Can Even a Small Amount of Greenery Be Helpful in Reducing Stress? A Systematic Review
Abstract
:1. Introduction
2. Materials and Methods
2.1. Search Strategy
2.2. Inclusion and Exclusion Criteria
2.3. Study Selection
2.4. Data Extraction
2.5. Quality Assessment
3. Results
3.1. Search Results
3.2. Risk of Bias
3.3. Characteristics of the Interventions
3.4. Intervention Results
3.4.1. Effect on Blood Pressure
3.4.2. Effect on Pulse Rate
3.4.3. Effect on HRV
3.4.4. Effect on Heart Rate
3.4.5. Effects on EEG
3.4.6. Effects on Anxiety
3.4.7. Effect on Emotion
3.4.8. Impact on Restorative Outcomes
3.4.9. Effects on Attention
3.4.10. Impact on Self-Reporting
3.4.11. Impact on Others
3.5. Intervention Effectiveness
3.5.1. Effectiveness of Indoor Small-Scale Greening for Stress Reduction
3.5.2. Effectiveness of Small-Scale Outdoor Greenery on Stress Reduction
3.5.3. Effectiveness of Non-Living Plant Environments on Stress Reduction
4. Discussion
5. Limitations
6. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A
Confounding | Participant Selection | Classification of Interventions | Deviation from Intended Intervention | Missing Data | Measurement of Outcomes | Reporting Bias | Overall Bias | |
---|---|---|---|---|---|---|---|---|
A. Hassan et al., (2020) | Moderate | Low | Low | Low | Low | Moderate | Moderate | Moderate |
Cammie K Coleman and Richard H. Mattson (1995) | Serious | Low | Low | Low | Serious | Serious | Moderate | Serious |
Hassan, Ahmad et al., (2018) | No information | Low | Low | Low | Low | Serious | Moderate | Serious |
Ke-Tsung Han (2008) | Serious | Low | Low | Low | Low | Serious | Moderate | Serious |
Masahiro Toyoda et al., (2019) | Serious | Low | Low | Moderate | Low | Moderate | Moderate | Serious |
Virginia I. Lohr et al., (1996) | Serious | Low | Low | Low | Low | Serious | Moderate | Serious |
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Inclusion Criteria: | Exclusion Criteria: |
---|---|
Empirical studies. | Studies that do not look at empirical evidence. |
Studies examined the association between small-scale greening and physiological stress responses, as well as self-reported psychological indicators (e.g., mood, anxiety, distress, perceived stress, recovery, attention, or cognitive function). | Studies did not examine the association between exposure to small-scale greening and physiological stress responses, as well as self-reported psychological indicators (e.g., mood, anxiety, distress, perceived stress, recovery, attention, or cognitive function). |
Studies that use human participants | Studies that do not use human participants |
Records were not written in English. | Records were not written in English. |
Authors and Year of Publication | Country | Design | Sample | Setting(s) | Intervention | Results |
---|---|---|---|---|---|---|
A. Hassan et al., (2020) [39] | China | Non-randomized control trials | N = 50 (No gender information) Mean age: 20.3, SD = 16.3 Chinese students from the campus of Sichuan Agricultural University | Greenery included: Indoor with ornamental plants (experimental) No greenery: Indoor without ornamental plants (control) | 5 min of viewing | The STAI scores were lower in the presence of plants, and there was no significant difference between blood pressure and pulse rate. Observation of plants in the work environment enhanced brain wave activity and decreased anxiety to reduce mental stress. |
Bin Jiang et al., (2014) [5] | USA | Randomized controlled trials | N = 158 (80 males and 78 females) Mean age: 21.2, SD = 2.7 Healthy Adults | Video of 10 neighborhood street scenes with different vegetation densities | Watch the 6-min video | There were significant differences between males and females: tree cover at different densities was not associated with pressure recovery for females. For males, pressure recovery increased at 1.7–24%, no change at 24–34%, and slower recovery above 34% (inverted U-shape). Moderate tree density caused greater pressure reduction. |
Cammie K. Coleman and Richard H. Mattson (1995) [43] | USA | Non-randomized control trials | N = 50 (No gender information) Age: 18–34 (No average age information) College Students | Greenery included: A green plant in the room or a life-size color photo of that plant (experimental) No greenery: A metal stool in the room (control) | Participated in 20-min sessions twice a week for 6 weeks. | Live plants and photographs had a positive response for 38% of participants. 23% had reduced stress in the control group. No significant differences were found for the rest. |
H. Ikei et al., (2014) [40] | Japan | Randomized controlled trials | N = 85 (41 males and 44 females) Mean age: 16, SD = 0.9 High school students | Greenery included: Exposed to foliage plants (experimental) No greenery: No foliage plants (control) | Ornamental plants for 3 min | Foliage plants resulted in a significant increase in parasympathetic (high-frequency component) activity, suppression of sympathetic (low-frequency component) activity, and a significant decrease in pulse rate. More comfort and relaxation after seeing the plants. |
Hassan, Ahmad, et al., (2018) [47] | China | Non-randomized control trials | N = 50 (No gender information) Mean age: 19.6, SD = 1.42 College students experiencing high academic stress | Greenery included: Indoor plant transplantation (experimental) No greenery: Playing mobile app games (control) | 15 min plant transplanting work | Blood pressure decreased significantly. No change in pulse rate. STAI decreased significantly. SDM felt more relaxed. Alpha and beta wave averages increased over time during the transplantation task. The results of the study suggest that contact with plants minimizes mental stress. |
Jiang S. et al., (2021) [45] | China | Randomized controlled trials | N = 50 (all females) Mean age: 22.32, SD = 2.56 Female college students | Scented primroses (experimental) Unscented primroses (control) | Exposure to plant environment for 10 min | Mean blood pressure and pulse rate in both conditions decreased significantly after the experiment, and the mean EEG was higher. Both groups of primroses were psychologically and physiologically beneficial. Fragrant primroses caused better effects. |
Ji-Young Choi et al., (2016) [50] | Korea | Randomized controlled trials | N = 103 (51 males and 52 females) Mean age: 21, SD = 2.3 College students | Green indices for indoor spaces were 5%, 20%, 50%, and 80% | Showing green for 3 min | There were no significant differences in physiological parameters with respect to the green index. Significant physiological and psychological improvements. Subjectively, participants preferred 50% of the green index the most. |
Johan Ottosson and Patrik Grahn (2005) [38] | Sweden | Randomized controlled trials | N = 15 (2 males and 13 females) Mean age: 86 Elderly people living in homes for the elderly. | Greenery included: Elderly home garden (experimental) No greenery: Elderly home indoor (control) | Outdoor leisure activities 1 h | Did not show any effect on blood pressure or heart rate. However, there was a restoration of attention in the elderly. |
K. Dijkstra et al., (2008) [36] | Netherlands | Randomized controlled trials | N = 77 (35 males and 42 females) Mean age: 21, SD = 2.2; Students, no details | Greenery included: With plant ward photo (experimental) No greenery: Without plant ward photo (control) | View photos of hospital rooms (exact time unknown) | Participants in the ward with indoor plants felt less self-reported stress than those in the ward with paintings. Indoor plants reduced stress by increasing the attractiveness of the room. |
Kate E. Lee et al., (2015) [35] | Australia | Randomized controlled trials | N = 150 (71% females) Mean age: 20 Volunteers were recruited from the University Psychology Research Experience Program and the broader student population. | Greenery included: Green roof simulation view (experimental) No greenery: Urban scenario with a concrete roof (control) | View 40 s | Changes in subcortical arousal and cortical attentional control occur. Attention is restored, and subsequent benefits may include improved performance and mood, as well as reduced stress. |
Katinka H. Evensen1 et al., (2013) [42] | Norway | Randomized controlled trials | N = 85 (28 males and 57 females) Mean age: 24.9, SD = 5.7 College students | Greenery included: Room with plants with windows (experimental); room with plants without windows (experimental) No greenery: Rooms with computers only (control) | Oriented attention for 10 min | There was no significant restorative effect of plants. Visual richness in the environment may be a restorative factor. The presence of indoor plants led to higher levels of perceptual fascination with the environment. |
Ke-Tsung Han (2008) [43] | China | Non-randomized control trials | N = 76 (58 males and 18 females) Mean age: 13.6 (experimental group); 13.5 (control group) Two classes of students in the second year of junior high school | Greenery included: Cinnamomum kotoense in the classroom (experimental) No greenery: No plants in the classroom (control) | Exposure to plant environment for 2.5 months | There was an immediate stronger sense of preference, comfort, and friendliness in the experimental group compared to the control group. STAI, RCS, and RS increased over time, and WBM decreased over time, with improvements over time but not statistically significant. |
Lee, MS (Lee, Min-sun) et al., (2015) [46] | Korea | Randomized controlled trials | N = 24 (all males) Mean age: 24.9, SD = 2.1 Young male adults | Greenery included: Caring for houseplants (experimental) No greenery: Computer tasks (control) | 15 min plant transplanting work | Mean activity of HRV increased over time and decreased at the end of the plant task. Diastolic blood pressure decreased. Positive interaction with houseplants reduces physical and psychological stress. |
Masahiro Toyoda et al., (2019) [37] | Japan | Non-randomized control trials | N = 63 (33 males and 30 females) Mean age: 38.7, SD = 9.3(male); 41.6, SD = 9.6 (female) Electricity company employees. | Greenery included: Small plants on the desk (experimental) No greenery: No plants on the desk (control) | Observe plants and take care of them for 4 weeks | STAI scores decreased significantly after the intervention period (p < 0.05); pulse rate decreased throughout. Conscious gazing at nearby plants can reduce psychological and physical stress in office workers. |
Preyen Archary and Andrew Thatcher (2021) [41] | USA | Randomized controlled trials | N = 60 (21 males and 39 females) Mean age: 21.80, SD = 6.09 Undergraduate students | Greenery included: Room with two large indoor foliage plants and one small bonsai table plant (experimental) No greenery: Facing the wall with no plants or other irritants (control) | Facing the plant for 6 min | Distress was significantly reduced, and engagement increased. The presence of indoor plants had a small positive effect on affective recovery and no effect on cognitive recovery. |
Seong-Hyun Park and Richard H. Mattson (2008) [48] | USA | Randomized controlled trials | N = 90 (52 males and 38 females) Mean age: 37.6, SD = 9.41 Patients who had undergone an appendectomy | Greenery included: Ward with foliage and flowering plants, 12 potted foliage and flowering plants (experimental) No greenery: No plants in the ward (control) | Mean length of stay in wards with plants 4.64 days | Patients had significantly lower postoperative analgesic intake and more positive physiological responses (as evidenced by lower systolic blood pressure and heart rate). Pain, anxiety, and fatigue scores were lower. |
Seungkeun Yeom et al., (2021) [16] | Korea | Randomized controlled trials | N = 27 (17 males and 10 females) Mean age: 25.53 (male); 23.15 (female) College students of different majors at Yonsei University | Greenery included: 8.0 m2 indoor virtual big green wall (experimental); 2.0 m2 indoor virtual small green wall (experimental) No greenery: Blank wall (control) | Sit in a chair for 5 min and walk around for 1 min | The small green wall had a more dramatic improvement effect. Subjects in the small green wall condition had substantially lower stress levels compared to the non-green wall condition. The large green wall reduced STAI levels but increased mental stress, fatigue, and anxiety. |
Virginia I. Lohr et al., (1996) [49] | USA | Non-randomized control trials | N = 96 (48 males and 48 females) Age: 18–46 (No average age information) Predominantly from undergraduate agricultural economics classes | Greenery included: Computer labs with plants (experimental) No greenery: Computer lab without plants (control) | Computer tasks completed in indoor spaces with plants | Participants were more productive. Less stressful and more focused. Significant increase in attention span. |
WeiLin et al., (2019) [12] | China | Randomized controlled trials | N = 240 (53% females) Mean age: 20.2, SD = 1.76 | Six different types of small simulated green spaces | Exposure of green space for 10 min | Walking in high PCA (per capita area) and sitting in low PCA have the most powerful effect on reducing stress |
Greening Type | Authors and Year of Publication | Physiological Stress Indicator | Psychological Stress Indicators | Results |
---|---|---|---|---|
Indoors | A. Hassan et al., (2020) [39] | Blood Pressure; EEG | State Trait Anxiety Inventory (STAI) | Stress has been significantly reduced |
Hassan, Ahmad et al., (2018) [47] | Blood Pressure; EEG | SDM; STAI | ||
H. Ikei et al., (2014) [40] | HRV; Pulse | SD | ||
Jiang S et al., (2021) [45] | Blood Pressure; Pulse; EEG | POMS; TMD; SD | ||
Ji-Young Choi et al., (2016) [50] | HRV; EEG | SD | ||
Ke-Tsung Han (2008) [43] | STAI; RCS; RS | |||
Lee, MS (Lee, Min-sun) et al., (2015) [46] | HRV; Blood Pressure | SDM | ||
Masahiro Toyoda et al., (2019) [37] | Pulse | STAI | ||
Seong-Hyun Park and Richard H. Mattson (2008) [48] | Blood Pressure; HR | STAI | ||
Virginia I. Lohr et al., (1996) [49] | Blood Pressure; Pulse | ZIPER | ||
Katinka H. Evensen1 et al., (2013) [42] | PRS; Likert Scale | No effect on pressure is shown | ||
Preyen Archary and Andrew Thatcher (2021) [41] | DSSQ-S | |||
WeiLin et al., (2019) [12] | Blood Pressure; Pulse; Finger SpO2 | TMD; POMS | Stress has been significantly reduced | |
Outdoors | Johan Ottosson and Patrik Grahn (2005) [38] | Systolic Blood Pressure; Diastolic Blood Pressure; HR | No effect on pressure is shown | |
Virtual | Kate E. Lee et al., (2015) [35] | 6-point Likert scale; PRS | Stress has been significantly reduced, but the big green wall may add pressure | |
Seungkeun Yeom et al., (2021) [16] | HR; EDA; EEG | STAI; | ||
Photos | K. Dijkstra et al., (2008) [36] | Stress Arousal Checklist | Stress has been significantly reduced | |
Photos or Indoors | Cammie K. Coleman and Richard H. Mattson (1995) [44] | Skin Temperature | Live plants and photographs had a positive response for 38% of participants, and 23% had reduced stress in the control group | |
Video | Bin Jiang et al., (2014) [5] | Salivary Cortisol; Skin Conductance | TSST | Stress has been significantly reduced |
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Gu, J.; Liu, H.; Lu, H. Can Even a Small Amount of Greenery Be Helpful in Reducing Stress? A Systematic Review. Int. J. Environ. Res. Public Health 2022, 19, 9778. https://doi.org/10.3390/ijerph19169778
Gu J, Liu H, Lu H. Can Even a Small Amount of Greenery Be Helpful in Reducing Stress? A Systematic Review. International Journal of Environmental Research and Public Health. 2022; 19(16):9778. https://doi.org/10.3390/ijerph19169778
Chicago/Turabian StyleGu, Jiaqi, Haixiao Liu, and Hong Lu. 2022. "Can Even a Small Amount of Greenery Be Helpful in Reducing Stress? A Systematic Review" International Journal of Environmental Research and Public Health 19, no. 16: 9778. https://doi.org/10.3390/ijerph19169778