Effects of an urban forest healing program on cancer-related fatigue in cancer survivors.

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).

Analysis of Perceptions, Preferences, and Participation Intention of Urban Forest Healing Program among Cancer Survivors.

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.