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Kwon CY, Lee B. Effectiveness of mind-body medicine for Hwa-Byung (a Korean cultural diagnosis of suppressed anger): A systematic review of interventional studies. Complement Ther Med 2024; 80:103016. [PMID: 38185401 DOI: 10.1016/j.ctim.2024.103016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 12/14/2023] [Accepted: 01/03/2024] [Indexed: 01/09/2024] Open
Abstract
OBJECTIVE This systematic review analysed the effectiveness of mind-body modalities (MBMs) in Hwa-byung (HB). METHODS Ten electronic databases were searched. Intervention studies using MBMs for individuals with HB, published up to July 2023, were included. The methodological quality of the included studies was assessed using the Cochrane RoB and ROBINS-I tools. Meta-analysis of continuous variables was presented as mean differences (MDs) and their 95% confidence intervals (CIs). RESULTS Nine studies including five randomized controlled clinical trials, were included. The MBM types were meditation, relaxation, biofield therapy, art therapy, and forest-based MBM, and comprehensive HB programs. Most studies used an MBM group, with 5-6 sessions delivered during an average of 4-5 weeks. As a result of the meta-analysis, art therapy showed a statistically significantly better effect on improving the Hwa-Byung Scale (HB-S) score compared to the waitlist control (MD = -7.74; 95% CI = -9.81 to -5.66). In the before-and-after comparison, MBMs were frequently reported to have significant benefits for improving the HB-S total score (7/7, 100%), depressive mood (4/5, 80%), and state anxiety (6/8, 75%). Some methodological flaws were identified in the included studies, including the reliability of diagnosis, non-implementation of assessor blinding, and inappropriate control groups. CONCLUSIONS This review identified potentially promising MBMs that were not previously recommended in the current HB clinical practice guidelines. In the future, high-quality clinical studies that include the use of standardized HB diagnostic criteria, homogeneous interventions, appropriate control groups, standard assessment tools such as the HB-S, and assessor blinding are needed.
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Affiliation(s)
- Chan-Young Kwon
- Department of Oriental Neuropsychiatry, Dong-eui University College of Korean Medicine, Busan, Republic of Korea.
| | - Boram Lee
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
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Kang M, Yang Y, Kim H, Jung S, Jin HY, Choi KH. The mechanisms of nature-based therapy on depression, anxiety, stress, and life satisfaction: examining mindfulness in a two-wave mediation model. Front Psychol 2023; 14:1330207. [PMID: 38187408 PMCID: PMC10768844 DOI: 10.3389/fpsyg.2023.1330207] [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: 10/30/2023] [Accepted: 12/05/2023] [Indexed: 01/09/2024] Open
Abstract
Background Nature-based therapy (NBT), which centers around engaging in activities within natural surroundings, has consistently demonstrated therapeutic benefits for mental health. While NBT highlights the potential of nature as a therapeutic resource for promoting mental health, there is limited knowledge regarding its underlying mechanisms. Methods Two hundred seventy-six Korean participants (204 women, mean age = 54.99 ± 23.25 years) participated in a 30-session gardening program held twice weekly for 15 weeks. Structural equation modeling with a two-wave autoregressive cross-lagged model was used to investigate the mediating effects of mindfulness. Results NBT significantly improved the mean scores of all psychological variables. The mediation model was partially confirmed, with mindfulness at post-intervention (T2) mediating the relationship between baseline (T1) depression and anxiety and post-intervention (T2) life satisfaction. However, no significant indirect effect was observed between the path from stress (T1) to life satisfaction (T2). Conclusion Mindfulness is a crucial component for improving mental health outcomes. This study underscores the need to prioritize and emphasize mindfulness practices in NBT.
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Affiliation(s)
- Minjung Kang
- School of Psychology, Korea University, Seoul, Republic of Korea
- KU Mind Health Institute, Korea University, Seoul, Republic of Korea
| | - Yeji Yang
- School of Psychology, Korea University, Seoul, Republic of Korea
- KU Mind Health Institute, Korea University, Seoul, Republic of Korea
| | - Hyunjin Kim
- School of Psychology, Korea University, Seoul, Republic of Korea
- KU Mind Health Institute, Korea University, Seoul, Republic of Korea
| | - Songhie Jung
- Gardens and Education Research Division, Korea National Arboretum, Pocheon, Republic of Korea
| | - Hye-Young Jin
- Gardens and Education Research Division, Korea National Arboretum, Pocheon, Republic of Korea
| | - Kee-Hong Choi
- School of Psychology, Korea University, Seoul, Republic of Korea
- KU Mind Health Institute, Korea University, Seoul, Republic of Korea
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Park KH, Lee H, Park EY, Sung JH, Song MK, An M, Bang E, Baek SY, Do Y, Lee S, Lim Y. Effects of an urban forest healing program on cancer-related fatigue in cancer survivors. Support Care Cancer 2023; 32:4. [PMID: 38051396 DOI: 10.1007/s00520-023-08214-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 11/28/2023] [Indexed: 12/07/2023]
Abstract
PURPOSE This study aimed to examine the effects of an eight-session structured urban forest healing program for cancer survivors with fatigue. BACKGROUND Cancer-related fatigue (CRF) is a complex and multifactorial common symptom among cancer survivors that limits quality of life (QoL). Although health benefits of forest healing on physiological, physical, and psychological aspect as well as on the immune system have been reported in many studies, there is limited evidence on the efficacy of specialized forest program for cancer survivors. METHOD A single-blinded, pre-test and post-test control group clinical trial was conducted with -75 cancer survivors assigned to either the forest healing group or the control group. The intervention was an eight-session structured urban forest program provided at two urban forests with easy accessibility. Each session consists of three or four major activities based on six forest healing elements such as landscape, phytoncides, anions, sounds, sunlight, and oxygen. Complete data of the treatment-adherent sample (≥ 6 sessions) was used to examine whether sociodemographic, clinical, physiological (respiratory function, muscle strength, balance, 6-min walking test) and psychological (distress, mood state, sleep quality, QoL) characteristics at baseline moderated the intervention effect on fatigue severity at 9 weeks. RESULTS Significant time-group interactions were observed muscle strength, balance, 6-min walking test, distress, fatigue, moods, and QoL. The mean difference in fatigue between pre- and post-forest healing program was 9.1 (95% CI 6.2 to 11.9), 11.9 (95% CI 7.6 to 16.1) in moods, and -93.9 (95% CI -123.9 to -64.0) in QoL, showing significant improvements in forest healing group, but no significant improvements in the control group. CONCLUSION This study suggests that a forest healing program positively impacts the lives of cancer survivors, by addressing both physical and psychological challenges associated with CRF. TRIAL REGISTRATION NUMBER KCT0008447 (Date of registration: May 19, 2023).
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Affiliation(s)
- Kwang-Hi Park
- Department of Nursing, College of Nursing, Gachon University, Hambangmoe-ro 191, Yeonsu-gu, Incheon, Korea.
- Graduate School, Department of Nursing, College of Nursing, Gachon University, Incheon, Korea.
| | - Haneul Lee
- Department of Physical Therapy, College of Health Science, Gachon University, Incheon, Korea
- Graduate School, Department of Physical Therapy, College of Health Science, Gachon University, Incheon, Korea
| | - Eun Young Park
- Department of Nursing, College of Nursing, Gachon University, Hambangmoe-ro 191, Yeonsu-gu, Incheon, Korea
- Graduate School, Department of Nursing, College of Nursing, Gachon University, Incheon, Korea
| | - Ji Hyun Sung
- College of Nursing, Kosin University, Busan, Korea
| | - Min Kyung Song
- Department of Nursing, College of Medicine, University of Ulsan, Ulsan, Korea
| | - Miyoung An
- Department of Nursing, Yeoju Institute of Technology, Yeoju, Korea
| | - Esther Bang
- Department of Nursing, College of Nursing, Gachon University, Hambangmoe-ro 191, Yeonsu-gu, Incheon, Korea
| | - Sang Yi Baek
- Graduate School, Department of Nursing, College of Nursing, Gachon University, Incheon, Korea
| | - Yerim Do
- Graduate School, Department of Physical Therapy, College of Health Science, Gachon University, Incheon, Korea
| | - Sieun Lee
- Graduate School, Department of Nursing, College of Nursing, Gachon University, Incheon, Korea
| | - Youngeun Lim
- Graduate School, Department of Physical Therapy, College of Health Science, Gachon University, Incheon, Korea
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Park EY, Song MK, Baek SY. Analysis of Perceptions, Preferences, and Participation Intention of Urban Forest Healing Program among Cancer Survivors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1604. [PMID: 36674361 PMCID: PMC9865761 DOI: 10.3390/ijerph20021604] [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: 01/03/2023] [Revised: 01/12/2023] [Accepted: 01/14/2023] [Indexed: 06/17/2023]
Abstract
It is important to manage the health of cancer survivors who have returned to their daily lives. An increasing number of cancer survivors are undertaking health care in forests near their residences. This cross-sectional study aimed to determine the perceptions of forest healing and the program preferences of adult cancer survivors. Data were collected from 388 female cancer survivors through an online survey. Breast cancer survivors comprised 66.2%, and 63.6% of the study participants were diagnosed with cancer within 2 to 5 years prior to the study. The subjective health status was 2.68 ± 0.61 out of 4 points. Of the participants, 62.1% had heard of forest healing and 65.7% intended to participate in the forest healing program. Participants who frequently visited the forest were more likely to participate in the forest healing program in the future than those who rarely visited the forest. A survey among 255 people on specific preferences for the program found that the regular visit type was preferred over the one-time visit type. These results are meaningful because they can be used as a basis for the development of a forest treatment program that reflects the needs of cancer survivors.
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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
| | - Sang Yi Baek
- College of Nursing, Gachon University, Incheon 21936, Republic of Korea
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Impact of COVID-19 Lock-Downs on Nature Connection in Southern and Eastern Africa. LAND 2022. [DOI: 10.3390/land11060872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
The response of African countries immediately after the COVID-19 pandemic declaration was rapid and appropriate, with low infections and mortality rates until June 2020. Severe lock-down measures were effective in Africa; however, the reduction in the amount of natural experience influences the quality of life in modern society. This study is conducted as an international comparative study in five African countries on changes in the perception of health recovery and outdoor activities in urban forests during the COVID-19 pandemic. An online survey was conducted with 430 respondents to investigate the relationships between COVID-19 stress, indoor activity, appreciation of greenspaces, perception of health recovery, and use of greenspaces. A structural equation model was used for analysis. The visit frequency and staying time in urban forests after lock-down dramatically decreased, raising concerns about nature-deficit disorder across the target countries after the end of the pandemic. This study confirmed urban dwellers’ desire for natural experiences and health recovery during the pandemic and predicts an explosive increase in urban forest utilization after the pandemic has ended.
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Perceived Benefits and Forest Tourists Consumption Intention: Environmental Protection Attitude and Resource Utilization Attitude as Mediators. FORESTS 2022. [DOI: 10.3390/f13050812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Establishing a relationship model between environmental protection and resource utilization attitude and consumption intention is the key to promoting the sustainable development of forest tourism. From the standpoint of the Stimulus–Organism–Response (SOR) framework, the purpose of this study is to explore the complex causal relationships between perceived benefits, attitudes toward environmental protection, resource utilization attitudes, and consumption intentions in the context of forest tourism. The research data have been collected using a questionnaire survey of 436 tourists at Siming Mountain in the suburbs of Ningbo city, China. Furthermore, it is analyzed by structural equation modeling. The results indicate a positive correlation between the perceived benefits and tourists’ consumption intention that is mediated by the tourists’ attitude toward resource utilization. Although the independent mediating effect of environmental protection attitude is not supported in this study, both attitudes have played a chain-mediating role between perceived benefit and consumption intention. This study contributes to the existing knowledge by measuring the impact of perceived benefits and environmental attitudes of forest tourists on consumption intentions.
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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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Accelerating the Nature Deficit or Enhancing the Nature-Based Human Health during the Pandemic Era: An International Study in Cambodia, Indonesia, Japan, South Korea, and Myanmar, following the Start of the COVID-19 Pandemic. FORESTS 2022. [DOI: 10.3390/f13010057] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
In modern society, the opportunity to experience nature is separate from everyday life, requiring time and effort. Since the start of the COVID-19 pandemic, restrictions on freedom of activity and communication around the world have become a crisis, causing a nature deficit by accelerating the process of separation from nature. At the same time, the pandemic has increased people’s motivation to return to nature, providing an opportunity to seek experiences and health recovery in nature. The authors conducted an international cross-sectional study in five Asian countries, investigating changes in the perception of recreational activities and health restoration in the natural environment, one of the many effects of the COVID-19 pandemic on human society. An online survey, completed by 524 respondents, has confirmed the efficacy of the SEM model, which includes COVID-19 stress, increased indoor activity, a preference for the natural environment, and the perception of health recovery. Although the five countries had different response values for each theme, the stress caused by restricted activities and communication during the pandemic was linked to a preference for natural experiences and the motivation to visit natural environments in all five countries, ultimately affecting perceptions of health recovery in nature. This study has shown that the COVID-19 pandemic, a disaster afflicting all human civilization, has changed people’s perceptions by enhancing their preference for natural recreational activities and health. It has accelerated people’s return to nature and fostered a positive perception of nature’s ability to promote good health.
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Exploring the Outdoor Recreational Behavior and New Environmental Paradigm among Urban Forest Visitors in Korea, Taiwan and Indonesia. FORESTS 2021. [DOI: 10.3390/f12121651] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This is international comparative research on the perception of local residents toward the natural environment in South Korea, Taiwan, and Indonesia. Through the New Ecological Paradigm (NEP) investigation, perceptions of natural environmental conservation and utilization of 664 urban forest visitors were analyzed, and the relationship between recreational behavior, NEP scores, and demographic characteristics was investigated. The three countries, with different histories, cultures, and economic development, showed statistically significant differences in all items. In terms of the NEP response score, Taiwan showed the most positive results with an average of 4.08. Frequent visits by the elderly and family were common significant factors of high NEP score for all survey locations. In the confirmatory factor analysis of latent variables for NEP, ‘limits to growth’ were significant in South Korea while ‘ecological crisis’ was more significant in Taiwan and Indonesia. Forest experience frequency was a common factor affecting NEP, indicating that frequent forest visits during leisure time are a major factor in improving the ecological paradigm.
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