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Czakert J, Kandil FI, Boujnah H, Tavakolian P, Blakeslee SB, Stritter W, Dommisch H, Seifert G. Scenting serenity: influence of essential-oil vaporization on dental anxiety - a cluster-randomized, controlled, single-blinded study (AROMA_dent). Sci Rep 2024; 14:14143. [PMID: 38898054 PMCID: PMC11187188 DOI: 10.1038/s41598-024-63657-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 05/30/2024] [Indexed: 06/21/2024] Open
Abstract
Dental fear and anxiety (DFA) is known as an immense challenge in oral healthcare, which can result in compromised oral health, pain, and uncomfortable treatment. The objective of this study was to analyze the effect of essential-oil vaporization on acute anxiety of patients in dental practices. Four dental practices used five weekly cycles of vaporization with each scent: Orange (Citrus sinensis), Swiss Pine (Pinus cembra), Good Mood (blended essential oils: Citrus sinensis, Citrus aurantifolia, Citrus limon, Osmanthus fragrance (5%)), Forest Walk (blended essential oils: Abies grandis, Pinus cembra, Myrtus communis c. t. 1,8-cineol, Abies alba, Citrus paradisi, Abies sibirica, Pseudotsuga menziesii, Vetiveria zizanoides), and water. Acute anxiety was the primary outcome (state-trait-anxiety inventory (STAI-S)). Secondary outcomes were trait anxiety (STAI-T), dental anxiety (Kleinknecht dental fear survey), and pain perception in treatment (numeric rating scale). Across all patients (n = 486), STAI-S was slightly higher in the control group (40.7 ± 11.6) than in the intervention groups (38.4 ± 10.5). Post-hoc analyses revealed that the effect is only robust for the subgroup of female patients (n = 296, p = 0.044). We also conducted a post-hoc additional analysis on a subpopulation with an increased level of STAI-T ≥ 42 (n = 131 patients). For this group the difference in acute anxiety between the control group (51.1 ± 11.9, n = 30) vs. the intervention groups (46.8 ± 9.6, n = 118) was significant (T = 4.39, p = 0.0379). The results of the study indicate a promising potential of essential-oil vaporization to alleviate dental anxiety, particularly in the subgroups of patients with a high level of trait anxiety, and particularly in female patients. The calming effects of the essential-oil vaporization were also highlighted by the anecdotical statements of the dental-practice staff. The anxiety-reducing role of essential-oil vaporization alone and as one part of combined techniques to counter DFA should be further explored using multi-perspective methodological approaches in research.
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Affiliation(s)
- Judith Czakert
- Department of Pediatric Oncology and Hematology, Research Group: Prevention, Integrative Medicine and Health Promotion, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany.
| | - Farid I Kandil
- Department of Nephrology and Medical Intensive Care, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
| | - Hiba Boujnah
- Department of Pediatric Oncology and Hematology, Research Group: Prevention, Integrative Medicine and Health Promotion, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
| | - Pantea Tavakolian
- Department of Pediatric Oncology and Hematology, Research Group: Prevention, Integrative Medicine and Health Promotion, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
| | - Sarah B Blakeslee
- Department of Pediatric Oncology and Hematology, Research Group: Prevention, Integrative Medicine and Health Promotion, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
| | - Wiebke Stritter
- Department of Pediatric Oncology and Hematology, Research Group: Prevention, Integrative Medicine and Health Promotion, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
| | - Henrik Dommisch
- Department of Periodontology, Oral Medicine and Oral Surgery, Dentistry, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
| | - Georg Seifert
- Department of Pediatric Oncology and Hematology, Research Group: Prevention, Integrative Medicine and Health Promotion, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
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Derrien MM, Bratman GN, Cerveny LK, Levy C, Blahna DJ, Frank P, Serio N. Public nature and health for homeless populations: Professionals' perceptions of contingent human benefits and harms. Soc Sci Med 2024; 347:116764. [PMID: 38513561 DOI: 10.1016/j.socscimed.2024.116764] [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: 07/07/2023] [Revised: 01/12/2024] [Accepted: 03/05/2024] [Indexed: 03/23/2024]
Abstract
This article investigates relationships between public nature and health for unsheltered homeless populations. It examines perceptions of health benefits and harms for people living in public natural areas including local, state, and national forests and parks in the Seattle metropolitan area (USA). Interviews with environmental, social service, and law enforcement professionals who regularly interact with this vulnerable population were conducted and thematically analyzed to understand perceptions of physical and mental health outcomes. Results show professionals' perspectives on the health benefits and detriments of time spent in natural environments and the contextual factors perceived to influence health. Interviewees' observations about the variability of personal circumstances and biophysical, social, and weather conditions encourage the nuanced consideration of how contingent therapeutic landscapes provide deeply needed benefits, but for a population with a diminished capacity to adapt when conditions change. We conclude with insights for future research that directly assesses homeless populations' exposures and health outcomes of living in public natural areas.
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Affiliation(s)
- Monika M Derrien
- US Department of Agriculture Forest Service, Pacific Northwest Research Station, Seattle, WA, 98103, USA.
| | - Gregory N Bratman
- School of Environmental and Forest Sciences, University of Washington, Seattle, WA, 98195, USA; Department of Psychology, University of Washington, Seattle, WA, 98195, USA; Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, 98195, USA
| | - Lee K Cerveny
- US Department of Agriculture Forest Service, Pacific Northwest Research Station, Seattle, WA, 98103, USA
| | - Chaja Levy
- School of Environmental and Forest Sciences, University of Washington, Seattle, WA, 98195, USA
| | - Dale J Blahna
- US Department of Agriculture Forest Service, Pacific Northwest Research Station, Seattle, WA, 98103, USA
| | - Paulo Frank
- School of Environmental and Forest Sciences, University of Washington, Seattle, WA, 98195, USA
| | - Naomi Serio
- School of Environmental and Forest Sciences, University of Washington, Seattle, WA, 98195, USA
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Bohdan K, Honeychurch KC. Under-researched and under-reported new findings in microplastic field. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 918:170466. [PMID: 38286279 DOI: 10.1016/j.scitotenv.2024.170466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 01/22/2024] [Accepted: 01/24/2024] [Indexed: 01/31/2024]
Abstract
After over 20 years of research on microplastic (MP) pollution, there are important areas of study which are still at the inception. In particular, between 2020 and 2023 new findings on MP have emerged, which open new sub-categories of MP research. These research areas include sea surface MP ejection, direct and indirect MP influence on climate and hydrological cycle, small and nano-sized MP analysis and the relationship between MP size and abundance. Not reported or barely mentioned in previous reviews, these globally-relevant findings are here highlighted and discussed with aim to promote their further research that will potentially result in new evidence of detrimental effects of MP pollution on the biosphere.
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Affiliation(s)
- Krzysztof Bohdan
- School of Applied Sciences, University of the West of England, Bristol, Frenchay Campus, Coldharbour Lane, Bristol BS16 1QY, UK.
| | - Kevin C Honeychurch
- School of Applied Sciences, University of the West of England, Bristol, Frenchay Campus, Coldharbour Lane, Bristol BS16 1QY, UK.
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Morita E, Kadotani H, Yamada N, Sasakabe T, Kawai S, Naito M, Tamura T, Wakai K. The Inverse Association between the Frequency of Forest Walking (Shinrin-yoku) and the Prevalence of Insomnia Symptoms in the General Japanese Population: A Japan Multi-Institutional Collaborative Cohort Daiko Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:350. [PMID: 38541349 PMCID: PMC10970638 DOI: 10.3390/ijerph21030350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 03/01/2024] [Accepted: 03/03/2024] [Indexed: 04/07/2024]
Abstract
Since a single forest walk (Shinrin-yoku or forest bathing) session is reported to improve sleep temporarily, occasional forest walks may have a positive effect on daily sleep. Therefore, this study aimed to examine whether more frequent forest walking is associated with better daily sleep conditions. Data from the second survey of the Japan Multi-Institutional Collaborative Cohort (J-MICC) Daiko Study conducted among residents of Nagoya City, Japan, were used. The study design was a cross-sectional study. In total, 2044 participants (529 men and 1515 women; age, mean ± standard deviation: 58.8 ± 9.9 years) were included in the analysis. Frequent forest walks were associated with a low percentage of insomnia symptoms (Insomnia Severity Index ≥10) in women, but not in men. The adjusted odds ratio for the group that rarely took forest walks with reference to the group that engaged in the activity once a month or more often was 2.04 (95% confidence interval: 1.29-3.23) in women. Forest walk frequency was not significantly associated with sleep duration or sleep efficiency as measured by actigraphy in either men or women. In conclusion, the results suggested that increasing the frequency of forest walks or Shinrin-yoku may be effective in preventing insomnia in women.
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Grants
- Priority Areas of Cancer (No. 17015018) Ministry of Education, Culture, Sports, Science and Technology, Japan.
- Innovative Areas (No. 221S0001) Ministry of Education, Culture, Sports, Science and Technology, Japan.
- JSPS KAKENHI Grant (No. 16H06277, 18K11065, 21H02246, 22H04923 and No. 26507005) Ministry of Education, Culture, Sports, Science and Technology, Japan.
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Affiliation(s)
- Emi Morita
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Japan
- Forestry and Forest Products Research Institute, Forest Research and Management Organization, 1 Matsunosato, Tsukuba 305-8687, Japan
| | - Hiroshi Kadotani
- Department of Psychiatry, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu 520-2192, Japan; (H.K.); (N.Y.)
| | - Naoto Yamada
- Department of Psychiatry, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu 520-2192, Japan; (H.K.); (N.Y.)
- Kanbayashi Memorial Hospital, 89-1 Orikuchinishi, Okucho, Ichinomiya 491-0201, Japan
| | - Tae Sasakabe
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Nagoya 466-8550, Japan; (T.S.); (T.T.); (K.W.)
- Department of Public Health, Aichi Medical University School of Medicine, Nagakute 480-1195, Japan
| | - Sayo Kawai
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Nagoya 466-8550, Japan; (T.S.); (T.T.); (K.W.)
- Department of Public Health, Aichi Medical University School of Medicine, Nagakute 480-1195, Japan
| | - Mariko Naito
- Department of Oral Epidemiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan;
| | - Takashi Tamura
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Nagoya 466-8550, Japan; (T.S.); (T.T.); (K.W.)
| | - Kenji Wakai
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Nagoya 466-8550, Japan; (T.S.); (T.T.); (K.W.)
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Kang MJ, Kim HS, Kim JY. Development and effects of a non-face-to-face forest therapy program for nurses during the COVID-19 pandemic. Jpn J Nurs Sci 2024; 21:e12566. [PMID: 37919044 DOI: 10.1111/jjns.12566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 08/21/2023] [Accepted: 09/11/2023] [Indexed: 11/04/2023]
Abstract
AIM In this study, we developed a non-face-to-face forest therapy program using videos and applied it to nurses working in hospitals during the prolonged COVID-19 situation to confirm the effect on their mental health. METHOD This study was a randomized control group pretest-posttest, and 27 clinical nurses in the experimental group and 28 clinical nurses in the control group participated. The program developed forest therapy videos and three city videos each. The experimental group watched the forest therapy video and the control group watched the city video and stress and happiness were measured through pre-test and post-test. RESULTS The stress level of clinical nurses who applied the non-face-to-face forest therapy program had a significant reduction effect compared to the control group on day 2 (t = -2.239 P = .026) and day 3 (t = -3.188, P = .003). On the other hand, there was no significant effect in happiness in both groups. In addition, repeated measures analysis of variance statistical analysis confirmed that the stress level of the experimental group significantly decreased over time (F = 10.578, P < .001). CONCLUSION The non-face-to-face forest therapy program is significant in that it had a positive effect on relieving stress by conducting a randomized controlled study targeting clinical nurses working in various hospitals.
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Affiliation(s)
- Mi-Jung Kang
- College of Nursing, Eulji University, Uijeongbu-si, Gyeonggi-do, Republic of Korea
| | - Hyun-Sun Kim
- College of Nursing, Eulji University, Uijeongbu-si, Gyeonggi-do, Republic of Korea
| | - Ji-Yeon Kim
- College of Nursing, Eulji University, Uijeongbu-si, Gyeonggi-do, Republic of Korea
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Torjinski M, Horwood S. Associations between nature exposure, screen use, and parent-child relations: a scoping review protocol. Syst Rev 2023; 12:217. [PMID: 37974236 PMCID: PMC10652600 DOI: 10.1186/s13643-023-02367-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 10/13/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Today's youth are growing up in an evolving digital world, and concerns about the potential detrimental effects of excessive screen use on biopsychosocial outcomes in childhood are mounting. Parents worry about the impacts of screen-use on their children's wellbeing but at the same time frequently fail to meet their own ideal screen time limits regarding their children's screen use. There is an opportunity to shift research focus away from inflexible and often unrealistic childhood screen time guidelines towards exploration of positive parenting strategies that may have multiple beneficial and significant effects on children's screen-related outcomes. An emerging body of literature suggests that screen time and nature exposure act on psychosocial outcomes in contrasting ways. There is evidence to suggest that exposure to natural environments may counteract some of the potential negative psychosocial effects of excessive screen use; however, this relationship is poorly understood. The overarching aim of this scoping review is to source, categorise, and synthesise existing research exploring the associations between nature exposure, screen use, and parenting across childhood. METHODS This mixed-methods systematic scoping review will be conducted following Arksey and O'Malley's framework with methodological enhancements from Levac and associates and recommendations from the Joanna Briggs Institute's methodological guidance for conducting scoping reviews. Five electronic databases will be searched from August 2022 onwards. Two reviewers will independently screen titles, abstracts, and full-text articles. Peer reviewed articles related to the constructs of nature exposure, screen use, and parent/child relations will be considered in the context of early to late childhood. Study characteristics will be collated using a data charting tool collaboratively developed by the research team. Evidence will be presented using tabular and textual form and described using qualitative thematic analysis. DISCUSSION This review will gather information about how key definitions are conceptualised, defined, and measured across the literature and map existing trends and areas for future research. It is intended that this review will inform and guide future research direction, recommendations, and programs aimed at supporting parents to navigate the challenges of parenting in a digital age. OSF REGISTRATION: https://doi.org/10.17605/OSF.IO/TFZDV.
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Affiliation(s)
- Marina Torjinski
- School of Psychology, Deakin University, Locked Bag 20000, Geelong, 3220, Australia.
- ARC Centre of Excellence for the Digital Child, Education Building (E Block), Level 4, QUT Kelvin Grove campus, Brisbane, Australia.
| | - Sharon Horwood
- School of Psychology, Deakin University, Locked Bag 20000, Geelong, 3220, Australia
- ARC Centre of Excellence for the Digital Child, Education Building (E Block), Level 4, QUT Kelvin Grove campus, Brisbane, Australia
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Oomen-Welke K, Hilbich T, Schlachter E, Müller A, Anton A, Huber R. Spending time in the forest or the field: qualitative semi-structured interviews in a randomized controlled cross-over trial with highly sensitive persons. Front Psychol 2023; 14:1207627. [PMID: 38022960 PMCID: PMC10661274 DOI: 10.3389/fpsyg.2023.1207627] [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: 04/17/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction The effects of spending time in forests have been subject to investigations in various countries around the world. Qualitative comparisons have been rarely done so far. Methods Sixteen healthy highly sensitive persons (SV12 score ≥ 18) aged between 18 and 70 years were randomly assigned to groups spending 1 h in the forest and in the field at intervals of one week. Semi-structured interviews were conducted after each intervention and analyzed using a mixed-methods approach of content analysis and grounded theory. Results Both natural environments induced feelings of inner calmness, inner cleansing, joy, freedom, connectedness, strengthening qualities, and heightened body awareness. The forest environment additionally offered emotional shelter, and showed advantages in promoting inner strength and self-concentration. Discussion People with previous negative experiences in the forest may feel safer in fields because of the wider view and better overview. Important preconditions are enough time and the absence of a judgmental authority. The two environments induced in part different but also similar emotions which might be useful to promote psychological well-being differentially.
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Affiliation(s)
- Katja Oomen-Welke
- Center for Complementary Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Tina Hilbich
- Center for Complementary Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Evelyn Schlachter
- Center for Complementary Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Alexander Müller
- Center for Complementary Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Andreas Anton
- Institute for Frontier Areas of Psychology and Mental Health (IGPP), Freiburg, Germany
| | - Roman Huber
- Center for Complementary Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Yeon PS, Kang SN, Lee NE, Kim IO, Min GM, Kim GY, Kim JG, Shin WS. Benefits of Urban Forest Healing Program on Depression and Anxiety Symptoms in Depressive Patients. Healthcare (Basel) 2023; 11:2766. [PMID: 37893840 PMCID: PMC10606414 DOI: 10.3390/healthcare11202766] [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: 08/12/2023] [Revised: 09/24/2023] [Accepted: 10/14/2023] [Indexed: 10/29/2023] Open
Abstract
Depression is considered a widespread mental health problem worldwide. Moreover, anxiety symptoms are very closely related to depression in patients, and it is known that the coexistence rate of depression and anxiety diagnosed simultaneously is high. Treatment and preventive management of depression and anxiety are essential for public health. Forest healing is attracting attention as a form of low-cost preventive medicine that is safe and has no side effects. However, although the physiological and psychological effects have been scientifically proven, it is insufficient to reveal a direct relationship between forest healing and depression. This study investigated the benefits of an urban forest healing program on depression and anxiety symptoms in depressive disorders. We employed a randomized controlled trial design. Forty-seven depressive patients were randomly divided into an urban forest healing program group and a control group. Measures included the Montgomery-Asberg depression rating scale (MADRS), the Hamilton Anxiety Rating Scale (HARS), and the State-Trait Anxiety Inventory (STAI) questionnaires. Our results revealed that the combination of general treatment and forest healing programs for patients with depression is more effective in improving depression and anxiety than routine treatment alone. We expect our work to serve as a starting point for more sophisticated research discussing the availability of non-pharmacological treatments in forest healing.
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Affiliation(s)
- Poung-Sik Yeon
- Department of Forest Sciences, Chungbuk National University, Cheongju 28644, Republic of Korea;
| | - Si-Nae Kang
- Graduated Department of Forest Therapy, Chungbuk National University, Cheongju 28644, Republic of Korea; (S.-N.K.); (N.-E.L.); (I.-O.K.); (G.-M.M.); (G.-Y.K.)
| | - Nee-Eun Lee
- Graduated Department of Forest Therapy, Chungbuk National University, Cheongju 28644, Republic of Korea; (S.-N.K.); (N.-E.L.); (I.-O.K.); (G.-M.M.); (G.-Y.K.)
| | - In-Ok Kim
- Graduated Department of Forest Therapy, Chungbuk National University, Cheongju 28644, Republic of Korea; (S.-N.K.); (N.-E.L.); (I.-O.K.); (G.-M.M.); (G.-Y.K.)
| | - Gyeong-Min Min
- Graduated Department of Forest Therapy, Chungbuk National University, Cheongju 28644, Republic of Korea; (S.-N.K.); (N.-E.L.); (I.-O.K.); (G.-M.M.); (G.-Y.K.)
| | - Ga-Yeon Kim
- Graduated Department of Forest Therapy, Chungbuk National University, Cheongju 28644, Republic of Korea; (S.-N.K.); (N.-E.L.); (I.-O.K.); (G.-M.M.); (G.-Y.K.)
| | - Jin-Gun Kim
- Korea Forest Therapy Forum Incorporated Association, Cheongju 28644, Republic of Korea
| | - Won-Sop Shin
- Department of Forest Sciences, Chungbuk National University, Cheongju 28644, Republic of Korea;
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Kolster A, Heikkinen M, Pajunen A, Mickos A, Wennman H, Partonen T. Targeted health promotion with guided nature walks or group exercise: a controlled trial in primary care. Front Public Health 2023; 11:1208858. [PMID: 37766747 PMCID: PMC10520711 DOI: 10.3389/fpubh.2023.1208858] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 07/21/2023] [Indexed: 09/29/2023] Open
Abstract
Background Contact with nature promotes wellbeing through diverse pathways, providing a potential way of supporting health especially in primary care, where patients commonly suffer from multimorbidity and poor general health. Social prescribing is a non-pharmaceutical approach for improving health as well as social inclusion. This field study explores and compares the effects of a nature-based and an exercise-based social prescribing scheme on mental wellbeing and sleep, in a primary care population. Methods Primary care patients identified to benefit from a general improvement to their health were recruited by nurses, doctors, or social workers to this non-randomized, intention-to-treat, pilot field-study. Participants (n = 79) chose between the group interventions, either taking part in guided walks in nature, including immersion in a forest with high biodiversity, or participating in a versatile sports program. Mental wellbeing was assessed with the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS), with additional questions evaluating self-rated health and sleep. Impact on mental wellbeing was explored in relation to perceived health. The amount and quality of sleep was measured with wrist-worn accelerometers. With a focus on everyday life impacts, the assessments took place before and after the 8-week intervention. All participants lived in Sipoo, Finland, an area with abundant accessible green space. Results Participants (mean age 57 years, 79% female) rated their general and mental health lower than the general population. Participation in the Nature-group resulted in improved mental wellbeing (change in WEMWBS by 3.15, p = 0.008), with a positive change for feeling relaxed, being cheerful, having energy to spare, feeling able to deal well with problems, feeling good about oneself and feeling close to other people. The Sports-group was beneficial for those initially rating their health as good. Sleep duration improved in the Sports-group, while participants in the Nature-group reported better sleep quality. Following the interventions there was improvement in perceived health and ability to function in both groups, while perceived mental health improved only in the Nature-group. Conclusion We attest that even in areas surrounded by greenery, active interventions can further improve health in a primary care population, and that nature-based interventions are beneficial for those in poor health. Clinical trial registration ClinicalTrials.gov, Identifier NCT05893212.
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Affiliation(s)
- Annika Kolster
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- Health Services, Western Uusimaa Wellbeing Services County, Espoo, Finland
| | - Malin Heikkinen
- Health and Social Welfare Service, Eastern Uusimaa Wellbeing Services County, Sipoo, Finland
| | | | - Anders Mickos
- Primary Health Care Unit, Helsinki University Hospital, Helsinki, Finland
| | - Heini Wennman
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Timo Partonen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
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Liu XK, Huang DL, Meng LP, Cheng W, Li YY, Qin LL, Yang A, Zeng F, Zou Q, Li QF. Prevalence and Risk Factors Underlying Occupational Stress and Depression Among Clinical Nurses in Secondary and Tertiary Hospitals of China During COVID-19 Setting. Risk Manag Healthc Policy 2023; 16:1377-1389. [PMID: 37545784 PMCID: PMC10404045 DOI: 10.2147/rmhp.s415349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 07/11/2023] [Indexed: 08/08/2023] Open
Abstract
Aim This study was designed to develop an effective measurement tool for occupational stress among medical staff and to identify the underlying risk factors among clinical nurses in China under depression during and after COVID-19. Methods In the first stage, an occupational stress scale was developed for medical staff based on qualitative and quantitative methods. The dimensions of the scale were based on childhood stress and seven other parameters of working stress. In the second stage, a provincial survey was conducted among clinical nurses in Hainan. The structure of Medical Staff Occupational Stress Scale was tested in secondary and tertiary hospitals. The socio-demographic information, occupational stress (measured using the developed scale), and current depression symptoms (assessed with the nine-item Patient Health Questionnaire) were evaluated. The risk factors for occupational stress-induced depression were tested using multivariate logistic regression. Results The Medical Staff Occupational Stress Scale consisted of 42 items under eight dimensions with strong reliability and validity. Almost 80% of the clinical nurses reported obvious symptoms of depression. Based on multivariate logistical regression analysis, the significant risk factors for depression in nurses at secondary hospitals and tertiary hospitals were childhood stress, teaching stress, relationship with patient stress, and administration stress. Conclusion The Medical Staff Occupational Stress Scale utilized in nursing population is based on strong psychometric features. Childhood stress contributes to occupational stress in nurses. The selection of nurses for clinical work may require evaluation of past history for childhood stress to prevent occupational depression. Teaching stress, relationship with patient stress and administration stress play significant roles in the prevention of depression among clinical nurses.
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Affiliation(s)
- Xiao-kun Liu
- Clinical Psychology Department, The First Affiliated Hospital of Hainan Medical University, Haikou City, Hainan Province, People’s Republic of China
| | - Dan-ling Huang
- Clinical Psychology Department, The First Affiliated Hospital of Hainan Medical University, Haikou City, Hainan Province, People’s Republic of China
- Neurology Department, Graduate School of Tianjin Medical University, Tianjin City, People’s Republic of China
| | - Li-ping Meng
- Clinical Psychology Department, The First Affiliated Hospital of Hainan Medical University, Haikou City, Hainan Province, People’s Republic of China
| | - Wei Cheng
- Clinical Psychology Department, The First Affiliated Hospital of Hainan Medical University, Haikou City, Hainan Province, People’s Republic of China
| | - Yi-yi Li
- Clinical Psychology Department, The First Affiliated Hospital of Hainan Medical University, Haikou City, Hainan Province, People’s Republic of China
| | - Lu-lu Qin
- Department of Social Medicine and Health Management, School of Medicine, Hunan Normal University, Changsha City, Hunan Province, People’s Republic of China
| | - Ao Yang
- Health Management Department, School of Management of Hainan Medical University, Haikou City, Hainan Province, People’s Republic of China
| | - Fan Zeng
- Graduate School of Hainan Medical University, Haikou City, Hainan Province, People’s Republic of China
| | - Qin Zou
- Clinical Psychology Department, The First Affiliated Hospital of Hainan Medical University, Haikou City, Hainan Province, People’s Republic of China
| | - Qi-fu Li
- Neurology Department, The First Affiliated Hospital of Hainan Medical University, Haikou City, Hainan Province, People’s Republic of China
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Pfeifer E, Pothmann K, Claaßen S, Wittmann M. Increased relaxation, less boredom, and a faster passage of time during a period of silence in the forest. PROGRESS IN BRAIN RESEARCH 2023; 277:157-180. [PMID: 37301568 DOI: 10.1016/bs.pbr.2022.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
INTRODUCTION There is growing evidence of the beneficial effects of exposure to nature on health and well-being. Time spent in nature can decrease stress, anxiety, depression, and improve mood. In the present study, we compared the experience of a short period of silence in the natural environment of a forest with the same amount of silence in a seminar room. METHODS We applied an intra-subject design with two 6:30-min sessions of silence in two different environments (forest, seminar room). The participants (n=41) were assigned to four groups. Two groups started with the indoor condition and two groups with the outdoor condition. After 1 week, the two groups were exposed to the other condition. Participants filled out personality-trait scales on meaning in life and belief in oneness with the world, as well as state scales assessing emotional reactions, relaxation, boredom, and the subjective sense of self, time, and space. RESULTS Participants felt significantly more relaxed and less bored in the forest compared to indoors. They experienced time less intensely, judging it to pass faster and to last shorter in the forest. Regarding trait variables, the higher the search for meaning, the higher oneness beliefs in participants. The higher oneness beliefs, the more positive participants felt during silence in the forest. DISCUSSION Interest in nature-assisted therapy is increasing in the healthcare sector. Exposure to silence in the natural setting of a forest could prove to be an effective complement to interventions applied in nature-assisted therapy, such as forest therapy.
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Affiliation(s)
- Eric Pfeifer
- Catholic University of Applied Sciences, Freiburg, Germany; Faculty of Psychotherapy Science, Sigmund Freud University, Vienna, Austria.
| | | | - Stefan Claaßen
- Catholic University of Applied Sciences, Freiburg, Germany
| | - Marc Wittmann
- Institute for Frontier Areas of Psychology and Mental Health, Freiburg, Germany
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Park EY, Song MK, An MY. Experiences of Forest Healing Instructors Who Met Cancer Patients in Forest Healing Programs: FGI Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4468. [PMID: 36901477 PMCID: PMC10002042 DOI: 10.3390/ijerph20054468] [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: 01/30/2023] [Revised: 02/24/2023] [Accepted: 02/28/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Demand for urban forest programs for the healing of cancer survivors is increasing. To develop a forest healing program for the integrated care of cancer patients, it is necessary to analyze the experiences of forest healing instructors who have conducted programs for cancer patients. METHODS This qualitative study applied focus group interviews (FGIs; four interviews with sixteen participants) to describe and understand the experiences of forest healing instructors who run forest healing programs for cancer patients. RESULTS Four themes were identified: "prepared encounters and unexpected encounters," "yearning for healing," "people who need special care," and "things to prepare for cancer patient programs." CONCLUSION Forest healing instructors had difficulty facilitating programs for cancer patients owing to prejudice and a lack of knowledge about the characteristics of cancer patients. Moreover, differentiated programs and places that align with the specific needs of cancer patients are needed. It is necessary to develop an integrated care forest healing program for cancer patients and educate forest healing instructors about the needs of cancer patients.
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Affiliation(s)
- Eun Young Park
- College of Nursing, Gachon University, Incheon 21936, Republic of Korea
| | - Min Kyung Song
- Department of Nursing, College of Medicine, University of Ulsan, Ulsan 44610, Republic of Korea
| | - Mi Young An
- Department of Nursing, Yeoju Institute of Technology, Yeoju 12652, Republic of Korea
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Lee K, Browning MHEM, Park YM. Spatiotemporal non-stationarity in green space and stress relationships: Recent evidence from South Korea. ENVIRONMENTAL RESEARCH 2023; 220:115214. [PMID: 36610534 DOI: 10.1016/j.envres.2023.115214] [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: 11/24/2022] [Revised: 12/27/2022] [Accepted: 01/02/2023] [Indexed: 06/17/2023]
Abstract
A growing body of literature has linked exposure to "green space" (vegetation-rich areas) and other forms of nature to mental health. Exposure-outcome associations at regional or national scales can overlook local associations that define how geographically distinct populations may experience nature differently. Large-scale results might downplay the importance of lived experiences and heterogeneity of human-nature relationships at local scales. The current study examines three types of vegetative cover and identifies how they are associated with perceived stress in South Korea during and before the COVID-19 pandemic. We find forest cover is consistently negatively associated with perceived stress at nationwide scales. In contrast, grass cover and the normalized difference vegetation index (NDVI) show mixed associations with perceived stress at nationwide scales. Models accounting for spatial and temporal variability demonstrate that associations of forest cover, grass cover, and NDVI with perceived stress varies across the country and the study's four-year time horizon. Local governments may need divergent urban greening strategies for health promotion that respond to their specific sociodemographic and pre-existing environmental conditions.
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Affiliation(s)
- Kangjae Lee
- Department of Location-Based Information System, Kyungpook National University, 2559 Gyeongsang-daero, Sangju-si, Gyeongsangbuk-do, 37224, Republic of Korea.
| | - Matthew H E M Browning
- Virtual Reality & Nature Lab, Department of Parks, Recreation and Tourism Management, Clemson University, 170 Sirrine Hall. Clemson, SC, 29634, USA.
| | - Yoo Min Park
- Department of Geography, Planning, and Environment, East Carolina University, A-237 Brewster Building, Greenville, NC, 27858, USA.
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Donelli D, Meneguzzo F, Antonelli M, Ardissino D, Niccoli G, Gronchi G, Baraldi R, Neri L, Zabini F. Effects of Plant-Emitted Monoterpenes on Anxiety Symptoms: A Propensity-Matched Observational Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2773. [PMID: 36833470 PMCID: PMC9957398 DOI: 10.3390/ijerph20042773] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/29/2023] [Accepted: 02/02/2023] [Indexed: 06/12/2023]
Abstract
Immersive experiences in green areas, particularly in forests, have long been known to produce beneficial effects for human health. However, the exact determinants and mechanisms leading to healthy outcomes remain to be elucidated. The purpose of this observational cohort study was to investigate whether inhaling plant-emitted biogenic volatile compounds, namely monoterpenes (MTs), can produce specific effects on anxiety symptoms. Data from 505 subjects participating in 39 structured forest therapy sessions at different Italian sites were collected. The air concentration of monoterpenes was measured at each site. STAI state questionnaires were administered before and after the sessions as a measure of anxiety. A propensity score matching analysis was then performed, considering an above-average exposure to inhalable air MTs as the treatment. The estimated effect was -1.28 STAI-S points (95% C.I. -2.51 to -0.06, p = 0.04), indicating that the average effect of exposure to high MT air concentrations during forest therapy sessions was to decrease anxiety symptoms.
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Affiliation(s)
- Davide Donelli
- Department of Medicine and Surgery, University of Parma, I-43121 Parma, Italy
- Division of Cardiology, Azienda Ospedaliero-Universitaria di Parma, I-43126 Parma, Italy
| | - Francesco Meneguzzo
- Institute of Bioeconomy, National Research Council, 10 Via Madonna del Piano, I-50019 Sesto Fiorentino, Italy
- Central Scientific Committee, Italian Alpine Club, 19 Via E. Petrella, I-20124 Milano, Italy
| | - Michele Antonelli
- Department of Public Health, AUSL-IRCCS of Reggio Emilia, I-42122 Reggio Emilia, Italy
| | - Diego Ardissino
- Department of Medicine and Surgery, University of Parma, I-43121 Parma, Italy
- Division of Cardiology, Azienda Ospedaliero-Universitaria di Parma, I-43126 Parma, Italy
| | - Giampaolo Niccoli
- Department of Medicine and Surgery, University of Parma, I-43121 Parma, Italy
- Division of Cardiology, Azienda Ospedaliero-Universitaria di Parma, I-43126 Parma, Italy
| | - Giorgio Gronchi
- Section of Psychology, Department of Neuroscience, Psychology, Drug Research and Child’s Health (NEUROFARBA), University of Florence, 12 Via di San Salvi, I-50135 Firenze, Italy
| | - Rita Baraldi
- Institute of Bioeconomy, National Research Council, 10 Via Madonna del Piano, I-50019 Sesto Fiorentino, Italy
| | - Luisa Neri
- Institute of Bioeconomy, National Research Council, 10 Via Madonna del Piano, I-50019 Sesto Fiorentino, Italy
| | - Federica Zabini
- Institute of Bioeconomy, National Research Council, 10 Via Madonna del Piano, I-50019 Sesto Fiorentino, Italy
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Huber D, Freidl J, Pichler C, Bischof M, Kiem M, Weisböck-Erdheim R, Squarra G, De Nigris V, Resnyak S, Neberich M, Bordin S, Zechner R, Hartl A. Long-Term Effects of Mountain Hiking vs. Forest Therapy on Physical and Mental Health of Couples: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20021469. [PMID: 36674227 PMCID: PMC9859399 DOI: 10.3390/ijerph20021469] [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: 11/10/2022] [Revised: 12/29/2022] [Accepted: 12/30/2022] [Indexed: 06/02/2023]
Abstract
BACKGROUND Lifelong physical activity is related to longer health span, which is reflected at an individual level, and is of substantial socioeconomic relevance. Sedentary lifestyles, on the other hand, pose an increasingly major public health problem. In addition, the COVID-19 pandemic had a negative impact on activity levels and well-being. Previous research indicates that contact with nature might improve exercise levels as well as well-being. METHODS This randomized, controlled clinical trial (ANKER-study) investigated the effects of two types of nature-based therapies (forest therapy and mountain hiking) in couples (FTG: n = 23; HG: n = 22;) with a sedentary or inactive lifestyle on health-related quality of life, relationship quality and other psychological and physiological parameters. RESULTS The results of this study displayed that healthy and highly functioning women and men with sedentary lifestyles mentally benefit from contact with nature (quality of life, satisfaction with life, mood, internal and external health-related control beliefs). The gender-specific effect on women is most visible in the physiological outcomes (hemopoietic system, aerobic capacity, skeletal muscle mass and hydration) of mountain hiking. Men and women showed small improvements in blood pressure as a result of the interventions. CONCLUSIONS The ANKER-study provides a method for valid comparison of forest therapy interventions for the first time. Regarding the COVID-19 pandemic, the nature-based intervention presented could offer a multimodal contribution to maintaining a more active lifestyle, further contact with nature that affects peoples physical as well as mental health, and an improvement in social interaction.
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Affiliation(s)
- Daniela Huber
- Institute of Ecomedicine, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria
| | - Johanna Freidl
- Institute of Ecomedicine, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria
| | - Christina Pichler
- Institute of Ecomedicine, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria
| | - Michael Bischof
- Institute of Ecomedicine, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria
| | - Martin Kiem
- Certified Nature and Forest Therapy Guide, 39010 Tisens, Italy
| | | | | | - Vincenzo De Nigris
- Institute of Sports Medicine, South Tyrol Health Authority, 39100 Bozen, Italy
| | - Stefan Resnyak
- Institute of Sports Medicine, South Tyrol Health Authority, 39100 Bozen, Italy
| | - Marcel Neberich
- Institute of Ecomedicine, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria
| | - Susanna Bordin
- Institute of Ecomedicine, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria
| | - René Zechner
- Institute of Ecomedicine, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria
| | - Arnulf Hartl
- Institute of Ecomedicine, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria
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Huntsman JL, Bulaj G. Health education via "empowerment" digital marketing of consumer products and services: Promoting therapeutic benefits of self-care for depression and chronic pain. Front Public Health 2023; 10:949518. [PMID: 36703812 PMCID: PMC9871258 DOI: 10.3389/fpubh.2022.949518] [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: 05/21/2022] [Accepted: 12/13/2022] [Indexed: 01/12/2023] Open
Abstract
Increasing health care costs and high economic burden exemplify the impact of chronic diseases on public health. Multifaceted approaches to treating chronic diseases include pharmaceutical drugs, digital therapeutics, and lifestyle medicine. Chronic diseases are largely preventable, and health promotion yields positive outcomes. However, despite positive return on investment (ROI) and cost-to-benefit ratio (CBR) for health promotion (median ROI 2.2, median CBR 14.4), commercial marketing of healthy lifestyles and self-care is limited. The objective of this perspective article is to discuss how digital marketing of consumer goods and services that support therapeutic self-care can also bridge public health and for-profit interests. We describe how "empowerment" marketing campaigns can provide evidence-based associations between products/services and self-care benefits for people living with chronic pain and depression. Such a "health education as marketing" strategy is illustrated by educational ads describing how contact with nature, music, and yoga can improve chronic pain and reduce depressive symptoms. Creating associations between health-related benefits of these activities with products (outdoor and yoga apparel, audio equipment) and services (music streaming services, music mobile apps, eco-tourism, yoga studios) that support them expand their value proposition, thus incentivizing profit-driven companies to engage in public health campaigns. Long-term success of companies that incorporate evidence-based health education as marketing and branding strategies will depend on following ethical considerations and advertising guidelines defined by consumer protection regulatory agencies, such as the Federal Trade Commission (FTC). In conclusion, integration of health education about self-care and commercial marketing can support health care outcomes and disease prevention.
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Affiliation(s)
| | - Grzegorz Bulaj
- OMNI Self-care, LLC, Salt Lake City, UT, United States,L. S. Skaggs College of Pharmacy, University of Utah, Salt Lake City, UT, United States,*Correspondence: Grzegorz Bulaj ✉
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Qiu Q, Yang L, He M, Gao W, Mar H, Li J, Wang G. The Effects of Forest Therapy on the Blood Pressure and Salivary Cortisol Levels of Urban Residents: A Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:458. [PMID: 36612777 PMCID: PMC9819785 DOI: 10.3390/ijerph20010458] [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: 12/17/2022] [Accepted: 12/20/2022] [Indexed: 06/17/2023]
Abstract
Urban residents have a higher risk of hypertension and psychological stress than rural residents. Aside from medical interventions, understanding how to control hypertension and alleviate the stress of urban populations has become a public concern. As an alternative medical measure, forest therapy has shown the effects of normalizing blood pressure (BP) and reducing stress increasingly in recent literature, but this is still inconclusive. In order to systematically verify forest therapy’s effects on the BP and mental stress of urban residents, we conducted meta-analyses to assess the changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), and salivary cortisol concentration (SCC; a stress biomarker) between the forest therapy group and urban control group. We searched 4 online databases, and 21 studies on BP involving 2270 participants and 13 studies on SCC involving 1786 participants were included. Through the meta-analysis, the mean difference and confidence interval (CI) estimates indicated that forest therapy significantly reduced participants’ SBP −3.44 (95% CI −5.74, −1.14), DBP −3.07 (95% CI −5.59, −0.54), and SCC −0.07 (95% CI −0.10, −0.04), as compared with urban control. Yet, there was substantial heterogeneity (I2 = 72.87−88.59%) among these studies. We also found that each prediction interval (PI) for SBP (95% PI −13.30, 6.42), DBP (95% PI −15.54, 9.41), and SCC (95% PI −0.18, 0.05) were all much wider than the CIs and contained values above 0. This means that forest therapy may reduce SBP, DBP, and SCC on average, but may not exclude adverse results. Meta-regression analyses showed that participants’ age and baseline SBP levels determined the heterogeneity among SBP studies. After forest therapy, older participants and those with higher baseline SBP levels had greater SBP-lowering effects. Among DBP studies, the primary source of heterogeneity was participants’ baseline DBP levels; participants with higher baseline DBP levels had greater DBP reduction. In subgroup analyses, we discovered that longer-term forest therapy programs (≥20 min) resulted in a greater reduction in BP and SCC than shorter-term forest therapy programs (<20 min). Additionally, seated viewing, walking, or multi-session programs in forests were observed to have similar effects on reducing BP and SCC. Despite extensive analyses, the study did not identify any sources of heterogeneity among forest therapy programs for lowering SCC levels. Overall, we conclude that forest therapy programs have beneficial therapeutic effects on urban residents’ physio-psychological health through lowering BP and relieving stress (reducing SCC). This finding provides solid evidence of the contribution of forest therapy to urban residents’ health and wellbeing.
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Affiliation(s)
- Quan Qiu
- Guangdong Key Laboratory for Innovative Development and Utilization of Forest Plant Germplasm, College of Forestry and Landscape Architecture, South China Agricultural University, Guangzhou 510642, China
- Faculty of Forestry, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Ling Yang
- Guangdong Key Laboratory for Innovative Development and Utilization of Forest Plant Germplasm, College of Forestry and Landscape Architecture, South China Agricultural University, Guangzhou 510642, China
| | - Mei He
- Faculty of Forestry, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
- Jiangxi Academy of Forestry, Nanchang 330013, China
| | - Wen Gao
- Faculty of Forestry, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
- Co-Innovation Center for Sustainable Forestry in Southern China, Nanjing Forestry University, Nanjing 210037, China
| | - Harrison Mar
- Faculty of Forestry, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Jiyue Li
- Guangdong Key Laboratory for Innovative Development and Utilization of Forest Plant Germplasm, College of Forestry and Landscape Architecture, South China Agricultural University, Guangzhou 510642, China
| | - Guangyu Wang
- Faculty of Forestry, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
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Liu S, Li C, Chu M, Zhang W, Wang W, Wang Y, Guo X, Deng F. Associations of forest negative air ions exposure with cardiac autonomic nervous function and the related metabolic linkages: A repeated-measure panel study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 850:158019. [PMID: 35973547 DOI: 10.1016/j.scitotenv.2022.158019] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 07/29/2022] [Accepted: 08/09/2022] [Indexed: 06/15/2023]
Abstract
Forest environment has many health benefits, and negative air ions (NAI) is one of the major forest environmental factors. Many studies have explored the effect of forest environment on cardiac autonomic nervous function, while forest NAI in the among function and the underlying mechanism still remain unclear. To explore the associations and molecular linkages between short-term exposure to forest NAI and heart rate variability (HRV), a repeated-measure panel study was conducted among 31 healthy adults. Participants were randomly selected to stay in a forest park for 3 days and 2 nights. Individual exposures including NAI were monitored simultaneously and HRV indices were measured repeatedly at the follow-up period. Urine samples were collected for non-targeted metabolomics analysis. Mixed-effect models were adopted to evaluate associations among NAI, HRV indices and metabolites. The median of NAI concentration was 68.11 (138.20) cm-3 during the study period. Short-term exposure to forest NAI was associated with the ameliorative HRV indices, especially the excitatory parasympathetic nerve. For instance, per interquartile range increase of 5-min moving average of NAI was associated with 9.99 % (95%CI: 8.95 %, 11.03 %) increase of power in high frequency. Eight metabolites were associated with NAI exposure. The down-regulated tyrosine metabolism was firstly observed, followed by other amino acid metabolic alterations. The NAI-related metabolic changes reflect the reduction of inflammation and oxidative stress. HRV indices were associated with 25 metabolites, mainly including arginine, proline and histidine metabolism. Short-term exposure to forest NAI is beneficial to HRV, especially to the parasympathetic nerve activity, by successively disturbing different metabolic pathways which mainly reflect the increased anti-inflammation and the reduced inflammation. The results will provide epidemiological evidences for developing forest therapy and improving cardiac autonomic nervous function.
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Affiliation(s)
- Shan Liu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Chen Li
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Mengtian Chu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Wenlou Zhang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Wanzhou Wang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Yazheng Wang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Xinbiao Guo
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Furong Deng
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China.
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Kim E, Park S, Kim S, Choi Y, Cho JH, Kim G. Is altitude a determinant of the health benefits of nature exposure? A systematic review and meta-analysis. Front Public Health 2022; 10:1021618. [PMID: 36504926 PMCID: PMC9732270 DOI: 10.3389/fpubh.2022.1021618] [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: 08/18/2022] [Accepted: 11/11/2022] [Indexed: 11/27/2022] Open
Abstract
Introduction Nature exposure is a widely accepted option for promoting public health owing to the recent surge of scientific evidence. However, the actual settings to facilitate this initiative is yet to be extensively reviewed. In this systematic review, we have aimed to provide an up-to-date summary of interventional studies investigating the psycho-physiological effects of forests and urban forests, including details on their physical settings, and investigate an effect-modifying role of altitude and summarize data on the magnitude and shape of the association. Methods A keyword search using five electronic academic databases (PubMed, Embase, PsycINFO, Web of Science, and Scopus) was conducted to identify relevant articles published in English from the inception year to the end of February 2022. The methodological quality was evaluated using the ROBINS-I or ROB2 tool, depending on the study design. Meta-regression and random effects model were jointly used to examine the relationship between altitude and health outcomes. Results We included 27 eligible studies and 31 cases extracted from 19 studies were used for the meta-analysis. In the meta-regression, we observed a non-linear association between altitude and psycho-physiological effects. Altitude had a positive quadratic association with anxiety (p < 0.000, adjusted R 2 = 96.79%), depression (p < 0.000, adjusted R 2 = 98.78%), and fatigue (p < 0.000, adjusted R 2 = 64.74%) alleviating effects. Conversely, altitude demonstrated a negative non-linear association with the blood pressure-lowering effect (p = 0.009, adjusted R 2 = 32.83%). Additionally, the thermal index (THI) and illuminance (lx) levels were significantly associated with effect sizes of psychological restoration. Discussion This review provides moderate-certainty evidence for an effect-modifying role of altitude. The meta-regression results suggested the optimal and minimal altitude ranges for psychological restoration and physiological relaxation, respectively. Despite some limitations, the study findings provide a significant basis for utilizing altitude, which is easily accessible and simple, to promote the health benefits of nature-based initiatives. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022310894, identifier: CRD42022310894.
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Ke GN, Utama IKAP, Wagner T, Sweetman AK, Arshad A, Nath TK, Neoh JY, Muchamad LS, Suroso DSA. Influence of mangrove forests on subjective and psychological wellbeing of coastal communities: Case studies in Malaysia and Indonesia. Front Public Health 2022; 10:898276. [PMID: 36438217 PMCID: PMC9686422 DOI: 10.3389/fpubh.2022.898276] [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: 03/17/2022] [Accepted: 10/05/2022] [Indexed: 11/11/2022] Open
Abstract
Mangrove forests possess multiple functions for the environment and society through their valuable ecosystem services. Along with this, the mangrove forests have large and diverse social values, in combination contributing to the health and wellbeing of the surrounding communities. This study aims (i) to assess the benefits of mangrove forests and their impact on subjective and psychological wellbeing of coastal communities and (ii) to understand the challenges coastal communities face that limit sustainable wellbeing. We have used a mixed methodological approach, combining workshop, interview, and survey, to obtain qualitative and quantitative information from two coastal communities in Malaysia and Indonesia. For quantitative data, 67 participants from both coastal communities participated using a pre-tested structured questionnaire. To obtain opinions from key informants in Malaysia and Indonesia, we organized two stakeholders' workshops and community interviews. When merging these interviews and workshops, we identified the following three themes related to the perception of mangrove forest benefits: (1) the advantage of living in a natural countryside; (2) the natural resources supporting employment, income, and family security; and (3) the increase in subjective and psychological wellbeing. The mean score of wellbeing for Indonesian participants (28.6) was slightly higher than that for Malaysian participants (26.2) and was significant. Overall, the respondents felt happy because the combination of job security and leisure activities supports feeling content and satisfied. The analyses also suggest that the combination of exposure to coastal environments and stress reduction promotes good mental health; however, diagnostic health data are lacking. The lower score of mental wellbeing in Malaysia is attributed to respondents involved in risky fishing activities and local regions with excessive tourism. The findings from this study imply that coastal mangrove forest management plays an important role in the living conditions of coastal communities and their subjective and psychological wellbeing. Hence, restoration and sustainability of mangrove ecosystem are important.
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Affiliation(s)
- Guek-Nee Ke
- Department of Psychology, School of Social Sciences, Heriot-Watt University Malaysia, Putrajaya, Malaysia,*Correspondence: Guek-Nee Ke
| | | | - Thomas Wagner
- The Lyell Centre, Heriot-Watt University, Edinburgh, United Kingdom
| | | | - Aziz Arshad
- Department of Aquaculture, Faculty of Agriculture, Universiti Putra Malaysia, Serdang, Malaysia
| | - Tapan Kumar Nath
- School of Environment and Geographical Sciences, University of Nottingham Malaysia, Semenyih, Malaysia
| | - Jing Yi Neoh
- Department of Psychology, School of Social Sciences, Heriot-Watt University Malaysia, Putrajaya, Malaysia
| | - Lutfi Surya Muchamad
- Department of Naval Architecture, Institute Teknologi Sepuluh Nopember, Surabaya, Indonesia
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Bermejo-Martins E, Pueyo-Garrigues M, Casas M, Bermejo-Orduna R, Villarroya A. A Forest Bathing Intervention in Adults with Intellectual Disabilities: A Feasibility Study Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13589. [PMID: 36294168 PMCID: PMC9603293 DOI: 10.3390/ijerph192013589] [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: 08/26/2022] [Revised: 10/17/2022] [Accepted: 10/18/2022] [Indexed: 06/16/2023]
Abstract
Forest bathing practices benefit individuals' physical and mental health. A growing number of published studies provide evidence of such effects in diverse populations and contexts. However, no literature has been found that evaluates the effects of forest bathing on people with intellectual disabilities. In this paper, we present a quasi-experimental pre-post protocol for assessing the preliminary efficacy and feasibility of a forest bathing intervention in a group of adults with intellectual disability. An 11-weekly session program will be applied in the forests of the Ollo Valley, Navarre (Spain). The preliminary efficacy outcomes will be blood pressure, psycho-physiological coherence parameters and quality of life. The feasibility of the intervention will be assessed through data on barriers and facilitators of the implementation process and indicators of environmental comfort (physiological equivalent temperature and thermic perception). This study offers an opportunity for people with intellectual disabilities to benefit from a forest bathing intervention and explore its effects not only on their quality of life, but also on the improvement in their physiological and psychological state. This feasibility study is an essential step to explore crucial aspects for a future full-scale trial.
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Affiliation(s)
- Elena Bermejo-Martins
- Department of Community, Maternity and Pediatric Nursing, School of Nursing, University of Navarra, Campus Universitario, 31008 Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
| | - María Pueyo-Garrigues
- Department of Community, Maternity and Pediatric Nursing, School of Nursing, University of Navarra, Campus Universitario, 31008 Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
| | - María Casas
- Department of Environmental Biology, Faculty of Science, University of Navarra, Campus Universitario, 31080 Pamplona, Spain
- Grupo de Humanidades Ambientales, BIOMA, 31008 Pamplona, Spain
| | - Raúl Bermejo-Orduna
- Department of Environmental Biology, Faculty of Science, University of Navarra, Campus Universitario, 31080 Pamplona, Spain
- Grupo de Humanidades Ambientales, BIOMA, 31008 Pamplona, Spain
| | - Ana Villarroya
- Department of Environmental Biology, Faculty of Science, University of Navarra, Campus Universitario, 31080 Pamplona, Spain
- Grupo de Humanidades Ambientales, BIOMA, 31008 Pamplona, Spain
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Yi Y, Seo E, An J. Does Forest Therapy Have Physio-Psychological Benefits? A Systematic Review and Meta-Analysis of Randomized Controlled Trials. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10512. [PMID: 36078228 PMCID: PMC9518146 DOI: 10.3390/ijerph191710512] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/11/2022] [Accepted: 08/13/2022] [Indexed: 06/12/2023]
Abstract
Forest therapy involves visiting forests or conducting forest-based treatment activities to improve one's health. Studies have investigated the health benefits of forests, but consensus has not been reached. This study comprised a systematic review and meta-analysis to determine how forest therapy affects the physiological and psychological health of adults. The Cumulative Index to Nursing and Allied Health Literature, Embase, and Medline databases were searched on 31 August 2021. Systematic review and meta-analysis, risk evaluation, GRADE evaluation, and advertisement effect evaluation were performed for each article. The effect size was calculated by dividing blood pressure as a physiological indicator and depression as a psychological indicator. Of the 16,980 retrieved studies, 17 were selected based on the inclusion criteria. Of these, eight studies were included in the meta-analysis. The effect size of forest therapy on improving systolic and diastolic blood pressure was not significant; however, it significantly reduced depression. While the results have limited generalizability due to the inclusion of few studies, the effects of forest therapy on reducing depression have been confirmed. Since the application of forest therapy was heterogeneous in these studies, a moderator effect analysis or subgroup analysis in meta-analysis should be performed in the future.
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Affiliation(s)
- Yunjeong Yi
- Department of Nursing, Kyung-In Women’s University, 63 Gyeyangsan-ro, Gyeyang-gu, Incheon 21041, Korea
| | - Eunju Seo
- Department of Nursing, Pai-Chai University, 155-40 Baejae-ro, Seo-gu, Daejeon 35345, Korea
| | - Jiyeon An
- Department of Nursing, Kyung-In Women’s University, 63 Gyeyangsan-ro, Gyeyang-gu, Incheon 21041, Korea
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Owens M, Bunce HLI. Nature-Based Meditation, Rumination and Mental Wellbeing. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9118. [PMID: 35897493 PMCID: PMC9332585 DOI: 10.3390/ijerph19159118] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 07/19/2022] [Accepted: 07/22/2022] [Indexed: 02/04/2023]
Abstract
Novel approaches for children and young people (CYP) in the prevention and intervention of mental illness are needed and nature-based interventions (NBI) may be clinically useful. This proof-of-principle study tested the effects of a novel brief nature-based meditation on rumination, depressive symptoms and wellbeing in young people. Sixty-eight university students were randomised to one of three conditions: active control (n = 23), indoor meditation (n = 22) or nature-based meditation (n = 23). Participants completed self-report measures on state and trait rumination post intervention and depression and wellbeing at a 2-week follow-up. Depressive rumination significantly decreased post intervention in the nature condition and depressive symptoms improved for both intervention groups. Wellbeing only significantly improved at follow-up in the nature condition. Nature condition participants demonstrated one minimal clinically important difference (MCID) for wellbeing at follow-up. Depressive symptoms for this condition were below the clinically significant threshold for depression. The number needed to treat (NNT) analysis suggested that two to five young people would need to complete the intervention. Preliminary evidence suggests NBIs, such as the one in the present study, can reduce depressive rumination and symptoms and improve wellbeing. Replication with larger clinical samples is required to substantiate findings.
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Affiliation(s)
- Matthew Owens
- Department of Psychology, The Mood Disorders Centre, University of Exeter, Exeter EX4 4QQ, UK
- The ROWAN Group, Exeter EX4 4QQ, UK;
| | - Hannah L. I. Bunce
- The ROWAN Group, Exeter EX4 4QQ, UK;
- CEDAR, University of Exeter, Exeter EX4 4QQ, UK
- Somerset Foundation Trust NHS, Taunton TA1 5DA, UK
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Wang X, Gong XF, Xiong KX, Guo DS, Liu LJ, Lin CM, Chang WY. Mapping of Research in the Field of Forest Therapy-Related Issues: A Bibliometric Analysis for 2007-2021. Front Psychol 2022; 13:930713. [PMID: 35898977 PMCID: PMC9309728 DOI: 10.3389/fpsyg.2022.930713] [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] [Received: 04/28/2022] [Accepted: 06/01/2022] [Indexed: 11/13/2022] Open
Abstract
Exposure to forest environments promotes human health. The number of relevant studies in this area has increased rapidly. However, an overall review of relevant analyses from the perspectives of bibliometrics and visualization is lacking. A scientometric analysis of 2,545 publications from 2007 to 2021 via the Web of Science database was conducted to identify the knowledge structure and frontiers objectively. The publications were subsequently analyzed in terms of the distribution of journals and countries, citation bursts, major subject areas, and evolutionary stages. The findings showed that the knowledge foundation of forest therapy was multidisciplinary with most published in the fields of environmental sciences and ecology but lacking input from social disciplines. The research hotspots evolved from the early focus on individual benefits obtained from nature to increasing attention on human well-being at the social-ecological scale. More rigorous experiments with strict randomized controlled trials and blinding are needed to accommodate the trend of forest therapy toward non-pharmacological treatments. According to Shneider's four-stage theory, forest therapy research is in the third stage of the scientific research process. More future studies utilizing novel technologies and decision-making frameworks to solve practical issues are needed for introducing health into policies and promoting human well-being.
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Affiliation(s)
- Xin Wang
- Laboratory of Environmental Education and Forest Therapy, College of Forestry, Fujian Agriculture and Forestry University, Fuzhou, China
| | - Xiang-Fei Gong
- Laboratory of Environmental Education and Forest Therapy, College of Forestry, Fujian Agriculture and Forestry University, Fuzhou, China
| | - Ke-Xin Xiong
- Laboratory of Environmental Education and Forest Therapy, College of Forestry, Fujian Agriculture and Forestry University, Fuzhou, China
| | - De-Sheng Guo
- Laboratory of Environmental Education and Forest Therapy, College of Forestry, Fujian Agriculture and Forestry University, Fuzhou, China
| | - Li-Jun Liu
- Forest Therapy Branch, Chinese Society of Forestry, Beijing, China
| | | | - Wei-Yin Chang
- Laboratory of Environmental Education and Forest Therapy, College of Forestry, Fujian Agriculture and Forestry University, Fuzhou, China
- Forest Therapy Branch, Chinese Society of Forestry, Beijing, China
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Healthy lifestyle changes favourably affect common carotid intima-media thickness: the Healthy Lifestyle Community Programme (cohort 2). J Nutr Sci 2022; 11:e47. [PMID: 35754985 PMCID: PMC9201878 DOI: 10.1017/jns.2022.46] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 05/18/2022] [Accepted: 05/20/2022] [Indexed: 11/05/2022] Open
Abstract
Common carotid intima-media thickness (ccIMT) progression is a risk marker for cardiovascular disease (CVD), whereas healthy lifestyle habits are associated with lower ccIMT. The objective of the present study was to test whether a healthy lifestyle intervention can beneficially affect ccIMT progression. A community-based non-randomised, controlled lifestyle intervention was conducted, focusing on a predominantly plant-based diet (strongest emphasis), physical activity, stress management and social health. Assessments of ccIMT were made at baseline, 6 months and 1 year. Participants had an average age of 57 years and were recruited from the general population in rural northwest Germany (intervention: n 114; control: n 87). From baseline to 1 year, mean ccIMT significantly increased in both the intervention (0⋅026 [95 % CI 0⋅012, 0⋅039] mm) and control group (0⋅045 [95 % CI 0⋅033, 0⋅056] mm). The 1-year trajectory of mean ccIMT was lower in the intervention group (P = 0⋅022; adjusted for baseline). In a subgroup analysis with participants with high baseline mean ccIMT (≥0⋅800 mm), mean ccIMT non-significantly decreased in the intervention group (-0⋅016 [95 % CI -0⋅050, 0⋅017] mm; n 18) and significantly increased in the control group (0⋅065 [95 % CI 0⋅033, 0⋅096] mm; n 12). In the subgroup, the 1-year trajectory of mean ccIMT was significantly lower in the intervention group (between-group difference: -0⋅051 [95 % CI -0⋅075, -0⋅027] mm; P < 0⋅001; adjusted for baseline). The results indicate that healthy lifestyle changes may beneficially affect ccIMT within 1 year, particularly if baseline ccIMT is high.
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Kang MJ, Kim HS, Kim JY. Effects of Forest-Based Interventions on Mental Health: A Meta-Analysis of Randomized Controlled Trials. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:4884. [PMID: 35457755 PMCID: PMC9031621 DOI: 10.3390/ijerph19084884] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/08/2022] [Accepted: 04/14/2022] [Indexed: 02/04/2023]
Abstract
Forest-based interventions are a promising alternative therapy for enhancing mental health. The current study investigated the effects of forest therapy on anxiety, depression, and negative and positive mental condition through a meta-analysis of recent randomized controlled trials, using the PRISMA guideline. Of 825 articles retrieved from databases including PubMed, EMBASE, CINAHL, Cochrane, and PsycINFO, 6 met the inclusion criteria. The results of this study showed that forest-based interventions improved the mental health of participants in the intervention groups when compared to those in the control groups. Thirty-four outcome variables were analyzed from six studies. The overall effect size of the forest therapy programs was 1.25 (95% CI = 0.93−1.57, p < 0.001), which was large and statistically significant. These findings imply that forest-based interventions can improve mental health as a nonpharmacological intervention. This study is significant in that it is a meta-analysis of mental health that included only high-quality domestic and international RCTs. In future studies, more RCTs related to various forest interventions and studies involving many participants should be undertaken, which will complement heterogeneity in future meta-analysis studies.
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Affiliation(s)
| | - Hyun-Sun Kim
- College of Nursing, Eulji University, 712, Dongil-ro, Uijeongbu-si 11759, Korea;
| | - Ji-Yeon Kim
- College of Nursing, Eulji University, 712, Dongil-ro, Uijeongbu-si 11759, Korea;
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27
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Moyers SI, Abildso CG, Kelley GA. Context, classification and study methodologies in research into nature-based therapies: protocol for a scoping review. BMJ Open 2022; 12:e060734. [PMID: 35393333 PMCID: PMC8991050 DOI: 10.1136/bmjopen-2021-060734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 03/15/2022] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Nature provides an array of health benefits, and recent decades have seen a resurgence in nature-based interventions (NBI). While NBI have shown promise in addressing health needs, the wide variety of intervention approaches create difficulty in understanding the efficacy of NBI as a whole. This scoping review will (1) identify the different nomenclature used to define NBI, (2) describe the interventions used and the contexts in which they occurred and (3) describe the methodologies and measurement tools used in NBI studies. METHODS AND ANALYSIS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols Extension for Scoping Reviews, four databases will be searched (PubMed, Web of Science, Scopus, ProQuest Dissertations and Theses Global) as well as cross-referencing for published and unpublished (masters theses and dissertations) studies on NBI in humans. Eligible studies must employ intervention or observational designs, and an English-language abstract will be required. Database searches will occur from inception up to the date of the search. Animal-based therapies and virtual-reality therapies involving simulated nature will be excluded. Independent dual screening and data abstraction will be conducted. Results will be analysed qualitatively as well as with simple descriptive statistics (frequencies and percentages). ETHICS AND DISSEMINATION Since this is a scoping review of previously published summary data, ethical approval for this study is not needed. Findings will be published in a peer-reviewed journal. This protocol has been registered with Open Science Framework (https://osf.io/mtzc8).
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Affiliation(s)
- Samantha I Moyers
- Department of Social and Behavioral Sciences, West Virginia University, Morgantown, West Virginia, USA
| | - Christiaan G Abildso
- Department of Social and Behavioral Sciences, West Virginia University, Morgantown, West Virginia, USA
| | - George A Kelley
- Department of Epidemiology and Biostatistics, West Virginia University, Morgantown, West Virginia, USA
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28
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Pichler C, Freidl J, Bischof M, Kiem M, Weißböck-Erdheim R, Huber D, Squarra G, Murschetz PC, Hartl A. Mountain Hiking vs. Forest Therapy: A Study Protocol of Novel Types of Nature-Based Intervention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3888. [PMID: 35409570 PMCID: PMC8997693 DOI: 10.3390/ijerph19073888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 03/17/2022] [Accepted: 03/21/2022] [Indexed: 02/04/2023]
Abstract
INTRODUCTION The global rise of urbanization has much triggered scientific interest in how nature impacts on human health. Natural environments, such as alpine landscapes, forests, or urban green spaces, are potential high-impact health resources. While there is a growing body of evidence to reveal a positive influence of these natural environments on human health and well-being, further investigations guided by rigorous evidence-based medical research are very much needed. OBJECTIVE The present study protocol aims at testing research methodologies in the context of a prospective clinical trial on nature-based interventions. This shall improve the standards of medical research in human-nature interactions. METHODS The ANKER Study investigates the influence of two novel types of nature-based therapy-mountain hiking and forest therapy-on physiological, psychological, and immunological parameters of couples with a sedentary lifestyle. Two intervention groups were formed and spent a seven-day holiday in Algund, Italy. The "forest therapy group" participated in daily guided low-power nature connection activities. The "hiking group", by contrast, joined in a daily moderate hiking program. Health-related quality of life and relationship quality are defined as primary outcomes. Secondary outcomes include nature connection, balance, cardio-respiratory fitness, fractional exhaled nitric oxide, body composition and skin hydration. Furthermore, a new approach to measure health-related quality of life is validated. The so-called "intercultural quality of life" comic assesses the health-related quality of life with a digitally animated comic-based tool.
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Affiliation(s)
- Christina Pichler
- Institute of Ecomedicine, Paracelsus Medical University, 5020 Salzburg, Austria; (C.P.); (J.F.); (M.B.); (R.W.-E.); (D.H.); (P.C.M.)
| | - Johanna Freidl
- Institute of Ecomedicine, Paracelsus Medical University, 5020 Salzburg, Austria; (C.P.); (J.F.); (M.B.); (R.W.-E.); (D.H.); (P.C.M.)
| | - Michael Bischof
- Institute of Ecomedicine, Paracelsus Medical University, 5020 Salzburg, Austria; (C.P.); (J.F.); (M.B.); (R.W.-E.); (D.H.); (P.C.M.)
| | - Martin Kiem
- Certified Nature and Forest Therapy Guide, 39010 Tisens, Italy;
| | - Renate Weißböck-Erdheim
- Institute of Ecomedicine, Paracelsus Medical University, 5020 Salzburg, Austria; (C.P.); (J.F.); (M.B.); (R.W.-E.); (D.H.); (P.C.M.)
| | - Daniela Huber
- Institute of Ecomedicine, Paracelsus Medical University, 5020 Salzburg, Austria; (C.P.); (J.F.); (M.B.); (R.W.-E.); (D.H.); (P.C.M.)
| | | | - Paul Clemens Murschetz
- Institute of Ecomedicine, Paracelsus Medical University, 5020 Salzburg, Austria; (C.P.); (J.F.); (M.B.); (R.W.-E.); (D.H.); (P.C.M.)
| | - Arnulf Hartl
- Institute of Ecomedicine, Paracelsus Medical University, 5020 Salzburg, Austria; (C.P.); (J.F.); (M.B.); (R.W.-E.); (D.H.); (P.C.M.)
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Owens M, Bunce HLI. The Potential for Outdoor Nature-Based Interventions in the Treatment and Prevention of Depression. Front Psychol 2022; 13:740210. [PMID: 35401311 PMCID: PMC8984301 DOI: 10.3389/fpsyg.2022.740210] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 02/15/2022] [Indexed: 01/05/2023] Open
Abstract
There is growing interest in nature-based interventions (NBI) to improve human health and wellbeing. An important nascent area is exploring the potential of outdoor therapies to treat and prevent common mental health problems like depression. In this conceptual analysis on the nature-depression nexus, we distil some of the main issues for consideration when NBIs for depression are being developed. We argue that understanding the mechanisms, or 'active ingredients' in NBIs is crucial to understand what works and for whom. Successfully identifying modifiable mediating intervention targets will pave the way for interventions with increased efficacy. We highlight a non-exhaustive list of five clinically relevant putative, candidate mechanisms which may underly the beneficial effects of NBIs on depression: stress, rumination, mindfulness, sleep and exercise. We also make the case that when developing NBIs it is important to not neglect young people, explore personalised approaches and focus on both treatment and prevention approaches. To achieve these aims methodologically rigorous programmes of clinical research are needed that include well-powered and controlled experimental designs including randomised controlled trials, qualitative research, longitudinal studies and large prospective cohorts.
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Affiliation(s)
- Matthew Owens
- Department of Psychology, The Mood Disorders Centre, University of Exeter, Exeter, United Kingdom
| | - Hannah L. I. Bunce
- CEDAR, University of Exeter and Somerset Foundation Trust NHS, Taunton, United Kingdom
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30
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Taylor EM, Robertson N, Lightfoot CJ, Smith AC, Jones CR. Nature-Based Interventions for Psychological Wellbeing in Long-Term Conditions: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063214. [PMID: 35328901 PMCID: PMC8954238 DOI: 10.3390/ijerph19063214] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 02/28/2022] [Accepted: 03/03/2022] [Indexed: 12/16/2022]
Abstract
Background: With the global burden of disease increasing, particularly in relation to often preventable chronic diseases, researchers and clinicians are keen to identify interventions that can mitigate ill health and enhance the psychological wellbeing of people living with long-term conditions (LTCs). It is long established that engagement with nature can support human health and wellbeing, and in recent years, nature-based interventions (NBIs) have been advanced as of potential benefit. This review thus sought to systematically appraise published evidence of the application of NBIs to address psychological wellbeing for those living with LTCs. Methods: A systematic search of three databases, PsycINFO, MEDLINE and SCOPUS, was undertaken, and the BestBETs quality assessment checklist was used to appraise methodological quality of elicited studies. Results: Of 913 studies identified, 13 studies (12 using quantitative methods, one qualitative) were used. Included papers reported use of a variety of psychological outcomes alongside more circumscribed physiological outcomes. Quality appraisal showed modest robustness, some methodological weaknesses and a dominance of application in developed countries, yet synthesis of studies suggested that reported psychological and physiological outcomes present a strong argument for NBIs having a promising and positive impact on psychological wellbeing. Conclusions: NBIs have positive psychological and physiological impacts on people with LTCs, suggesting they may be a suitable addition to current maintenance treatment. Future research should focus on minimising study bias and increasing the potential for cross-cultural applications.
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Affiliation(s)
- Eleanor M. Taylor
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester LE1 7HA, UK;
- Correspondence: (E.M.T.); (C.R.J.)
| | - Noelle Robertson
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester LE1 7HA, UK;
| | - Courtney J. Lightfoot
- Leicester Kidney Lifestyle Team, Department of Health Sciences, University of Leicester, Leicester LE1 7RH, UK; (C.J.L.); (A.C.S.)
| | - Alice C. Smith
- Leicester Kidney Lifestyle Team, Department of Health Sciences, University of Leicester, Leicester LE1 7RH, UK; (C.J.L.); (A.C.S.)
| | - Ceri R. Jones
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester LE1 7HA, UK;
- Correspondence: (E.M.T.); (C.R.J.)
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31
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Healthy Dwelling: Design of Biophilic Interior Environments Fostering Self-Care Practices for People Living with Migraines, Chronic Pain, and Depression. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042248. [PMID: 35206441 PMCID: PMC8871637 DOI: 10.3390/ijerph19042248] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/11/2022] [Accepted: 02/13/2022] [Indexed: 12/22/2022]
Abstract
The benefits of biophilic interior design have been recognized by healthcare facilities, but residential environments receive relatively less attention with respect to improving the health of people living with chronic diseases. Recent “stay-at-home” restrictions due to the COVID-19 pandemic further emphasized the importance of creating interior spaces that directly and indirectly support physical and mental health. In this viewpoint article, we discuss opportunities for combining biophilic interventions with interior design, fostering disease-specific self-care. We provide examples of designing residential spaces integrating biophilic interventions, light therapy, relaxation opportunities, mindfulness meditation, listening to music, physical activities, aromatherapy, and quality sleep. These modalities can provide the clinical benefits of reducing migraine headaches and chronic pain, as well as improving depressive symptoms. The disease-specific interior environment can be incorporated into residential homes, workplaces, assisted-living residences, hospitals and hospital at home programs. This work aims to promote a cross-disciplinary dialogue towards combining biophilic design and advances in lifestyle medicine to create therapeutic interior environments and to improve healthcare outcomes.
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Harper NJ, Fernee CR. Unpacking Relational Dignity: In Pursuit of an Ethic of Care for Outdoor Therapies. Front Psychol 2022; 13:766283. [PMID: 35222181 PMCID: PMC8866185 DOI: 10.3389/fpsyg.2022.766283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 01/07/2022] [Indexed: 12/03/2022] Open
Abstract
Dignity is a universal principle that requires us to treat every person as having worth beyond who a particular person is or what they do. Dignity is a complex and sometimes contested idea, that at times can be compromised in health care and allegedly also within the practice of outdoor therapy. Outdoor therapies comprise a range of therapeutic approaches including nature-based therapy, adventure therapy, animal-assisted therapy, forest therapy, wilderness therapy, surf therapy, and more. Within the literature of outdoor therapies there has been limited research on ethics related to common understandings of care concepts such as relational dignity and human rights. The aim of this paper is therefore to unravel briefly whether dignity in general, and relational qualities of dignified care more particularly, might be a useful concept to apply in order to support an ethical practice in outdoor therapies.
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Affiliation(s)
- Nevin J. Harper
- Faculty of Human and Social Development, University of Victoria, Victoria, BC, Canada
| | - Carina Ribe Fernee
- Department of Child and Adolescent Mental Health, Sørlandet Hospital HE, Kristiansand, Norway
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
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Zaldo-Aubanell Q, Serra I, Bach A, Knobel P, I López FC, Belmonte J, Daunis-I-Estadella P, Maneja R. Environmental heterogeneity in human health studies. A compositional methodology for Land Use and Land cover data. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 806:150308. [PMID: 34844306 DOI: 10.1016/j.scitotenv.2021.150308] [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: 06/02/2021] [Revised: 09/08/2021] [Accepted: 09/08/2021] [Indexed: 06/13/2023]
Abstract
The use of Land use and Land cover (LULC) data is gradually becoming more widely spread in studies relating the environment to human health. However, little research has acknowledged the compositional nature of these data. The goal of the present study is to explore, for the first time, the independent effect of eight LULC categories (agricultural land, bare land, coniferous forest, broad-leaved forest, sclerophyll forest, grassland and shrubs, urban areas, and waterbodies) on three selected common health conditions: type 2 diabetes mellitus (T2DM), asthma and anxiety, using a compositional methodological approach and leveraging observational health data of Catalonia (Spain) at area level. We fixed the risk exposure scenario using three covariates (socioeconomic status, age group, and sex). Then, we assessed the independent effect of the eight LULC categories on each health condition. Our results show that each LULC category has a distinctive effect on the three health conditions and that the three covariates clearly modify this effect. This compositional approach has yielded plausible results supported by the existing literature, highlighting the relevance of environmental heterogeneity in health studies. In this sense, we argue that different types of environment possess exclusive biotic and abiotic elements affecting distinctively on human health. We believe our contribution might help researchers approach the environment in a more multidimensional manner integrating environmental heterogeneity in the analysis.
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Affiliation(s)
- Quim Zaldo-Aubanell
- Institute of Environmental Science and Technology (ICTA), Autonomous University of Barcelona (UAB), Z building, ICTA-ICP, Carrer de les columnes, UAB Campus, 08193, Bellaterra, Barcelona, Spain; Environment and Human Health Laboratory (EH(2) Lab), Forest Science and Technology Center of Catalonia, Ctra. de St. Llorenç de Morunys, km 2, 25280 Solsona, Spain.
| | - Isabel Serra
- Centre de Recerca Matemàtica, Edifici C, 08193 Bellaterra, Barcelona, Spain; Barcelona Supercomputing Center, 08034 Barcelona, Spain
| | - Albert Bach
- Environment and Human Health Laboratory (EH(2) Lab), Forest Science and Technology Center of Catalonia, Ctra. de St. Llorenç de Morunys, km 2, 25280 Solsona, Spain; Forest Science and Technology Center of Catalonia, Ctra. de St. Llorenç de Morunys, km 2, 25280 Solsona, Spain
| | - Pablo Knobel
- Environment and Human Health Laboratory (EH(2) Lab), Forest Science and Technology Center of Catalonia, Ctra. de St. Llorenç de Morunys, km 2, 25280 Solsona, Spain
| | - Ferran Campillo I López
- Environment and Human Health Laboratory (EH(2) Lab), Forest Science and Technology Center of Catalonia, Ctra. de St. Llorenç de Morunys, km 2, 25280 Solsona, Spain; Paediatric Environmental Health Specialty Unit, Paediatric Team of the Garrotxa Region, Olot and Garrotxa Region Hospital Foundation, Avinguda Països Catalans 86, 17800 Olot, Catalonia, Spain
| | - Jordina Belmonte
- Institute of Environmental Science and Technology (ICTA), Autonomous University of Barcelona (UAB), Z building, ICTA-ICP, Carrer de les columnes, UAB Campus, 08193, Bellaterra, Barcelona, Spain; Department of Animal Biology, Plant Biology and Ecology, Autonomous University of Barcelona (UAB), C building, UAB Campus 08193, Bellaterra, Barcelona, Spain
| | - Pepus Daunis-I-Estadella
- Department of Computer Science, Applied Mathematics and Statistics, Universitat de Girona, Carrer Universitat de Girona, 6, 17003 Girona, Spain
| | - Roser Maneja
- Environment and Human Health Laboratory (EH(2) Lab), Forest Science and Technology Center of Catalonia, Ctra. de St. Llorenç de Morunys, km 2, 25280 Solsona, Spain; Forest Science and Technology Center of Catalonia, Ctra. de St. Llorenç de Morunys, km 2, 25280 Solsona, Spain; Geography Department, Autonomous University of Barcelona (UAB), B building, UAB Campus 08193, Bellaterra, Barcelona, Spain
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Park KH. Analysis of Urban Forest Healing Program Expected Values, Needs, and Preferred Components in Urban Forest Visitors with Diseases: A Pilot Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:513. [PMID: 35010772 PMCID: PMC8744597 DOI: 10.3390/ijerph19010513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 12/30/2021] [Accepted: 12/31/2021] [Indexed: 02/06/2023]
Abstract
Although the effectiveness of urban forest therapy has been studied and proven, most people are not well aware of the positive healing effects of urban forests that are easily accessible in daily life compared to the known healing effect of forests located outside urban areas. In addition, there has been a study on the analysis of urban forest healing program needs in the general population, but there is a lack of evidence on the expected values and needs of urban forest healing for people with diseases. Therefore, this pilot survey aimed to investigate the expected values, needs, and preferred components of urban forest healing programs in urban forest visitors with disease via an online user survey and see if there were any differences in the purpose of the urban forest visits and expected values of urban forest healing depending on the type of disease. The survey was conducted on 294 urban forest visitors with diseases. About 79% of respondents agreed with the healing effects of urban forest, however most respondents expected healing effects on mental health rather than on physical health ("mood change" was the highest with score of 4.43/5, followed by "reliving stress" (4.35/5) and "mental and physical stability" (4.31/5)). In addition, more than 82.0% of respondents agreed to participate in the program if a healing program for disease was developed. The results of the current pilot survey indicate that the purpose of the urban forest visits and expected values of urban forest healing were largely not different by the type of disease, and people with disease had a relatively lower awareness and lower expected values of urban forest healing effects on physical health, but high demand for the program. Urban forest therapy programs should be developed based on the specific clinical characteristics of the disease to maximize the effectiveness of the program. Additionally, policies should be implemented to promote the beneficial effects of urban forest healing not only for mental health but also for physical health.
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Affiliation(s)
- Kwang-Hi Park
- Department of Nursing, College of Nursing, Gachon University, Incheon 21936, Korea
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Jo SH, Park JS, Yeon PS. The Effect of Forest Video Using Virtual Reality on the Stress Reduction of University Students Focused on C University in Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:12805. [PMID: 34886531 PMCID: PMC8657194 DOI: 10.3390/ijerph182312805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/01/2021] [Accepted: 12/02/2021] [Indexed: 11/17/2022]
Abstract
The purpose of this study is to study the effect of forest videos using virtual reality (VR) on the stress of college students. The study subjects were 60 college students who watched two-dimensional (2D) and VR videos, and we compared their control heart rate variability (HRV) and electroencephalogram (EEG). As a result, it was found that the VR group had a positive effect on high frequency (HF), standard deviation of all NN intervals (SDNN), and root-mean-square of successive differences (RMSSD) compared with the control group, and the VR group had a positive effect on HF compared with the 2D group. Second, EEG, a physiological indicator, showed statistical differences in Relative Alpha Power (RA), Relative Beta Power (RB), and Ratio of SMR-Mid Beta to Theta (RSMT) in VR groups in intra-group analysis. Among them, it was investigated that watching forest videos on VR became a state of concentration and immersion due to the increase in RSMT. As a result of the above, it was investigated that forest videos using VR had a positive effect on the physiological stress on college students. Therefore, it is expected that a positive effect will occur if VR is used as an alternative to stress management for college students.
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Affiliation(s)
- Seong-Hee Jo
- Forest Welfare Research Center, Korea Forest Welfare Institute, Youngju 36043, Korea;
| | - Jin-Seok Park
- Department of Forest Therapy, Chungbuk National University, Cheongju 28644, Korea;
| | - Poung-Sik Yeon
- Department of Forest Therapy, Chungbuk National University, Cheongju 28644, Korea;
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Yeon PS, Jeon JY, Jung MS, Min GM, Kim GY, Han KM, Shin MJ, Jo SH, Kim JG, Shin WS. Effect of Forest Therapy on Depression and Anxiety: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312685. [PMID: 34886407 PMCID: PMC8657257 DOI: 10.3390/ijerph182312685] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/26/2021] [Accepted: 11/27/2021] [Indexed: 12/15/2022]
Abstract
This systematic review and meta-analysis aimed to summarize the effects of forest therapy on depression and anxiety using data obtained from randomized controlled trials (RCTs) and quasi-experimental studies. We searched SCOPUS, PubMed, MEDLINE(EBSCO), Web of science, Embase, Korean Studies Information Service System, Research Information Sharing Service, and DBpia to identify relevant studies published from January 1990 to December 2020 and identified 20 relevant studies for the synthesis. The methodological quality of eligible primary studies was assessed by ROB 2.0 and ROBINS-I. Most primary studies were conducted in the Republic of Korea except for one study in Poland. Overall, forest therapy significantly improved depression (Hedges’s g = 1.133; 95% confidence interval (CI): −1.491 to −0.775) and anxiety (Hedges’s g = 1.715; 95% CI: −2.519 to −0.912). The quality assessment resulted in five RCTs that raised potential concerns in three and high risk in two. Fifteen quasi-experimental studies raised high for nine quasi-experimental studies and moderate for six studies. In conclusion, forest therapy is preventive management and non-pharmacologic treatment to improve depression and anxiety. However, the included studies lacked methodological rigor and required more comprehensive geographic application. Future research needs to determine optimal forest characteristics and systematic activities that can maximize the improvement of depression and anxiety.
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Affiliation(s)
- Poung-Sik Yeon
- Department of Forest Sciences, Chungbuk National University, Cheongju 28644, Korea;
| | - Jin-Young Jeon
- Graduated Department of Forest Therapy, Chungbuk National University, Cheongju 28644, Korea; (J.-Y.J.); (M.-S.J.); (G.-M.M.); (G.-Y.K.); (K.-M.H.); (M.-J.S.)
| | - Myeong-Seo Jung
- Graduated Department of Forest Therapy, Chungbuk National University, Cheongju 28644, Korea; (J.-Y.J.); (M.-S.J.); (G.-M.M.); (G.-Y.K.); (K.-M.H.); (M.-J.S.)
| | - Gyeong-Min Min
- Graduated Department of Forest Therapy, Chungbuk National University, Cheongju 28644, Korea; (J.-Y.J.); (M.-S.J.); (G.-M.M.); (G.-Y.K.); (K.-M.H.); (M.-J.S.)
| | - Ga-Yeon Kim
- Graduated Department of Forest Therapy, Chungbuk National University, Cheongju 28644, Korea; (J.-Y.J.); (M.-S.J.); (G.-M.M.); (G.-Y.K.); (K.-M.H.); (M.-J.S.)
| | - Kyung-Mi Han
- Graduated Department of Forest Therapy, Chungbuk National University, Cheongju 28644, Korea; (J.-Y.J.); (M.-S.J.); (G.-M.M.); (G.-Y.K.); (K.-M.H.); (M.-J.S.)
| | - Min-Ja Shin
- Graduated Department of Forest Therapy, Chungbuk National University, Cheongju 28644, Korea; (J.-Y.J.); (M.-S.J.); (G.-M.M.); (G.-Y.K.); (K.-M.H.); (M.-J.S.)
| | - Seong-Hee Jo
- National Center for Forest Therapy, Yeongju 36043, Korea;
| | - Jin-Gun Kim
- Korea Forest Therapy Forum Incorporated Association, Cheongju 28644, Korea
- Correspondence: (J.-G.K.); (W.-S.S.); Tel.: +82-10-6480-4171 (J.-G.K.); +82-43-261-2536 (W.-S.S.)
| | - Won-Sop Shin
- Department of Forest Sciences, Chungbuk National University, Cheongju 28644, Korea;
- Correspondence: (J.-G.K.); (W.-S.S.); Tel.: +82-10-6480-4171 (J.-G.K.); +82-43-261-2536 (W.-S.S.)
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Rzymski P. Comment on "Mushroom intake and depression: A population-based study using data from the US National Health and Nutrition Examination Survey (NHANES), 2005-2016". J Affect Disord 2021; 295:937-938. [PMID: 34706465 DOI: 10.1016/j.jad.2021.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 09/05/2021] [Indexed: 11/29/2022]
Abstract
The collection of wild mushrooms for consumption remain highly popular in different populations and is also practiced in the US. It cannot be ruled out that the decreased (not dose-dependent) odd of depression in mushroom consumers is, at least partially, due to their exposure to the natural environment and associated lifestyle factors. Therefore, further research focusing on depression rates in groups of mushroom hunters is encouraged.
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Affiliation(s)
- Piotr Rzymski
- Department of Environmental Medicine, Poznan University of Medical Sciences, 60-806 Poznań, Poland.
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Park S, Choi Y, Kim G, Kim E, Kim S, Paek D. Physiological and Psychological Assessments for the Establishment of Evidence-Based Forest Healing Programs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9283. [PMID: 34501872 PMCID: PMC8430466 DOI: 10.3390/ijerph18179283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 08/26/2021] [Accepted: 08/29/2021] [Indexed: 11/16/2022]
Abstract
This study aimed to establish a health and medical foundation for forest healing programs and provide a basis for developing an evaluation system for such programs. While the number of visitors to forests and interest in forest healing effects are increasing, few studies have examined the various indicators of the persistent changes in forest healing effects. Therefore, this study conducted pre-, post-, and follow-up experiments on 87 health and clinical indicators in a sample of 88 adolescent participants. The relationships between pre-, post-, and follow-up experiment results for each indicator were analyzed. Of the 87 indicators, 46 showed significant changes, including systolic blood pressure, diastolic blood pressure, cholesterol, serotonin, vitamin D, CD16+CD56 count, interferon-γ, resilience, and self-esteem. The findings are significant for studying diverse participants and indicators and lay the foundation for developing forest healing programs by clarifying aspects such as the indicators suitable for short-term observation versus the indicators requiring long-term observation. Based on these analyses, the results of this study are expected to be useful when conducting research to establish an evidence-based forest healing program in the future.
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Affiliation(s)
- Sujin Park
- Future Forest Strategy Department, Forest Human Service Division, National Institute of Forest Science, Seoul 02455, Korea; (S.P.); (Y.C.); (G.K.); (E.K.); (S.K.)
- Graduate School of Public Health, Seoul National University, Seoul 08826, Korea
| | - Yeji Choi
- Future Forest Strategy Department, Forest Human Service Division, National Institute of Forest Science, Seoul 02455, Korea; (S.P.); (Y.C.); (G.K.); (E.K.); (S.K.)
| | - Geonwoo Kim
- Future Forest Strategy Department, Forest Human Service Division, National Institute of Forest Science, Seoul 02455, Korea; (S.P.); (Y.C.); (G.K.); (E.K.); (S.K.)
| | - Eunsoo Kim
- Future Forest Strategy Department, Forest Human Service Division, National Institute of Forest Science, Seoul 02455, Korea; (S.P.); (Y.C.); (G.K.); (E.K.); (S.K.)
| | - Soojin Kim
- Future Forest Strategy Department, Forest Human Service Division, National Institute of Forest Science, Seoul 02455, Korea; (S.P.); (Y.C.); (G.K.); (E.K.); (S.K.)
| | - Domyung Paek
- Graduate School of Public Health, Seoul National University, Seoul 08826, Korea
- Institute of Health and Environment, Seoul National University, Seoul 08826, Korea
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Bang KS, Kim S, Lee G, Choi S, Shin DA, Kim M. The Development of a Health Promotion Program for Unmarried Mothers Living in Residential Facilities Using Urban Forests: An Intervention Mapping Approach Based on the Transtheoretical Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8684. [PMID: 34444433 PMCID: PMC8391451 DOI: 10.3390/ijerph18168684] [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: 07/09/2021] [Revised: 08/12/2021] [Accepted: 08/13/2021] [Indexed: 11/17/2022]
Abstract
Unmarried mothers living in residential facilities (UMLFs) in Korea face complex and challenging physical, psychological, and socioeconomic issues. This study developed a physical and mental health promotion program using urban forests for UMLFs based on the transtheoretical model and evidence. We utilized an intervention mapping approach (IMA) and assessed the needs of UMLFs by analyzing previous quantitative studies. Moreover, we conducted a qualitative hermeneutic phenomenological study involving nine participants. Based on the needs assessment, important and changeable determinants were identified; further, the program performance and change objectives were classified to achieve the program goals and establish the intervention strategy. We found that physical activity using forests, self-reflection using metaphors, five-sense activities, achievement activities using natural objects, building interpersonal relationships in the forest, and designing future plans, are desirable methods for improving the health of UMLFs. The IMA was deemed appropriate for the systematic development of health promotion programs for UMLFs through clear links among change objectives, theoretical methods, and practice strategies. These results should be applied to future intervention studies.
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Affiliation(s)
- Kyung-Sook Bang
- Faculty of College of Nursing, The Research Institute of Nursing Science, Seoul National University, Seoul 03080, Korea; (K.-S.B.); (S.K.)
| | - Sungjae Kim
- Faculty of College of Nursing, The Research Institute of Nursing Science, Seoul National University, Seoul 03080, Korea; (K.-S.B.); (S.K.)
| | - Gumhee Lee
- College of Nursing, Seoul National University, Seoul 03080, Korea; (S.C.); (D.-A.S.); (M.K.)
| | - Sinyoung Choi
- College of Nursing, Seoul National University, Seoul 03080, Korea; (S.C.); (D.-A.S.); (M.K.)
| | - Da-Ae Shin
- College of Nursing, Seoul National University, Seoul 03080, Korea; (S.C.); (D.-A.S.); (M.K.)
| | - Misook Kim
- College of Nursing, Seoul National University, Seoul 03080, Korea; (S.C.); (D.-A.S.); (M.K.)
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Abe T, Okuyama K, Hamano T, Takeda M, Yamasaki M, Isomura M, Nakano K, Sundquist K, Nabika T. Assessing the Impact of a Hilly Environment on Depressive Symptoms among Community-Dwelling Older Adults in Japan: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094520. [PMID: 33923194 PMCID: PMC8123156 DOI: 10.3390/ijerph18094520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 04/22/2021] [Accepted: 04/22/2021] [Indexed: 11/16/2022]
Abstract
Although some neighborhood environmental factors have been found to affect depressive symptoms, few studies have focused on the impact of living in a hilly environment, i.e., land slope, on depressive symptoms among rural older adults. This cross-sectional study aimed to investigate whether a land slope is associated with depressive symptoms among older adults living in rural areas. Data were collected from 935 participants, aged 65 years and older, who lived in Shimane prefecture, Japan. Depressive symptoms were assessed using the Zung Self-Rating Depression Scale (SDS) and defined on the basis of an SDS score ≥ 40. Land slopes within a 400 m network buffer were assessed using geographic information systems. Odds ratios (ORs) with 95% confidence intervals (CIs) of depressive symptoms were estimated using logistic regression. A total of 215 (23.0%) participants reported depressive symptoms. The land slope was positively associated with depressive symptoms (OR = 1.04; 95% CI = 1.01-1.08) after adjusting for all confounders. In a rural setting, living in a hillier environment was associated with depressive symptoms among community-dwelling older adults in Japan.
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Affiliation(s)
- Takafumi Abe
- Center for Community-Based Healthcare Research and Education (CoHRE), Head Office for Research and Academic Information, Shimane University, Shimane 693-8501, Japan; (K.O.); (T.H.); (M.T.); (M.Y.); (M.I.); (K.N.); (K.S.)
- Correspondence: ; Tel.: +81-853-20-2586
| | - Kenta Okuyama
- Center for Community-Based Healthcare Research and Education (CoHRE), Head Office for Research and Academic Information, Shimane University, Shimane 693-8501, Japan; (K.O.); (T.H.); (M.T.); (M.Y.); (M.I.); (K.N.); (K.S.)
- Center for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund University, 20502 Malmö, Sweden
| | - Tsuyoshi Hamano
- Center for Community-Based Healthcare Research and Education (CoHRE), Head Office for Research and Academic Information, Shimane University, Shimane 693-8501, Japan; (K.O.); (T.H.); (M.T.); (M.Y.); (M.I.); (K.N.); (K.S.)
- Department of Sports Sociology and Health Sciences, Faculty of Sociology, Kyoto Sangyo University, Kyoto 603-8555, Japan
| | - Miwako Takeda
- Center for Community-Based Healthcare Research and Education (CoHRE), Head Office for Research and Academic Information, Shimane University, Shimane 693-8501, Japan; (K.O.); (T.H.); (M.T.); (M.Y.); (M.I.); (K.N.); (K.S.)
| | - Masayuki Yamasaki
- Center for Community-Based Healthcare Research and Education (CoHRE), Head Office for Research and Academic Information, Shimane University, Shimane 693-8501, Japan; (K.O.); (T.H.); (M.T.); (M.Y.); (M.I.); (K.N.); (K.S.)
- Faculty of Human Sciences, Shimane University, Shimane 690-8504, Japan
| | - Minoru Isomura
- Center for Community-Based Healthcare Research and Education (CoHRE), Head Office for Research and Academic Information, Shimane University, Shimane 693-8501, Japan; (K.O.); (T.H.); (M.T.); (M.Y.); (M.I.); (K.N.); (K.S.)
- Faculty of Human Sciences, Shimane University, Shimane 690-8504, Japan
| | - Kunihiko Nakano
- Center for Community-Based Healthcare Research and Education (CoHRE), Head Office for Research and Academic Information, Shimane University, Shimane 693-8501, Japan; (K.O.); (T.H.); (M.T.); (M.Y.); (M.I.); (K.N.); (K.S.)
| | - Kristina Sundquist
- Center for Community-Based Healthcare Research and Education (CoHRE), Head Office for Research and Academic Information, Shimane University, Shimane 693-8501, Japan; (K.O.); (T.H.); (M.T.); (M.Y.); (M.I.); (K.N.); (K.S.)
- Center for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund University, 20502 Malmö, Sweden
- Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY 10029-5674, USA
| | - Toru Nabika
- Department of Functional Pathology, Faculty of Medicine, Shimane University, Shimane 693-8501, Japan;
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