Nature Immersion Research Articles

P032 THE IMPACT OF NATURE IMMERSION THERAPY ON BLOOD PRESSURE IN HYPERTENSIVE SUBJECTS: A PILOT STUDY

Background and Objective: Conscious nature immersion therapy, termed “Vitamin N”, has shown promise in reducing blood pressure levels in individuals with or without hypertension. This pilot study aims to assess the effect of nature immersion on blood pressure specifically in hypertensive subjects. Methods: A convenience sample of stable hypertensive individuals participated in a standardized 3-hour nature immersion session. Systolic and diastolic blood pressure levels were recorded before the intervention (Phase I), after 30 minutes of the intervention (Phase II), and 48 hours post-intervention (Phase III). Statistical analysis employed a one-way non-parametric ANOVA, Kruskal-Wallis test, and Dunn's post hoc test, with a bilateral significance level of 95%. A criterion of at least 3 mmHg reduction in blood pressure was set for clinical significance. Results Eighteen participants, comprising 12 women (64.67%) and 6 men (33.33%), with a mean age of 60±9.04 years and 61±6.88 years, respectively, were included. Six individuals had a medical history of Diabetes Mellitus Type 2, and one had a history of coronary heart disease. Significant differences in median systolic (MSP) and diastolic pressures (MDP) were observed across the three phases (p<0.05). Notably, Phase II and Phase III showed consistent reductions in blood pressure compared to Phase I, exceeding the established 3 mmHg reduction criterion. Conclusions: Conscious nature immersion therapy (“Vitamin N”) exhibited a significant effect in lowering both systolic and diastolic blood pressure levels among hypertensive individuals. These findings suggest the potential of nature immersion as a non-pharmacological intervention for managing hypertension.

P037 IMPROVING WELLBEING AND MENTAL HEALTH IN HYPERTENSIVE PATIENTS: A PILOT STUDY ON NATURE IMMERSION THERAPY

Background and Objective: Nature immersion therapy, also known as “Vitamin N,” has demonstrated a significant impact on enhancing well-being and mental health indicators. This pilot study aims to investigate the effects of Vitamin N treatment on the well-being, mental health, and affect scores of hypertensive patients undergoing medical treatment. Methods: A convenience sample of stable hypertensive individuals participated in a standardized 3-hour nature immersion session. Participants completed pre- and post-treatment assessments using the World Health Organization-Five Well-Being Index (WHO-5), Positive and Negative Affect Schedule (PANAS), and Warwick-Edinburgh Mental Well-being Scale (WEMWBS). Paired samples analysis, including the Wilcoxon signed-rank test, was employed to assess changes in scores, along with effect size calculations. Results: The study comprised 18 participants, including 12 females (64.67%) and 6 males (33.33%), with 6 having a history of diabetes. Following conscious nature immersion therapy, a significant improvement was observed in the scores of the well-being scale, WHO-5, WEMWBS, and PANAS positive affect scale (p < 0.05). Conclusions: Conscious immersion therapy in nature yielded notable improvements in well-being assessment scales and increased positive affect scores (PANAS), suggesting potential benefits for enhancing well-being in patients with arterial hypertension.

Improving immersive experiences in virtual natural setting for public health and environmental design: A systematic review and meta-analysis of randomized controlled trials.

In recent years, virtual reality (VR) technology has emerged as a powerful tool in the field of therapeutic landscapes. For hospitalized patients or individuals with limited mobility, VR provides highly personalized therapy by simulating authentic natural environments within a safe, convenient, and engaging setting. This study investigated the effectiveness of immersing patients in virtual natural environments for health recovery and compared the varying impacts of different types of landscapes on patients' recovery levels. The aim was to complement traditional medical approaches and enhance environmental design in the field of public health. Researchers systematically reviewed databases (January 2018 to August 2, 2023) to identify randomized controlled trials comparing the efficacy of virtual nature immersion with other treatments. The inclusion/exclusion criteria were established based on the population, intervention, comparison, outcomes, study design, and other aspects (expanded PICO) framework. The Cochrane tool was employed to assess the risk of bias. Meta-analysis was conducted by pooling the mean differences with a 95% confidence interval. Among 30 trials, a total of 2123 patients met the inclusion criteria, with 15 studies included in the meta-analysis. 30 trials met the criteria. Results show significant improvements in pain, anxiety, fear, and some physiological indicators with virtual nature-based treatments. On the other hand, natural scenes incorporating blue and green elements have been applied more extensively and have shown more significant effects. In comparison to conventional methods, this study strongly advocates that virtual reality environments are a crucial tool in bridging the gap between patients and nature, demonstrating their potential to reshape medical interventions and improve environmental design in the field of public health.

A Dynamic and Inclusive Approach.

After a year of transition to a new publisher, Creative Nursing 2024 will build on our legacy of nurturing novice authors with a Student Article of the Year initiative; presenting courageous discourse as reflected in our overarching theme for the year, The Impact of Social Forces on Nursing and Health; and publishing even more new knowledge in the form of research and discussion of nursing theories and models. This issue's theme, Activism, Advocacy, and Allyship, is exemplified by articles about paths to a nursing workforce that reflect the people we serve, and about concepts such as hygge, dialectical pluralism, acculturative stress, shared decision-making for breast health, nature immersion, iceberg demographics, and self-care in palliative care.

An Evolving Structure of Nature Immersion: Roots in Nightingale's Vital Power.

Background: In Florence Nightingale's view, vital power resides in both earthy materials and human nature and is an essential element of health. Vital power is defined as a health force that manifests in states of being while doing in nature to generate well-being, but little is known about the generative process of vital force. Purpose: This secondary study explored the vital power of children who experienced well-being while doing in nature. Methods: Using a framework of the Nature Immersion Model, directed content analysis of parental reflections on their children's vital power experiences sought to explore patterns of being while doing in nature observed in association with parental reports of: (a) change in their children's well-being and (b) qualities of vital power evident in parental descriptions of those changes in well-being. Conclusions: The essence of vital power encompassed feelings of a life-spark, natural energy that prompted a healing shift. Implications for Practice: Linkage between a middle-range Theory of Nature Immersion and Nightingale's perspective adds a new avenue for integrating the spiritual-physical-mental dimension of self during creative nursing praxis.

Supporting Wellness, Resilience, and Community With Forest Therapy.

Physician burnout has reached epidemic proportions. Although burnout is rooted in systems, practices for physician wellbeing and community can address exhaustion, burnout, and isolation. Inspired by the Japanese practice shinrin-yoku, forest therapy/bathing (FT) is a nature immersion practice that improves wellbeing in a group setting. This program offered guided FT experiences to frontline faculty physicians in the Department of Medicine and evaluated potential for impact on burnout, resilience, and community. Faculty physicians were recruited via email invitations to a free Forest Therapy group experience in the Arnold Arboretum in Boston, MA. Participants completed pre-and post-course surveys and evaluated its value as a community experience. Surveys measured burnout, resilience, and qualitative feedback on the experience. Twenty-seven faculty completed the baseline survey, twenty-three faculty participated, with 19 survey respondents. At baseline, 85% reported feeling burned out at least once a month. 46% reported feeling burned out more than a few times a month. 83% of participants responded that forest therapy could help them with the feeling of being burned out from work. Post-intervention, 100% of participants rated the experience as very or extremely valuable. 96% of participants reported they were interested in more frequent forest therapy sessions. 100% of participants would recommend this practice to other faculty. 70% of respondents reported the program could help them with burnout. Despite high baseline resilience, 94% of participants reported that forest therapy could help with stressful events and setbacks. Post-intervention, participants reported feeling relaxed, at peace, and calm. This pilot demonstrates feasibility and acceptability for physicians of FT. Participants would consider recommending FT to their colleagues, and agreed that FT can help with wellbeing, and expressed enthusiasm for the community experience. This program may also be successfully incorporated into programs for leadership, teambuilding, and support after adverse events.

The impact of ecotherapeutic mental health interventions (forest therapy, therapeutic ornithology, and nature-based mindfulness) on stress reduction and mental wellbeing: a qualitative analysis

Introduction and objective: Nature and mental health are in an important relationship, especially in the context of stress reduction. In the current times, when more than half of the human population lives in cities, where people are exposed to an excess of stimuli such as noise, light pollution, time pressure, and the fast pace of life, the relaxing potential of nature immersion seems to be an essential protective factor. Forest therapy and nature-based mindfulness are well-researched ecotherapeutic methods, and therapeutic ornithology is also recognised as a very popular and beneficial activity supporting mental wellbeing. However, only a limited number of studies have been carried out to explore the impact of combining these three different ecotherapeutic techniques. Materials and methods: During an ecotherapeutic programme for adults held in the Biebrza River Valley, Poland, in the spring of 2022, the above-mentioned nature-based interventions supporting mental wellbeing were performed. Twelve Polish volunteers participated in a three-day ecotherapeutic programme led by two psychiatrists and ecotherapists. Qualitative interviews were conducted and analysed using the interpretative phenomenological method. Results: The results indicated that forest therapy, nature-based mindfulness, and therapeutic ornithology worked differently, but they also shared many common features and could be an effective combination in coping with different types of stress and anxiety symptoms. They were also found to improve the general wellbeing at different levels and dimensions. Conclusions: The studied combination of ecotherapeutic techniques is worth considering both in personal self-care practice and in designing ecotherapeutic programmes for stress reduction an wellbeing improvement.

The acute psychological effects of screen time and the restorative potential of nature immersion amongst adolescents: A randomised pre-post pilot study

Excessive screen time can deplete the cognitive resources required for effective emotion regulation, such as sustained attention and inhibitory control. Contrastingly, time spent in natural environments encourages attention restoration and stress reduction. Therefore, time in natural environments may be important for buffering the psychological consequences of screen time. A randomised pre-post pilot study was undertaken to investigate the acute psychological effects of screen time in adolescents, and to explore the restorative potential of nature immersion. Eighty-seven adolescents (52% female, mean age = 15.5 years) participated in the study. Participants completed measures of mood, sustained attention capacity (Sustained Attention to Response Task), and inhibitory control (Stop-Signal Task) at three time-points: (1) at baseline, (2) after a 30-minute period of screen time, and (3) after a 20-minute period of rest. Participants were randomised to either an indoor setting or an outdoor environment (Botanic Gardens) for the rest period. Linear mixed modelling was used to examine the effect of time and resting condition on the outcome variables. A lack of change in baseline mood, sustained attention capacity, and inhibitory control was observed following the brief screen time period, which limited the ability to test the relative benefit of the outdoor vs indoor environment. The study demonstrated the feasibility of a novel and ecologically valid paradigm to test this relationship in school students, but future studies should look to apply the recommendations provided regarding altering the attentional demands of the screen time activity used. The potential for natural environments to benefit student wellbeing and performance remains an important area of continued research.

Using multisensory virtual reality nature immersion as a therapeutic modality for improving HRV and cognitive functions in post-traumatic stress disorder: a pilot-study

Introduction: Immersive virtual reality (VR) applications are burgeoning within healthcare as they promote high levels of engagement. Notwithstanding, existing solutions only stimulate two of our five senses (audio and visual), thus may not be optimal in the sense of promoting immersion and of “being present”. In this paper, we explore the benefits of an immersive multisensory experience as a therapeutic modality for participants suffering from post-traumatic stress disorder (PTSD).Methods: In addition to 360-degree videos and corresponding natural sounds, nature smells are also presented by means of a portable ION 2 scent diffusion device attached to an Oculus Quest 2 VR head-mounted display. A 3-week 12-sessions protocol was applied to a sample of 20 participants diagnosed with PTSD.Results and discussion: We report the outcomes seen from a battery of qualitative metrics, including cognitive functioning tests, psychological symptoms, severity of PTSD, and several self-reported questionnaires and heart rate variability (HRV) metrics. Results are compared not only between pre-and post intervention, but also after a 3-month follow-up period. Results suggest a decrease in the severity of PTSD, as well as improvements in processing speed and sustained attention post-intervention, but also sustained decrease in the severity of PTSD and in dissociative tendencies at the 3-month follow-up. Overall, participants rated the experience as highly immersive and produced very mild to no symptoms of cybersickness, thus corroborating the feasibility and usefulness of the proposed multisensory immersive VR tool for reducing PTSD symptoms.

The evolved nest, oxytocin functioning, and prosocial development.

Prosociality, orientation to attuned, empathic relationships, is built from the ground up, through supportive care in early life that fosters healthy neurobiological structures that shape behavior. Numerous social and environmental factors within early life have been identified as critical variables influencing child physiological and psychological outcomes indicating a growing need to synthesize which factors are the most influential. To address this gap, we examined the influence of early life experiences according to the evolved developmental niche or evolved nest and its influence on child neurobiological and sociomoral outcomes, specifically, the oxytocinergic system and prosociality, respectively. To-date, this is the first review to utilize the evolved nest framework as an investigatory lens to probe connections between early life experience and child neurobiological and sociomoral outcomes. The evolved nest is comprised of characteristics over 30 million years old and is organized to meet a child's basic needs as they mature. Converging evidence indicates that humanity's evolved nest meets the needs of a rapidly developing brain, optimizing normal development. The evolved nest for young children includes soothing perinatal experiences, breastfeeding, positive touch, responsive care, multiple allomothers, self-directed play, social embeddedness, and nature immersion. We examined what is known about the effects of each evolved nest component on oxytocinergic functioning, a critical neurobiological building block for pro-sociomorality. We also examined the effects of the evolved nest on prosociality generally. We reviewed empirical studies from human and animal research, meta-analyses and theoretical articles. The review suggests that evolved nest components influence oxytocinergic functioning in parents and children and help form the foundations for prosociality. Future research and policy should consider the importance of the first years of life in programming the neuroendocrine system that undergirds wellbeing and prosociality. Complex, interaction effects among evolved nest components as well as among physiological and sociomoral processes need to be studied. The most sensible framework for examining what builds and enhances prosociality may be the millions-year-old evolved nest.

Creating equitable and sustainable opportunities for nature immersion to support restoration from stress within mental health nursing: A critical interpretive synthesis.

In the face of global environmental changes threatening health, and despite increased calls for nurses to broker access to nature-based well-being interventions for people with mental health difficulties, there is a surprising absence of literature examining the nature-nursing relationship, inhibiting its inclusion within nursing curricula and practice. This critical interpretive synthesis supports the notion that nature immersion has the capacity to increase positive affect, reduce negative affect, provide restoration from everyday stress, promote meaning-making, enhance belonging, and foster an interest in caring for the natural world. Yet, critical examination of the literature reveals multiple social and environmental inequalities and unmasks latent anthropocentric, gendered, and colonialist thinking, which threatens the delivery of equitable and just sustainable practice. Recommendations are made for a transdisciplinary, systemic approach, which recognizes and responds to our shared humanity and vulnerability in pursuit of planetary health.

"That Was the Happiest Time of My Life": Understanding Childhood Eco-Connections in Appalachian Communities.

The goal of this study was to explore facets of childhood eco-connections, using retrospective qualitative data from adults. One hundred and forty-five adults from predominantly rural and small-town communities in southern Appalachia (71.7% female), average age 36.23 years (SD = 12.08) participated in semi-structured qualitative interviews on key life experiences and the places they grew up. Mentions about place-related childhood memories or interactions were grouped into four themes based on exploratory thematic content analysis: nature nostalgia (positive reminiscences about nature experiences); nature immersion (extensive contact with the natural world during childhood); formative experiences with nature (nature interactions that taught a skill or life lesson); and rhythms of nature (appreciation of seasonal or cyclical patterns). Childhood eco-connections are multifaceted and often emerge from early impactful or intense experiences. Pro-environmentalism messages to youth may benefit from more references to childhood eco-connections.

Nature Immersion in an Extreme Environment: Hiroshima Survivors’ Personal Emergence Following Their Atomic Bomb Experience

Nature immersion is defined as multidimensional connecting with earthy materials to generate personal emergence. Personal emergence is an embodied healing force observable via synchronization of bodily rhythms. Research has revealed positive effects of green space for healing. However, little is known about healing of survivors in the space impacted with radioactive nuclear energies. To use the theory of nature immersion to guide exploration of the concepts of connecting with earthy materials, personal emergence and space-time expansion in a sample of people who had experienced the catastrophic nature upheaval of the Hiroshima bombings on 6 August 1945. A descriptive exploratory design with directed content analysis was used with existing qualitative data consisting of 29 Hiroshima atomic-bombing survivors' description of their experience. Self-healing empirically manifested through 23 survivors' connection with earthy materials. There was synchrony between recuperating natural space and healing of survivors. Synchrony, as a dimension of human connection with nature, transcended the disharmony of bombing upheaval. Although further exploration is necessary, these findings serve as evidence about the essence of healing as related to nature for those in extreme environments.

Hopeful tourism to grapple and engage with emotions in the Anthropocene

AbstractThe Anthropocene is characterised by people’s significant influences on global systems, which generate both high levels of uncertainty and profound change in our lifetime. We must start to better engage with what it might mean to inhabit and know the world differently, especially as we experience extensive loss and change, and because grief is increasingly with us. At the same time, we must better engage with our emotions productively and find hope through active, conscious processing and mourning. In this commentary, we explore the potential of engaging in nature‐based tourism to help us grapple with, process, and positively engage with the emotions of the Anthropocene. We gained insights about such potential for healing by collaborating with two eco‐tourism enterprises in Australia: Mount Barney Lodge in Southeast Queensland and Salt and Bush Eco Tours in the Peel River Region on the west coast of Australia. We found that nature immersion can heal and renew. Moreover, guides who know about and are connected to or living closely with nature play critical roles as interpreters or intermediaries with nature. They can also inspire gratitude and positive emotions by encouraging us to (re)connect with nature and provide new and transformative perspectives that bring comfort and motivate action.

Diurnal Avifaunal Species in the Designated Mangrove Eco-park in Cabadbaran City, Philippines

The Cabadbaran Mangrove Eco-Park (CaME) intends to rehabilitate and establish eco-tourism through nature immersion and birdlife watching. However, baseline assessment of avifauna is lacking. Thus, this study aimed to identify the composition of diurnal bird species present in the designated mangrove eco-park, determine the diversity, dominance and evenness of the mangrove avifauna, and compare the bird species richness in the three sites. A total of 36 avian species representing 24 families and 9 orders were recorded during the study. Among the 373 individuals documented, 181 were found in abandoned fishponds which is 49% of all bird individuals; while C. hybrida, T. stagnatilis, and E. garzetta were the most abundant species. Shannon-Wiener diversity index revealed that mangrove site (H’=2.78) was the most diverse among the three sites which can be attributed to the presence of lush vegetations. Conversely, dominant species were recorded in the abandoned fishponds which were composed of migratory species mostly. There was a significant difference of species richness in mangrove site compared to other sites since species richness was highly influenced by vegetations. Moreover, this study also documented the first scientific record of migratory species in the area, which could be one of the stopovers of migratory species. Henceforth, the es

Episodic memories of wilderness experiences foster sustainable leadership style transformation

PurposeThis research evaluates (1) work situations prompting participants to recall memories of a wilderness-based leadership training program, (2) the content of such memories, and (3) the leadership attitudes and behaviors inspired by those memories.Design/methodology/approachA qualitative content analysis of semi-structured interviews was performed with 36 leaders who had participated in a wilderness leadership transformation program in the past (on average six years before).FindingsThe findings suggest that, at moments with emotional pressure and psychological stress, episodic memories of wilderness experiences have a positive influence on actual leadership style. Memories involved moments of solitude, a deep connection with nature, and peer-to-peer counseling. The interviewees regularly relived their emotion-laden wilderness experiences, acquiring direction and guidance. Simultaneously, episodic memories of nature immersion promoted an enduring transformation of their leadership styles.Research limitations/implicationsThe findings cannot be blindly generalized as referring to all leaders. The leaders in this study are a subset of leaders who are inclined towards personal growth and leadership development. It is challenging to motivate leaders unkeen on changing to achieve better leadership.Practical implicationsThis study indicates that the inclusion of emotional concepts to address the root causes of learning among leaders might be the most promising way to innovate leadership development.Originality/valueThe present study makes a novel contribution to relevant literature by examining leadership transformation through episodic remembrance of leaders' experiences in nature.

Therapeutic landscapes, outdoor programs for veterans, and public lands.

In recent decades, scholars have developed ideas about therapeutic landscapes that explore how social processes, symbolism, and physical features generate diverse meanings. We examine here how therapeutic landscapes are produced and utilized for outdoor programs for military veterans, particularly veterans experiencing post-traumatic stress. Outdoor programs for veterans (OPVs) provide restorative opportunities through nature immersion and outdoor recreation. OPVs involve diverse social settings, activity types, durations, geographic and land management contexts, and degrees of therapeutic intervention. In many combinations they can generate therapeutic landscapes conducive to some degree of recovery. Our analysis relies on qualitative data gathered through semi-structured interviews with OPV providers and participants, mental health specialists, and public land officials. Arguing against a reductionistic approach, we suggest that the diversity of OPVs and disparate character of activities, locations, and dosages may contribute in important ways to the efficacy of these programs. Ironically, the very qualities that present challenges for measuring and evaluating the benefits of OPVs may prove to be advantageous with respect to therapeutic outcomes. We highlight how public lands present a distinctive set of attributes that make them particularly well-suited to provide therapeutic opportunities, and that agency policies can shape the development of therapeutic landscapes.

Urban Children's Well-Being Factors and Qualities of Being and Doing in Natural Space: Nature Immersion.

Research has suggested positive effects of nature immersion-a state of being or an act of doing in natural space-for urban children who were otherwise at risk for emotional or behavioral problems. However, few studies have systematically investigated natural space qualities that predict child well-being at the clinical level. The purpose of this study was to increase the understanding of natural space qualities as factors of urban child well-being. Explanatory mixed methods were used. Quantitative data (N = 174) included a survey and two parental reports of child well-being. Interviews provided qualitative data (N = 15). Data were analyzed using generalized linear model and content analysis. Both data streams were merged into a point of meta-inference that contributed to parental assessment of enhanced child well-being: More frequent nature-child space-time immersion combined with parental valuing of nature connection (p < .001) as a soothing and safe resource. The factors of urban nature immersion affected child well-being over parental socioeconomic affluence alone. The evidence corresponds to Nightingale's tenet that an act of doing, which is considered an action of the child's own will, affects one's sense of well-being. The findings indicate that nature immersion can be applied to urban child self-care and holistic nursing modalities.

A Guide to Nature Immersion: Psychological and Physiological Benefits

Nature exposure has been renowned for its positive physiological and psychological benefits. Recent years have seen a rise in nature immersion programs that make use of Guided Forest Therapy walks in a standard sequence of sensory awareness activities to expose participants to natural environments in a safe but effective manner. The study aimed to compare the efficacy of guided versus unguided nature immersion, upon three dependent variables of mood, nature connectedness and heartrate. 51 participants were assigned to either guided or unguided nature immersion. Nature connectedness (Connectedness to Nature Scale, CNS), Environmental Identity Scale, EID short form) and mood (Positive and Negative Affect Scale, PANAS) were assessed before and after nature immersion, while heart rate was tracked continuously by a wristwatch heart rate tracker throughout the 2-h experience. Demographics and general health practice (GHP) information were also collected. A mixed model ANOVA revealed that nature connectedness and mood (but not heart rate) improved post-immersion for all participants. Comparing the guided/unguided conditions, there were no significant differences in the change in nature connectedness, mood or heart rate. Comparing within the five segments within the standard sequence in the guided condition, the third and fifth segments revealed a significantly lower heart rate compared to the baseline heart rate.

Quantum management: the practices and science of flourishing enterprise

Quantum Management brings to light the power of direct-intuitive practices – such as meditation, nature immersion, and countless others – to transform a leader’s consciousness as the highest point of leverage for entrepreneurial creativity embedding social purpose. Layered on top of such practices are insights from quantum physics and related disciplines that offer a radically different view of organizational life. Such insights help managers understand how direct-intuitive practices work to change a person at the deepest level of their identity. Direct-intuitive practices give managers an experience of wholeness that heightens their awareness of how their actions impact others and the world. Such awareness leads managers to pursue business as a force for good not only because of the analytic business case for it, which remains important, but because of who they are being. Recent developments in science inform their experience by re-framing their understanding of the nature of reality.