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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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