Summarised details of 25 papers retained following selection process
| Author(s) | Title | Country | Participants | Type of nature-based therapy | Purpose of study | Study design | Core findings |
|---|---|---|---|---|---|---|---|
| Chatalos (2013) | Sustainability: ecopsychological insights and person-centred contributions | United Kingdom | N/A | N/A | To propose a person-centred approach in ecopsychology to address the psychological roots of the ecological crisis | Theoretical | Through facilitating an individual’s realisation of one’s embeddedness within the larger ecosystem, ecopsychology aims to increase awareness of sustainability and connectedness to the non-human world |
| Christie et al. (2016) | Personality disorder and intellectual disability: The impacts of horticultural therapy within a medium-secure unit | United Kingdom | Male residents of a medium secure unit with a dual diagnosis of personality disorder and intellectual disability (n = 7) | Horticulture therapy | To explore the efficacy of HT for enhancement of subjective health and well-being | Qualitative; focus groups 12-month gardening group; designing, creating and maintaining a garden on the in-patient unit site | Participants identified enhanced gardening knowledge, employability skills, personal development, reduced stress, positive changes in behaviour towards self and others and improved life-satisfaction because of interaction with the natural environment, intrinsic motivation and opportunities to develop horticultural skills |
| Corazon et al. (2011) | Developing the therapeutic potential of embodied cognition and metaphors in nature-based therapy: Lessons from theory to practice | Denmark | N/A | N/A | To examine the interplay between cognition and bodily involvement in relation to nature-based therapy | Theoretical | NBT is a therapeutic tool, not the goal itself. Using NBT metaphors to bring the learning beyond the therapeutic setting and into everyday life. NBT has shown psychological benefits through the use of meaningful, pleasurable and rewarding occupations, thus enhancing an individual’s self-concept, self-esteem and empowerment |
| Kucher et al. (2020) | 3-Dimensional nature-based therapeutics in paediatric patients with total pancreatectomy and islet auto-transplant | USA | Paediatric patients (8–18 years) scheduled for total pancreatectomy and islet auto-transplant (TPIAT) (n = 6) | Use of NBT through virtual reality | To demonstrate that the use of 3-D nature-based therapy (NBT) glasses will lead to a reduction in pain, nausea and anxiety in children and adolescents undergoing TPIAT | Mixed methods; interviews/scoring pre and post (Wong-Baker FACES, BARF scales and a novel nature-based anxiety scale) | Pre- and post-intervention scores showed a reduction in pain, stress and anxiety because of virtual reality NBT use. Proposed as a tool for those that cannot access NBT (non-mobile patients) |
| Kusumawaty and Yunike (2020) | The complexity of caring for people with mental disorders: family challenges in contributing to horticultural therapy | Indonesia | Female family caregivers of persons with mental health conditions (n = 5) | Horticultural therapy | To explore: –family caregivers’ experience of accompanying their family members to HT –family caregivers’ perception of their family members’ participation in HT | Qualitative; interviews | To encourage service users to engage with HT, family caregivers must have strong motivation, patience, sincerity and confidence. Family caregivers identified the following benefits of HT: enhanced self-confidence, communication and social skills |
| Lee et al. (2021) | Horticultural therapy program for mental health of prisoners: Case report | Korea | Male prisoners at risk of developing mental health conditions (n = 5) | 12-Week horticultural therapy programme, once per week for 90 min | To develop a horticultural therapy programme and to determine the association of 12 sessions with participants’ psychological health using case analysis | Mixed methods; Beck Depression Inventory, State-Trait Anger Expression Inventory, Rosenberg Self-esteem Scale and Satisfaction with Life Scale. Interviews, workbooks and emotional change checklists that were recorded in each session | Post-programme resulted in a decrease of depressive symptoms, and an increase in self-esteem and life satisfaction. Prisoners reported feelings of peacefulness, rejuvenation, sense of freedom and warmth, post-intervention |
| Lee et al. (2014) | Influence of forest therapy on cardiovascular relaxation in young adults | Japan | Young Japanese male adults (n = 48) | 2 days of forest walking and urban walking | To evaluate the short-term effects of forest walking on cardiovascular reactivity | Quantitative; comparative study of urban vs forest walking; measured data included heart rate variability, heart rate, blood pressure and psychological state | Forest walking resulted in significantly decreased values of sympathetic nervous activity and increased values of parasympathetic nervous activity, and significantly decreased heart rate, negative mood states and anxiety levels. No significant change in blood pressure was noted |
| Lim et al. (2020) | A guide to nature immersion: psychological and physiological benefits | Singapore | Students of the Singapore University and community residents of Singapore (n = 51) | Participation in guided/unguided nature immersion forest walks | To compare the efficacy of guided versus unguided nature immersion, upon three dependent variables of mood, nature connectedness and heart rate | Mixed methods; pre- and post-test: Connectedness to Nature Scale, Environmental Identity Scale (short form) and Positive and Negative Affect Scale. Heart rate was tracked continuously by a wristwatch heart rate tracker throughout the 2-h experience | Participants’ experienced an increase in their mood, nature connectedness and positive effect scores. No significant change in heart rate was reported. Participants reported feeling more relaxed, happy and refreshed after the nature immersion. The guided versus unguided groups did not differ in the results |
| Masel et al. (2018) | Vitamin “G”arden: a qualitative study exploring perception/s of horticultural therapy on a palliative care ward | Austria | Palliative care patients (n = 17) and health-care team members (n = 5) | 1–3 HT sessions that involved nature-related crafts | To explore the effects of HT on patients and team members on a palliative care ward | Qualitative; semi-structured interviews with pre-determined open-ended questions | Palliative care patients identified improved well-being, variation of clinical routine, creation and relationship building. Palliative care members identified improved mood and relationships with patients. High dropout rate (45%) was evident because of worsening of participants’ condition |
| Nakau et al. (2013) | Spiritual care of cancer patients by integrated medicine in urban green space: a pilot study | Japan | 4 Male and 18 Female oncology patients (n = 22) | Integrated forest therapy (FT), HT, yoga meditation, support group therapy; sessions once a week for 12 weeks | To examine the effect of spiritual care of cancer patients by integrated medicine in a green environment | Quantitative; measured data included: spirituality, quality of life (QoL), fatigue, psychological state and natural killer cell activity | Significant positive changes were noted in: spiritual and functional well-being, QoL, anxiety and cancer-associated fatigue. Significantly increased natural killer cell activity and improvement in psychological state were also identified |
| Oh et al. (2020) | Six-step model of nature-based therapy process | Korea | General public (n = 180) | Self-reported essays on forest therapy experiences | To develop a theoretical model of the nature-based therapy process | Theoretical | Six-step model of nature-based therapy process: Stimulation, Acceptance, Purification, Insight, Recharging, Change. Each of these steps is categorised into three aspects: emotional change (1–3), cognitive change (3–4) and behaviour change (5–6) |
| Phelps et al. (2015) | Sowing the seeds or failing to blossom? A feasibility study of a simple ecotherapy-based intervention in women affected by breast cancer | United Kingdom | Females at different stages of breast cancer (n = 7) | Cultivating, customising and nurturing a garden bowl at home for three months | To explore the acceptability and potential psychological benefits of a simple ecotherapy-based intervention for individuals affected by cancer | Qualitative; written diaries and focus group | The participants found the intervention therapeutic on a number of levels: reflecting cancer journeys; a source of positivity; making meaning through memories; and a sense of control |
| Pretty et al. (2017) | Green mind theory: how brain–body-behaviour links into natural and social environments for healthy habits | United Kingdom | N/A | N/A | To propose a green mind theory to link the human mind with the brain and body, and connect the body into natural and social environments | Theoretical | NBT facilitates immersive-attention through engagement with one’s environment. Behaviour change and habit formation are required for changes to be made in infrastructure, policies and resourcing |
| Sahlin et al. (2012) | How do participants in nature-based therapy experience and evaluate their rehabilitation? | Sweden | Females (n = 8) and males (n = 3) with stress-related mental disorders (depression, exhaustion disorder, Post Traumatic Stress Disorder) | Nature-based rehabilitation programme with MDT input; 3 h four times per week for 28 weeks | To explore how the participants experienced, explained and evaluated their rehabilitation to inform development of effective rehabilitation programmes for individuals suffering from stress-related mental disorders | Qualitative; semi-structured interviews | Three themes emerged: being in the right or wrong phase; experiencing existential dimensions; and changing dysfunctional patterns of thoughts/behaviours. Nature facilitated existential reflections and was experienced as a supportive environment |
| Seifert (2014) | Cultivating new lives: An ethnographic pilot study of eco-therapy provision for people with alcohol-related problems in Northern Ireland | United Kingdom | Staff and service users with alcohol problems | 39 various eco-therapy projects | A pilot study to establish the relevance and effectiveness of eco-therapy as a public health intervention | Opinion/pilot study | Community gardens and rehabilitation centres were the two key eco-therapy projects identified. Community gardens were less formal, inclusive and provided a connection to the local community. These projects were described as a preventive activity for participants. Rehabilitation centres were more formal, with the length of stay ranging from six weeks to six months. The eco-therapies were viewed as a de-institutionalising activity |
| Sidenius et al. (2020) | A new approach to nature consumption post-nature-based therapy | Denmark | Persons with a diagnosis of adjustment disorder, reaction to severe stress and an incapacity to work (n = 43) | NBT | To examine whether participants of a NBT intervention in the therapy garden Nacadia have changed their nature consumption one-year post-intervention compared with one year pre-intervention | Mixed methods; questionnaires and interviews | Four themes emerged of the participants nature consumption post-intervention: New approach to green spaces; Awareness of self and environments; New attitudes to everyday tasks; and Maintaining beneficial mind-sets. Post-intervention, participants reported maintaining a beneficial state of mind, thus enhancing mood and quality of life. Proposed that NBT could be an accessible tool to enhance health |
| Sidenius et al. (2015) | A year in the therapy forest garden Nacadia®-participants’ use and preferred locations in the garden during a nature-based treatment program | Denmark | Persons who are severely stressed and unable to work because of stress-related symptoms (n = 27) | NBT programme for 10 weeks | To investigate participants’ use, preferred locations, experiences and seasonal influences during NBT in the nature-like settings of Nacadia | Qualitative; behaviour mapping and semi-structured interviews | General preference for locations with enclosed proportions, while sensing expanses and feeling safe to relax or interact with components of nature-like environments were identified. Seasonal factors did not affect use and preference of locations, while weather conditions affected use and choice of nature-based activities, particularly for participants with a low level of mental capacity |
| Song et al. (2013) | Individual differences in the physiological effects of forest therapy based on Type A and Type B behavior patterns | Japan | Male college students with no history of physical or psychiatric disorders (n = 485) | Viewing forest or urban environments for 15 min | To explain individual differences in physiological responses to forest environments based on Type A and B behavioural patterns | Quantitative; physiological measurements | The significantly decreased heart rate following exposure to forest areas was only evident in the Type B group. Heart rate and diastolic blood pressure were significantly lower in the low-scoring Type B group |
| Stigsdotter (2015) | Nature, health and design | Denmark | N/A | N/A | To argue that not all nature environments support positive health outcomes | Theoretical | Not all nature environments support health and well-being. Through evidence-based design, nature designs can be an inclusive environment, closely aligning it with universal design principles |
| Sung et al. (2012) | The effect of cognitive behavior therapy-based ‘forest therapy’ program on blood pressure, salivary cortisol level, and quality of life in elderly hypertensive patients | Korea | Elderly patients with mild hypertension (n = 56) | Three-day CBT-based FT intervention targeting hypertension management education, self-efficacy, motivation and relaxation techniques | To develop the CBT-based FT programme and investigate its effects on blood pressure, salivary cortisol and QoL measures | Quantitative; physiological and QoL measurements, pre- and post-programme | There was no difference in overall long-term blood pressure between the study and control groups. Study group demonstrated a significantly increased total score of QoL measures and decreased salivary cortisol level |
| Vujcic et al. (2017) | Nature based solution for improving mental health and well-being in urban areas | Serbia | Psychiatric day hospital users (n = 30) | HT 1 h/day three days per week for four weeks | To understand how spending time and performing HT in specially designed urban green environments can improve mental health | Quantitative; RCT; pre- and post-intervention assessment using DASS21 scale | A significant decrease on the stress subscale was notes, while no change was noted on the depression and anxiety subscales following HT. Gender and education did not change the effects of HT. Male participants experienced larger change on the anxiety subscale between the study and control groups. No such difference was noted in females |
| Wang et al. (2019) | The influence of forest resting environments on stress using virtual reality | China | University students and social workers (total n = 96) aged 18–35 years | Exposure to virtual reality through images of seven forest resting environments | To explore the effects of different types of forest resting environments, using virtual reality, on stress, blood pressure, heart rate and salivary amylase | Quantitative; independent group design; data included physiological, stress and mood measurements | All seven forest resting environments were shown to decrease stress to some extent. The more natural environments were more effective in relieving stress. The most natural environment did not show outstanding results in terms of stress relief. Natural environments with some man-made components or structure demonstrated significant physiological stress relief. A dynamic water landscape was effective at stress relief, both physiologically and psychologically |
| Warber et al. (2015) | Addressing ‘nature-deficit disorder’: a mixed methods pilot study of young adults attending a wilderness camp | USA | Staff and students (n = 36) | 4-Week-long wilderness camp | To investigate whether nature-based camp experiences would increase connection to nature and promote multiple dimensions of well-being | Mixed methods; pre-camp and post-camp online questionnaires, interviews | Significant increase in all nature-related measures. Increased change scores on exposure to nature were correlated with improvement in social well-being. Increased nature connection was associated with decreased perceived stress. No change shown in physical activity and psychological measures |
| Windhorst and Williams (2016) | Bleeding at the roots: Post‐secondary student mental health and nature affiliation | Canada | Post-secondary stakeholders/university students | N/A | To present and evaluate three ways in which universities may foster student–nature relationships, both on their campuses and in their surrounding communities | Opinion piece | Proposed three student–nature affiliation strategies: Raising awareness of local natural environments; Creating natural settings indoors; and Using nature-based therapies |
| Zeng et al. (2020) | Benefits of a three-day bamboo forest therapy session on the physiological responses of university students | China | University students (n = 120) | Three-day bamboo forest therapy (FT) that involved 15 min of viewing of forest landscape and 15 min of walking in the bamboo forest | To investigate the effects of bamboo FT on physiological responses, namely, blood pressure, heart rate and peripheral oxygen saturation | Quantitative; RCT; physiological measurements and semantic differential method questionnaire | Following the FT, blood pressure and heart rate decreased, and peripheral oxygen saturation increased. The viewing activities had a more pronounced effect on decreased heart rate |
| Author(s) | Title | Country | Participants | Type of nature-based therapy | Purpose of study | Study design | Core findings |
|---|---|---|---|---|---|---|---|
| Sustainability: ecopsychological insights and person-centred contributions | United Kingdom | N/A | N/A | To propose a person-centred approach in ecopsychology to address the psychological roots of the ecological crisis | Theoretical | Through facilitating an individual’s realisation of one’s embeddedness within the larger ecosystem, ecopsychology aims to increase awareness of sustainability and connectedness to the non-human world | |
| Personality disorder and intellectual disability: The impacts of horticultural therapy within a medium-secure unit | United Kingdom | Male residents of a medium secure unit with a dual diagnosis of personality disorder and intellectual disability ( | Horticulture therapy | To explore the efficacy of HT for enhancement of subjective health and well-being | Qualitative; focus groups 12-month gardening group; designing, creating and maintaining a garden on the in-patient unit site | Participants identified enhanced gardening knowledge, employability skills, personal development, reduced stress, positive changes in behaviour towards self and others and improved life-satisfaction because of interaction with the natural environment, intrinsic motivation and opportunities to develop horticultural skills | |
| Developing the therapeutic potential of embodied cognition and metaphors in nature-based therapy: Lessons from theory to practice | Denmark | N/A | N/A | To examine the interplay between cognition and bodily involvement in relation to nature-based therapy | Theoretical | NBT is a therapeutic tool, not the goal itself. Using NBT metaphors to bring the learning beyond the therapeutic setting and into everyday life. NBT has shown psychological benefits through the use of meaningful, pleasurable and rewarding occupations, thus enhancing an individual’s self-concept, self-esteem and empowerment | |
| 3-Dimensional nature-based therapeutics in paediatric patients with total pancreatectomy and islet auto-transplant | USA | Paediatric patients (8–18 years) scheduled for total pancreatectomy and islet auto-transplant (TPIAT) ( | Use of NBT through virtual reality | To demonstrate that the use of 3-D nature-based therapy (NBT) glasses will lead to a reduction in pain, nausea and anxiety in children and adolescents undergoing TPIAT | Mixed methods; interviews/scoring pre and post (Wong-Baker FACES, BARF scales and a novel nature-based anxiety scale) | Pre- and post-intervention scores showed a reduction in pain, stress and anxiety because of virtual reality NBT use. Proposed as a tool for those that cannot access NBT (non-mobile patients) | |
| The complexity of caring for people with mental disorders: family challenges in contributing to horticultural therapy | Indonesia | Female family caregivers of persons with mental health conditions ( | Horticultural therapy | To explore: | Qualitative; interviews | To encourage service users to engage with HT, family caregivers must have strong motivation, patience, sincerity and confidence. Family caregivers identified the following benefits of HT: enhanced self-confidence, communication and social skills | |
| Horticultural therapy program for mental health of prisoners: Case report | Korea | Male prisoners at risk of developing mental health conditions ( | 12-Week horticultural therapy programme, once per week for 90 min | To develop a horticultural therapy programme and to determine the association of 12 sessions with participants’ psychological health using case analysis | Mixed methods; Beck Depression Inventory, State-Trait Anger Expression Inventory, Rosenberg Self-esteem Scale and Satisfaction with Life Scale. Interviews, workbooks and emotional change checklists that were recorded in each session | Post-programme resulted in a decrease of depressive symptoms, and an increase in self-esteem and life satisfaction. Prisoners reported feelings of peacefulness, rejuvenation, sense of freedom and warmth, post-intervention | |
| Influence of forest therapy on cardiovascular relaxation in young adults | Japan | Young Japanese male adults ( | 2 days of forest walking and urban walking | To evaluate the short-term effects of forest walking on cardiovascular reactivity | Quantitative; comparative study of urban vs forest walking; measured data included heart rate variability, heart rate, blood pressure and psychological state | Forest walking resulted in significantly decreased values of sympathetic nervous activity and increased values of parasympathetic nervous activity, and significantly decreased heart rate, negative mood states and anxiety levels. No significant change in blood pressure was noted | |
| A guide to nature immersion: psychological and physiological benefits | Singapore | Students of the Singapore University and community residents of Singapore ( | Participation in guided/unguided nature immersion forest walks | To compare the efficacy of guided versus unguided nature immersion, upon three dependent variables of mood, nature connectedness and heart rate | Mixed methods; pre- and post-test: Connectedness to Nature Scale, Environmental Identity Scale (short form) and Positive and Negative Affect Scale. Heart rate was tracked continuously by a wristwatch heart rate tracker throughout the 2-h experience | Participants’ experienced an increase in their mood, nature connectedness and positive effect scores. No significant change in heart rate was reported. Participants reported feeling more relaxed, happy and refreshed after the nature immersion. The guided versus unguided groups did not differ in the results | |
| Vitamin “G”arden: a qualitative study exploring perception/s of horticultural therapy on a palliative care ward | Austria | Palliative care patients ( | 1–3 HT sessions that involved nature-related crafts | To explore the effects of HT on patients and team members on a palliative care ward | Qualitative; semi-structured interviews with pre-determined open-ended questions | Palliative care patients identified improved well-being, variation of clinical routine, creation and relationship building. Palliative care members identified improved mood and relationships with patients. High dropout rate (45%) was evident because of worsening of participants’ condition | |
| Spiritual care of cancer patients by integrated medicine in urban green space: a pilot study | Japan | 4 Male and 18 Female oncology patients ( | Integrated forest therapy (FT), HT, yoga meditation, support group therapy; sessions once a week for 12 weeks | To examine the effect of spiritual care of cancer patients by integrated medicine in a green environment | Quantitative; measured data included: spirituality, quality of life (QoL), fatigue, psychological state and natural killer cell activity | Significant positive changes were noted in: spiritual and functional well-being, QoL, anxiety and cancer-associated fatigue. Significantly increased natural killer cell activity and improvement in psychological state were also identified | |
| Six-step model of nature-based therapy process | Korea | General public ( | Self-reported essays on forest therapy experiences | To develop a theoretical model of the nature-based therapy process | Theoretical | Six-step model of nature-based therapy process: Stimulation, Acceptance, Purification, Insight, Recharging, Change. Each of these steps is categorised into three aspects: emotional change (1–3), cognitive change (3–4) and behaviour change (5–6) | |
| Sowing the seeds or failing to blossom? A feasibility study of a simple ecotherapy-based intervention in women affected by breast cancer | United Kingdom | Females at different stages of breast cancer ( | Cultivating, customising and nurturing a garden bowl at home for three months | To explore the acceptability and potential psychological benefits of a simple ecotherapy-based intervention for individuals affected by cancer | Qualitative; written diaries and focus group | The participants found the intervention therapeutic on a number of levels: reflecting cancer journeys; a source of positivity; making meaning through memories; and a sense of control | |
| Green mind theory: how brain–body-behaviour links into natural and social environments for healthy habits | United Kingdom | N/A | N/A | To propose a green mind theory to link the human mind with the brain and body, and connect the body into natural and social environments | Theoretical | NBT facilitates immersive-attention through engagement with one’s environment. Behaviour change and habit formation are required for changes to be made in infrastructure, policies and resourcing | |
| How do participants in nature-based therapy experience and evaluate their rehabilitation? | Sweden | Females ( | Nature-based rehabilitation programme with MDT input; 3 h four times per week for 28 weeks | To explore how the participants experienced, explained and evaluated their rehabilitation to inform development of effective rehabilitation programmes for individuals suffering from stress-related mental disorders | Qualitative; semi-structured interviews | Three themes emerged: being in the right or wrong phase; experiencing existential dimensions; and changing dysfunctional patterns of thoughts/behaviours. Nature facilitated existential reflections and was experienced as a supportive environment | |
| Cultivating new lives: An ethnographic pilot study of eco-therapy provision for people with alcohol-related problems in Northern Ireland | United Kingdom | Staff and service users with alcohol problems | 39 various eco-therapy projects | A pilot study to establish the relevance and effectiveness of eco-therapy as a public health intervention | Opinion/pilot study | Community gardens and rehabilitation centres were the two key eco-therapy projects identified. Community gardens were less formal, inclusive and provided a connection to the local community. These projects were described as a preventive activity for participants. Rehabilitation centres were more formal, with the length of stay ranging from six weeks to six months. The eco-therapies were viewed as a de-institutionalising activity | |
| A new approach to nature consumption post-nature-based therapy | Denmark | Persons with a diagnosis of adjustment disorder, reaction to severe stress and an incapacity to work ( | NBT | To examine whether participants of a NBT intervention in the therapy garden Nacadia have changed their nature consumption one-year post-intervention compared with one year pre-intervention | Mixed methods; questionnaires and interviews | Four themes emerged of the participants nature consumption post-intervention: New approach to green spaces; Awareness of self and environments; New attitudes to everyday tasks; and Maintaining beneficial mind-sets. Post-intervention, participants reported maintaining a beneficial state of mind, thus enhancing mood and quality of life. Proposed that NBT could be an accessible tool to enhance health | |
| A year in the therapy forest garden Nacadia®-participants’ use and preferred locations in the garden during a nature-based treatment program | Denmark | Persons who are severely stressed and unable to work because of stress-related symptoms ( | NBT programme for 10 weeks | To investigate participants’ use, preferred locations, experiences and seasonal influences during NBT in the nature-like settings of Nacadia | Qualitative; behaviour mapping and semi-structured interviews | General preference for locations with enclosed proportions, while sensing expanses and feeling safe to relax or interact with components of nature-like environments were identified. Seasonal factors did not affect use and preference of locations, while weather conditions affected use and choice of nature-based activities, particularly for participants with a low level of mental capacity | |
| Individual differences in the physiological effects of forest therapy based on Type A and Type B behavior patterns | Japan | Male college students with no history of physical or psychiatric disorders ( | Viewing forest or urban environments for 15 min | To explain individual differences in physiological responses to forest environments based on Type A and B behavioural patterns | Quantitative; physiological measurements | The significantly decreased heart rate following exposure to forest areas was only evident in the Type B group. Heart rate and diastolic blood pressure were significantly lower in the low-scoring Type B group | |
| Nature, health and design | Denmark | N/A | N/A | To argue that not all nature environments support positive health outcomes | Theoretical | Not all nature environments support health and well-being. Through evidence-based design, nature designs can be an inclusive environment, closely aligning it with universal design principles | |
| The effect of cognitive behavior therapy-based ‘forest therapy’ program on blood pressure, salivary cortisol level, and quality of life in elderly hypertensive patients | Korea | Elderly patients with mild hypertension ( | Three-day CBT-based FT intervention targeting hypertension management education, self-efficacy, motivation and relaxation techniques | To develop the CBT-based FT programme and investigate its effects on blood pressure, salivary cortisol and QoL measures | Quantitative; physiological and QoL measurements, pre- and post-programme | There was no difference in overall long-term blood pressure between the study and control groups. Study group demonstrated a significantly increased total score of QoL measures and decreased salivary cortisol level | |
| Nature based solution for improving mental health and well-being in urban areas | Serbia | Psychiatric day hospital users ( | HT 1 h/day three days per week for four weeks | To understand how spending time and performing HT in specially designed urban green environments can improve mental health | Quantitative; RCT; pre- and post-intervention assessment using DASS21 scale | A significant decrease on the stress subscale was notes, while no change was noted on the depression and anxiety subscales following HT. Gender and education did not change the effects of HT. Male participants experienced larger change on the anxiety subscale between the study and control groups. No such difference was noted in females | |
| The influence of forest resting environments on stress using virtual reality | China | University students and social workers (total | Exposure to virtual reality through images of seven forest resting environments | To explore the effects of different types of forest resting environments, using virtual reality, on stress, blood pressure, heart rate and salivary amylase | Quantitative; independent group design; data included physiological, stress and mood measurements | All seven forest resting environments were shown to decrease stress to some extent. The more natural environments were more effective in relieving stress. The most natural environment did not show outstanding results in terms of stress relief. Natural environments with some man-made components or structure demonstrated significant physiological stress relief. A dynamic water landscape was effective at stress relief, both physiologically and psychologically | |
| Addressing ‘nature-deficit disorder’: a mixed methods pilot study of young adults attending a wilderness camp | USA | Staff and students ( | 4-Week-long wilderness camp | To investigate whether nature-based camp experiences would increase connection to nature and promote multiple dimensions of well-being | Mixed methods; pre-camp and post-camp online questionnaires, interviews | Significant increase in all nature-related measures. Increased change scores on exposure to nature were correlated with improvement in social well-being. Increased nature connection was associated with decreased perceived stress. No change shown in physical activity and psychological measures | |
| Bleeding at the roots: Post‐secondary student mental health and nature affiliation | Canada | Post-secondary stakeholders/university students | N/A | To present and evaluate three ways in which universities may foster student–nature relationships, both on their campuses and in their surrounding communities | Opinion piece | Proposed three student–nature affiliation strategies: Raising awareness of local natural environments; Creating natural settings indoors; and Using nature-based therapies | |
| Benefits of a three-day bamboo forest therapy session on the physiological responses of university students | China | University students ( | Three-day bamboo forest therapy (FT) that involved 15 min of viewing of forest landscape and 15 min of walking in the bamboo forest | To investigate the effects of bamboo FT on physiological responses, namely, blood pressure, heart rate and peripheral oxygen saturation | Quantitative; RCT; physiological measurements and semantic differential method questionnaire | Following the FT, blood pressure and heart rate decreased, and peripheral oxygen saturation increased. The viewing activities had a more pronounced effect on decreased heart rate |