
- Centre for Public Health and Wellbeing, University of the West of England, Bristol BS16 1QY, UK;
- Correspondence:
| | - Anna Bornioli
- Erasmus Centre for Urban, Port and Transport Economics, Erasmus University Rotterdam, Burgemeester Oudlaan 50, 3062 PA Rotterdam, The Netherlands;
| | - Isabelle Bray
- Centre for Public Health and Wellbeing, University of the West of England, Bristol BS16 1QY, UK;
| | - Nigel Newbutt
- College of Education, School of Teaching and Learning, Institute of Advanced Learning Technologies, University of Florida, Gainesville, FL 32611, USA;
| | - David Satenstein
- Department of Education and Childhood, Faculty of Arts, Creative Industries and Education, University of the West of England, Bristol BS16 1QY, UK;
| | - Chris Alford
- Psychological Sciences Research Group, University of the West of England, Bristol BS16 1QY, UK;
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Thunström AO, Sarajlic Vukovic I, Ali L, Larson T, Steingrimsson S. Prevalence of virtual reality (VR) games found through mental health categories on STEAM: a first look at VR on commercial platforms as tools for therapy. Nord J Psychiatry 2022; 76:474-485. [PMID: 34851240 DOI: 10.1080/08039488.2021.2003859] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Immersive virtual reality (VR) games are increasingly becoming part of everyday life. Several studies support immersive VR technology as a treatment method for mental health problems. There is however little insight into the prevalence of commercially available VR games for treatment of mental health problems on commercial platforms such as STEAM, and to what extent they can be used as tools for treatment or add-on treatment of mental health problems. OBJECTIVE The aim of this study was to take a first look at the prevalence and overview of content of commercially available games. The games were found using search words related to psychiatric diagnosis or care. METHODS We performed a search for keywords related to symptoms, diagnosis, and treatment strategies of mental health problems. The search was performed November 2020 on STEAM. A scheme was created for elimination and inclusion of games, eliminating those games which were irrelevant to mental health or had triggering elements such as violence, excessive movement which could trigger nausea, horror and pornographic imagery. RESULTS In total, 735 hits were found, 565 unique games. After the games were reviewed for content via trailers, descriptions and screenshots, 32%, i.e. 182 games passed the inclusion criteria. Majority of the games which were excluded were either not connected to mental health, contained violence, adult content or were in other ways irrelevant or inappropriate. CONCLUSIONS Commercial platforms are only at the beginning of the development towards therapeutic content. Currently the quality and usability for therapeutic use is scarce but holds great potential.
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Affiliation(s)
- Almira Osmanovic Thunström
- Region Västra Götaland, Psykiatri Affektiva, Department of Psychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden.,Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Iris Sarajlic Vukovic
- Region Västra Götaland, Psykiatri Affektiva, Department of Psychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Lilas Ali
- Region Västra Götaland, Psykiatri Affektiva, Department of Psychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden.,Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Tomas Larson
- Region Västra Götaland, Psykiatri Affektiva, Department of Psychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Steinn Steingrimsson
- Region Västra Götaland, Psykiatri Affektiva, Department of Psychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden.,Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
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Chin S, Cavadino A, Akroyd A, Tennant G, Dobson R, Gautier A, Reynolds L. An Investigation of Virtual Reality Nature Experiences in Patients With Metastatic Breast Cancer: Secondary Analysis of a Randomized Controlled Trial. JMIR Cancer 2022; 8:e38300. [PMID: 35867398 PMCID: PMC9356329 DOI: 10.2196/38300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/24/2022] [Accepted: 06/11/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Connection with nature has well-established physical and psychological benefits. However, women with metastatic breast cancer (MBC) are often unable to access nature because of physical limitations, psychological barriers, and treatment demands. Virtual reality (VR) nature experiences offer an alternative means of connecting with nature and may be of particular benefit to patients with cancer who are house- or hospital-bound. OBJECTIVE This study aims to explore whether VR nature experiences are associated with physical and psychological benefits for women with MBC who are disconnected with nature. METHODS This secondary analysis of a previous randomized controlled crossover trial recruited participants from the emailing lists of breast cancer support organizations. Participants were provided VR headsets for daily use in their homes for over 3 weeks. In the first week, participants used 1 of 2 VR nature experiences (Ripple or Happy Place) daily, followed by a 1-week washout period, before using the other VR experience every day for the final week. Outcomes assessed changes between baseline and postintervention scores in quality of life (EQ-5D-5L), pain (Brief Pain Inventory Short Form), fatigue (Functional Assessment of Chronic Illness Therapy-fatigue), depression (Depression, Anxiety, and Stress Scale-depression), anxiety (Depression, Anxiety, and Stress Scale-anxiety), and spiritual well-being (Functional Assessment of Chronic Illness Therapy- Spiritual Well-being) and investigated whether benefits were greater in participants who were not strongly connected with nature at baseline. RESULTS A total of 38 women with MBC completed the VR interventions and were included in the analyses. Participants reported significantly less fatigue (P=.001), less depression (P<.001), and greater quality of life (P=.02) following the interventions than at baseline. Women with a weaker connection to nature reported greater fatigue (P=.03), depression (P=.006), and anxiety (P=.001), and poorer spirituality (P=.004) than their strongly connected counterparts. Only those with a weaker baseline connection with nature showed improvements in depression following the intervention (P=.03), with similar trends observed in fatigue (P=.07) and quality of life (P=.10). CONCLUSIONS This study provides preliminary evidence that feeling connected with nature is associated with better physical and psychological status in patients with MBC and that VR nature interventions might be beneficial for this clinical population. Future studies should focus on activities that encourage connection with nature (rather than simply exposure to nature) and investigate the aspects of VR nature interventions that have the greatest therapeutic potential. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12619001480178; https://tinyurl.com/et6z3vac.
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Affiliation(s)
- Stanley Chin
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
| | - Alana Cavadino
- Section of Epidemiology and Biostatistics, The University of Auckland, Auckland, New Zealand
| | - Amelia Akroyd
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
| | - Geraldine Tennant
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
| | - Rosie Dobson
- National Institute for Health Innovation, The University of Auckland, Auckland, New Zealand
| | | | - Lisa Reynolds
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
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Litleskare S, Fröhlich F, Flaten OE, Haile A, Kjøs Johnsen SÅ, Calogiuri G. Taking real steps in virtual nature: a randomized blinded trial. VIRTUAL REALITY 2022; 26:1777-1793. [PMID: 35818369 PMCID: PMC9261150 DOI: 10.1007/s10055-022-00670-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 06/08/2022] [Indexed: 06/15/2023]
Abstract
Studies show that green exercise (i.e., physical activity in the presence of nature) can provide the synergistic psychophysiological benefits of both physical exercise and nature exposure. The present study aimed to investigate the extent to which virtual green exercise may extend these benefits to people that are unable to engage in active visits to natural environments, as well as to promote enhanced exercise behavior. After watching a video validated to elicit sadness, participants either performed a treadmill walk while exposed to one of two virtual conditions, which were created using different techniques (360° video or 3D model), or walked on a treadmill while facing a blank wall (control). Quantitative and qualitative data were collected in relation to three overarching themes: "Experience," "Physical engagement" and "Psychophysiological recovery." Compared to control, greater enjoyment was found in the 3D model, while lower walking speed was found in the 360° video. No significant differences among conditions were found with respect to heart rate, perceived exertion, or changes in blood pressure and affect. The analysis of qualitative data provided further understanding on the participants' perceptions and experiences. These findings indicate that 3D model-based virtual green exercise can provide some additional benefits compared to indoor exercise, while 360° video-based virtual green exercise may result in lower physical engagement.
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Affiliation(s)
- Sigbjørn Litleskare
- Department of Public Health and Sport Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
| | - Fred Fröhlich
- Game School–Department of Game Development, Inland Norway University of Applied Sciences, Hamar, Norway
| | - Ole Einar Flaten
- Game School–Department of Game Development, Inland Norway University of Applied Sciences, Hamar, Norway
| | - Amelia Haile
- Department of Public Health and Sport Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
| | - Svein Åge Kjøs Johnsen
- Department of Psychology, Inland Norway University of Applied Sciences, Lillehammer, Norway
| | - Giovanna Calogiuri
- Department of Public Health and Sport Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
- Department of Nursing and Health Sciences, Centre for Health and Technology, University of South-Eastern Norway, Drammen, Norway
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VR in Nursing Facilities - A randomized controlled multicenter pilot study analyzing the changes in the state of mind of seniors in nursing facilities through the viewing of 360° videos. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-022-01721-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Abstract
Context
VR as an application to enhance well-being is sparsely researched in the elderly population. The aim of the pilot study was to analyze the effect of 360° videos of different categories on the state of mind of seniors in nursing facilities. Furthermore, for the implementation in everyday life, the usability of the system and the experience for seniors should be evaluated.
Methods
The VR experience was used as a supplement to existing care services in three facilities on eight subjects. Mood state was assessed using the Questionnaire for the Assessment of Happiness before and after the intervention. Demographic data and technology acceptance were collected beforehand. After the intervention, subjects were interviewed about confounding factors and side effects, and nursing home staff were interviewed about the usability of the system and the organizational concept of implementation.
Results
There was a positive effect on state of mind. Gender and spatial mobility turned out to be influencing factors. Categories containing people, animals and action achieved the highest increases in the state of mind. Interest in using technical devices correlated negatively with the change in mood state. None of the subjects found the VR goggles distracting or reported motion sickness. Very good usability was indicated by the employees.
Conclusion
A very high willingness to use this technology was found among nursing staff and residents. The tendencies of the positive effect of 360° videos on the state of mind, as well as differentiation based on the mentioned characteristics gender and spatial mobility, should be verified by a larger sample to empirically validate the use of this technology to increase the quality of life.
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Ibrahim YA, Saravanamuttoo T, Johnson SA. Viewing Digital Nature Scenes Not Sufficient to Enhance Verbal Creativity in Children. ECOPSYCHOLOGY 2022. [DOI: 10.1089/eco.2021.0037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Yasmeen A. Ibrahim
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Canada
| | | | - Shannon A. Johnson
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Canada
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Ross AM, Jones RJF. Simulated Forest Immersion Therapy: Methods Development. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095373. [PMID: 35564767 PMCID: PMC9105281 DOI: 10.3390/ijerph19095373] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/25/2022] [Accepted: 04/27/2022] [Indexed: 02/01/2023]
Abstract
Shinrin-yoku, forest bathing, may provide relief from chronic and breakthrough pain in patients with axial spondyloarthritis and improve immune function through increasing NK cell numbers and activity and their downstream effectors, perforin and granulysin, after chemo- or radiation therapy in breast and prostate cancer patients. The aim of this paper is to describe the study protocol for a simulated forest immersion therapy using virtual reality and atomized phytoncides, volatile organic compounds found in forested areas designed to effect positive change for these two patient populations. The setting, including the room set up and samples with inclusion/exclusion specific to this type of intervention, is outlined. Measures and calibration procedures pertinent to determining the feasibility of simulated forest immersion therapy are presented and include: ambient and surface room temperatures and relative humidity in real time, ambient ultrafine particulate matter, ambient droplet measurement that coincides with volatile organic compounds, specific phytoncides, and virtual reality and atomization of phytoncide set up. Particular lessons learned while training and setting up the equipment are presented. Simulated forest immersion therapy is possible with attention to detail during this early phase when development of methods, equipment testing, and feasibility in deploying the intervention become operational. The expected outcome of the development of the methods for this study is the creation of a standardized approach to simulating forest therapy in a controlled laboratory space.
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Meyer ML, Kaesler A, Wolffgramm S, Perić NL, Bunjaku G, Dickmann L, Serino S, Di Lernia D, Tuena C, Bernardelli L, Pedroli E, Wiederhold BK, Riva G, Shiban Y. COVID Feel Good: Evaluation of a Self-Help Protocol to Overcome the Psychological Burden of the COVID-19 Pandemic in a German Sample. J Clin Med 2022; 11:jcm11082080. [PMID: 35456172 PMCID: PMC9029872 DOI: 10.3390/jcm11082080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 03/30/2022] [Accepted: 04/01/2022] [Indexed: 01/27/2023] Open
Abstract
The COVID-19 pandemic has severe consequences for physical as well as mental well-being. In times of restricted social contact, online self-help programs offer a low-threshold first aid to cope with the psychological burden. This current study evaluates the online self-help protocol “COVID Feel Good” in a German sample. The multicentric study was designed as a single cohort with a waiting list control condition. The convenience sample consisted of 38 German individuals who experienced at least two months of restrictions during the COVID-19 pandemic. The 7-day self-help protocol included the VR video “Secret Garden” as well as a social or cognitive exercise each day. General distress, depression, anxiety, stress, and hopelessness were assessed as primary outcomes. Social connectedness and fear of coronavirus were measured as secondary outcomes. Results showed a significant decrease in all primary outcomes except for hopelessness. Furthermore, the results indicated a significant improvement in social connectedness. Treatment effects on general distress, depression, stress, and anxiety persisted for two weeks after participation. The present study indicates that VR-based self-help protocols can mitigate the psychological burden associated with the pandemic, supporting recent findings.
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Affiliation(s)
- Marie Lisa Meyer
- Department of Psychology, Private University of Applied Science, 37073 Goettingen, Germany; (M.L.M.); (A.K.); (S.W.); (N.L.P.); (G.B.); (L.D.)
| | - Arne Kaesler
- Department of Psychology, Private University of Applied Science, 37073 Goettingen, Germany; (M.L.M.); (A.K.); (S.W.); (N.L.P.); (G.B.); (L.D.)
| | - Stefanie Wolffgramm
- Department of Psychology, Private University of Applied Science, 37073 Goettingen, Germany; (M.L.M.); (A.K.); (S.W.); (N.L.P.); (G.B.); (L.D.)
| | - Nicolina Laura Perić
- Department of Psychology, Private University of Applied Science, 37073 Goettingen, Germany; (M.L.M.); (A.K.); (S.W.); (N.L.P.); (G.B.); (L.D.)
| | - Gentian Bunjaku
- Department of Psychology, Private University of Applied Science, 37073 Goettingen, Germany; (M.L.M.); (A.K.); (S.W.); (N.L.P.); (G.B.); (L.D.)
| | - Lilith Dickmann
- Department of Psychology, Private University of Applied Science, 37073 Goettingen, Germany; (M.L.M.); (A.K.); (S.W.); (N.L.P.); (G.B.); (L.D.)
| | - Silvia Serino
- Department of Psychology, Università Cattolica del Sacro Cuore, 20123 Milan, Italy; (S.S.); (D.D.L.)
| | - Daniele Di Lernia
- Department of Psychology, Università Cattolica del Sacro Cuore, 20123 Milan, Italy; (S.S.); (D.D.L.)
| | - Cosimo Tuena
- Humane Technology Lab, Università Cattolica del Sacro Cuore, 20123 Milan, Italy; (C.T.); (G.R.)
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, 20149 Milan, Italy;
| | | | - Elisa Pedroli
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, 20149 Milan, Italy;
- Faculty of Psychology, University of eCampus, 22060 Novedrate, Italy
| | - Brenda K. Wiederhold
- Virtual Reality Medical Center, La Jolla, CA 92037, USA;
- Virtual Reality Medical Institute, 1200 Brussels, Belgium
| | - Giuseppe Riva
- Humane Technology Lab, Università Cattolica del Sacro Cuore, 20123 Milan, Italy; (C.T.); (G.R.)
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, 20149 Milan, Italy;
| | - Youssef Shiban
- Department of Psychology, Private University of Applied Science, 37073 Goettingen, Germany; (M.L.M.); (A.K.); (S.W.); (N.L.P.); (G.B.); (L.D.)
- Correspondence:
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A mixed-methods exploration of virtual reality as a tool to promote green exercise. Sci Rep 2022; 12:5715. [PMID: 35383263 PMCID: PMC8983725 DOI: 10.1038/s41598-022-09622-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 03/21/2022] [Indexed: 12/29/2022] Open
Abstract
The salutogenic effects of green exercise are widely recognised, yet many individuals do not engage in this health-related behaviour. Using a convergent mixed methods approach, this study explored the impact of experiencing nature through Virtual Reality (VR) on the decision-making process relating to green exercise. Three experimental trials were conducted (overall n = 136), in which healthy adults were exposed to different VR scenarios reproducing a virtual walk in an existing urban green area. Participants reported medium–high rating of intent to visit the location. Significant pre-to-post increments in future green exercise intention were observed after the VR exposure, though a significance difference was not achieved in comparison with a control condition. Qualitative analysis revealed the impact of the VR experience on behaviour regulation, and highlighted the pivotal role of anticipated emotional benefits. Despite scepticism, the VR experience was effective in arousing curiosity to explore natural environments, which was associated with environmental perceptions as well as nostalgic and socio-cultural perspectives.
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Darcy PM, Taylor J, Mackay L, Ellis NJ, Gidlow CJ. Understanding the Role of Nature Engagement in Supporting Health and Wellbeing during COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073908. [PMID: 35409590 PMCID: PMC8997429 DOI: 10.3390/ijerph19073908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/17/2022] [Accepted: 03/23/2022] [Indexed: 12/04/2022]
Abstract
The importance of natural environments in supporting health and wellbeing has been well evidenced in supporting positive mental and physical health outcomes, including during periods of crisis and stress. Given the disproportionate impacts of the COVID-19 pandemic have been greatest for those who are most vulnerable, understanding the role of natural environment and alternative forms of nature engagement in supporting health and wellbeing for vulnerable groups is important. This study explored how nature engagement supported health and wellbeing in those with a pre-existing health condition during the first UK lockdown. Semi-structured interviews were conducted with 17 adults with a pre-existing health condition and analysed using Interpretative Phenomenological Analysis (IPA). Four themes were identified: COVID-19 versus nature; Nature as an extension and replacement; Nature connectedness; and Therapeutic nature. The findings show the importance of nature in supporting health and wellbeing in those with a pre-existing health condition through engagement with private and public natural environments, micro-restorative opportunities, nature connection as an important pathway, and the therapeutic benefits of nature engagement. The present research extends the evidence-base beyond patterns of nature engagement to a deeper understanding of how those with existing health conditions perceived and interacted with nature in relation to their health and wellbeing during the first UK lockdown. Findings are discussed in relation to health supporting environments, micro-restorative opportunities, and policy implications.
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Affiliation(s)
- Patricia M. Darcy
- Centre for Health and Development, Staffordshire University, Stoke-on-Trent ST4 2DF, UK; (N.J.E.); (C.J.G.)
- Correspondence:
| | - Jennifer Taylor
- School of Health, Science and Wellbeing, Staffordshire University, Stoke-on-Trent ST4 2DE, UK; (J.T.); (L.M.)
| | - Lorna Mackay
- School of Health, Science and Wellbeing, Staffordshire University, Stoke-on-Trent ST4 2DE, UK; (J.T.); (L.M.)
| | - Naomi J. Ellis
- Centre for Health and Development, Staffordshire University, Stoke-on-Trent ST4 2DF, UK; (N.J.E.); (C.J.G.)
| | - Christopher J. Gidlow
- Centre for Health and Development, Staffordshire University, Stoke-on-Trent ST4 2DF, UK; (N.J.E.); (C.J.G.)
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Not all types of nature have an equal effect on urban residents' well-being: A structural equation model approach. Health Place 2022; 74:102759. [PMID: 35255415 DOI: 10.1016/j.healthplace.2022.102759] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 12/22/2021] [Accepted: 01/24/2022] [Indexed: 01/05/2023]
Abstract
A growing amount of research shows a positive association between urban nature and urban residents' psychological and physical well-being and quality of life. With its focus on specific dimensions of well-being and reliance either on large-scale objective data sets or experimental and comparative designs, prior research does not explicitly address the relationships between the various types of urban nature as experienced by citizens and their overall well-being. The present research proposes a model for the potential influence of the perceptions of the type and characteristics of nature close to urban residences and citizens' well-being via their frequency of exposure to, and their activities in, nature. Using WHOQOL-26 as a measure of well-being and constructing or adapting measurements for the other variables, a questionnaire was designed and administered among a sample of 2500 French urban residents. Psychometric tests, structural equation modeling, and mediation analyses were conducted on the collected data. The results show that: (1) The perceived characteristics of nature near urban residences have both direct and indirect influences on the psychological, physical, environmental, and resources-related dimensions of citizens' well-being; (2) Less domesticated nature-forests, fields, and scrubland-contributes to psychological well-being by favoring light or calm activities in nature, and to physical well-being by supporting exposure to nature. Such wilder nature is also positively associated with the perceived quality of urban residences; (3) Small spots of nature, located close to one's residence-a balcony, a patio, or a roof garden-make a similar but smaller contribution to well-being; (4) Domesticated nature-city gardens and parks-contribute marginally to the physical and resources-related dimensions of well-being. These results complement past research on the perceived characteristics of nature by showing how nature, as experienced by urban citizens, refers to different vegetation spaces. They also invite urban planners and policymakers to acknowledge the positive association between "wilder" natural spaces and well-being.
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Greenspace, Inflammation, Cardiovascular Health, and Cancer: A Review and Conceptual Framework for Greenspace in Cardio-Oncology Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042426. [PMID: 35206610 PMCID: PMC8872601 DOI: 10.3390/ijerph19042426] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 02/12/2022] [Accepted: 02/17/2022] [Indexed: 02/04/2023]
Abstract
Cardiovascular disease (CVD) is a leading cause of global morbidity and mortality. Cancer survivors have significantly elevated risk of poor cardiovascular (CV) health outcomes due to close co-morbid linkages and shared risk factors between CVD and cancer, as well as adverse effects of cancer treatment-related cardiotoxicity. CVD and cancer-related outcomes are exacerbated by increased risk of inflammation. Results from different pharmacological interventions aimed at reducing inflammation and risk of major adverse cardiovascular events (MACEs) have been largely mixed to date. Greenspaces have been shown to reduce inflammation and have been associated with CV health benefits, including reduced CVD behavioral risk factors and overall improvement in CV outcomes. Greenspace may, thus, serve to alleviate the CVD burden among cancer survivors. To understand pathways through which greenspace can prevent or reduce adverse CV outcomes among cancer survivors, we review the state of knowledge on associations among inflammation, CVD, cancer, and existing pharmacological interventions. We then discuss greenspace benefits for CV health from ecological to multilevel studies and a few existing experimental studies. Furthermore, we review the relationship between greenspace and inflammation, and we highlight forest bathing in Asian-based studies while presenting existing research gaps in the US literature. Then, we use the socioecological model of health to present an expanded conceptual framework to help fill this US literature gap. Lastly, we present a way forward, including implications for translational science and a brief discussion on necessities for virtual nature and/or exposure to nature images due to the increasing human-nature disconnect; we also offer guidance for greenspace research in cardio-oncology to improve CV health outcomes among cancer survivors.
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‘That is a place where I would want to go’: investigating digital nature to enhance social wellbeing among older adults. AGEING & SOCIETY 2022. [DOI: 10.1017/s0144686x2100177x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Feelings of disconnectedness and social isolation among older adults are increasingly recognised as important challenges of our times. Interestingly, nature interaction can stimulate social connectedness and enhance perceived social support, indicating that nature can contribute to social wellbeing. However, nature may not always be around or accessible for older adults. In such cases, digital nature could provide an alternative means for enjoying nature's benefits. To identify limitations and restrictions that older adults experience with respect to nature interaction, and to explore preferences with respect to digital nature and their potential for influencing social wellbeing, two studies are reported: a qualitative study comprising focus groups with Dutch care centre residents (N = 26) and a subsequent quantitative study (N = 200) testing effects of digital landscapes on social wellbeing measures. Findings from the focus groups indicate that opportunities for nature interaction and preferences for digital nature vary with mobility restrictions, whereas findings from the quantitative study testify to the potential of digital nature for enhancing social wellbeing and related emotions. These findings extend research on how (digital) nature interventions can contribute to the social wellbeing of older adults and pinpoint essential nature characteristics important for doing so.
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Croghan IT, Hurt RT, Aakre CA, Fokken SC, Fischer KM, Lindeen SA, Schroeder DR, Ganesh R, Ghosh K, Bauer BA. Virtual Reality for Health Care Professionals During a Pandemic: A Pilot Program. J Prim Care Community Health 2022; 13:21501319221086716. [PMID: 35352605 PMCID: PMC8972930 DOI: 10.1177/21501319221086716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Objective: The purpose of this pilot study was to evaluate the safety and use of a nature-based virtual reality (VR) experience among health care providers (HCP) during a pandemic. Methods: Twenty-four frontline HCP participated in this crossover pilot where the viewing order of the experiences were randomized. All participants attended in-person consent, baseline, and end-of-study visits. The intervention consisted of viewing 2 nature-based scenes (“walk in the woods” and “forest of focus”) through 3-D VR and with computer 4K graphic imagery. Randomization took place with regards to the viewing order (VR vs 4K computer video, scene 1 and 2). Outcomes measured were safety, acceptability and changes in intensity of anxiety feelings, resilience, emotional distress, cognitive function, and self-efficacy. Results: Among the 26 HCP expressing interest in the study, 24 enrolled in this study. The majority were male (58.3%), white (66.7%) and of an average age of 46.3 ± 10.5 years (standard deviation (SD)). End of the study survey showed that almost all participants (96%) would participate in the study again and recommend it to others. Twenty-three of the 24 participants also felt relaxed after seeing the imagery. With respect to anxiety (as measured by the STAI Y1), the VR “walk in the woods” had the greatest reduction from pre to post (6.4 points, SD = 5.98) followed by VR “forest of focus” (5.8 points, SD = 9.29), computer screen “forest of focus” (5.0 points, SD = 8.89), and computer screen “walk in the woods” (4.1 points, SD = 6.22). All 4 sessions had a significant decrease in score from pre to post (P-values ≤.005), but there was no significant difference in the change from pre- to post-session between the 4 groups (P-value = .5835). Conclusion: The use of the VR among HCP has promise for reducing stress among health care providers during a high stress period, such as a pandemic but much larger studies are needed.
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