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Article

Effects of Integrated Indirect Forest Experience on Emotion, Fatigue, Stress, and Immune Function in Hemodialysis Patients

Department of Nursing, Kangwon National University, Chuncheon 24341, Korea
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Int. J. Environ. Res. Public Health 2021, 18(4), 1701; https://doi.org/10.3390/ijerph18041701
Received: 21 December 2020 / Revised: 2 February 2021 / Accepted: 7 February 2021 / Published: 10 February 2021
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
Background: Most hemodialysis patients may experience physiological and psychological stress. Exposure to nature has been reported to reduce psychological and physiological stress levels and improve immune function. This study aimed to investigate psychological and physiological effects of integrated indirect forest experience on chronic renal failure patients undergoing hemodialysis. Methods: As a quasi-experiment, this study employed a nonequivalent control group, repeated measurements, and a non-synchronized design. In total, 54 participants were included: 26 and 28 patients in the experimental and control groups, respectively. During hemodialysis, five types of forest therapy stimuli (visual, auditory, olfactory, tactile, and motor) were applied 3 times per week for 4 weeks during 15 min sessions. Results: Positive, but not negative, emotion measures differed between the groups after the intervention. Fatigue and physiological stress levels were significantly reduced in the experimental group, whereas no significant difference was found between the groups with respect to measures of psychological stress. Activation of both the parasympathetic and sympathetic nervous systems was similar in both groups, as was the number of natural killer cells. Conclusion: Integrated indirect forest experience may help increase positive emotions and reduce fatigue and stress levels during hemodialysis in patients with chronic renal failure. View Full-Text
Keywords: hemodialysis; indirect forest experience; emotion; fatigue; stress; heart rate variability; natural killer cells hemodialysis; indirect forest experience; emotion; fatigue; stress; heart rate variability; natural killer cells
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MDPI and ACS Style

Kang, H.; Chae, Y. Effects of Integrated Indirect Forest Experience on Emotion, Fatigue, Stress, and Immune Function in Hemodialysis Patients. Int. J. Environ. Res. Public Health 2021, 18, 1701. https://doi.org/10.3390/ijerph18041701

AMA Style

Kang H, Chae Y. Effects of Integrated Indirect Forest Experience on Emotion, Fatigue, Stress, and Immune Function in Hemodialysis Patients. International Journal of Environmental Research and Public Health. 2021; 18(4):1701. https://doi.org/10.3390/ijerph18041701

Chicago/Turabian Style

Kang, Hyoyoung, and Youngran Chae. 2021. "Effects of Integrated Indirect Forest Experience on Emotion, Fatigue, Stress, and Immune Function in Hemodialysis Patients" International Journal of Environmental Research and Public Health 18, no. 4: 1701. https://doi.org/10.3390/ijerph18041701

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