An Analysis of Theoretical Perspectives in Research on Nature-Based Interventions and Pain
Abstract
:1. Introduction
1.1. Acute and Chronic Pain
1.2. Nature-Based Interventions
2. Materials and Methods
2.1. Literature Review
2.2. Theory Analysis
3. Results
3.1. Stress Reduction Theory
3.2. Attention Restoration Theory
4. Discussion
A Note on Biophilia Hypothesis
5. Strengths and Limitations
6. Conclusions and Future Theory Development
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Article Name, Authors, Year, and Country | Sample | Aims | Method/Design | Theoretical Framework |
---|---|---|---|---|
A Randomized Trial of Nature Scenery and Sounds Versus Urban Scenery and Sounds to Reduce Pain in Adults Undergoing Bone Marrow Aspirate and Biopsy, Lechtzin et al., 2010, U.S.A. [49] | N = 120 adult patients Nature arm (n = 44), City arm (n = 39), standard care arm (n = 37). | Determine the impact of exposure to sights and sounds of nature on pain outcomes during Bone Marrow Aspirate and Biopsy (BMAB). | RCT with 3 groups. Groups were exposed to an audio-visual nature scene, city scene, or were provided standard care during the procedure. Pain scores and categorical pain outcomes were measured. | Described |
Plant Therapy: a Nonpharmacological and Noninvasive Treatment Approach Medically Beneficial to the Wellbeing of Hospital Patients, Khan et al., 2016, Germany [50] | N = 270 adult patients | To investigate the effect of therapeutic horticulture on health outcomes in patients within two surgical wards of a hospital. | Mixed methods. Patients were randomly assigned to either ward with a total of 135 patients in each group. In ward A, patients were exposed to therapeutic horticulture, and in ward B, patients were exposed to standard hospital rooms. Small group discussion and focal interviews followed the intervention. Vital signs, hospital stay (days), and analgesic consumption were measured. | Described |
The Effects of Forest Therapy on Coping with Chronic Widespread Pain: Physiological and Psychological Differences between Participants in a Forest Therapy Program and a Control Group, Han et al., 2016, South Korea [51] | N = 61 adults Control (n = 28) or FT (n = 33) | Test the impact of forest therapy (FT) sessions on symptoms of chronic widespread pain (CWP). | Quasi-experimental, two-groups repeated measures design. FT sessions lasted 2 days and were designed with physical activities and psychological approaches to address CWP. Measures included Heart-rate Variability, with NK cell activity, pain and depressive symptoms, and health-related quality of life. | Described |
The Soothing Sea: A Virtual Coastal Walk Can Reduce Experienced and Recollected Pain, Tanja-Dijkstra et al., 2017, U.K. [52] | N = 85 adults (Study 1) N = 70 adults (Study 2) | To investigate the impact of simulated nature via Virtual Reality (VR) on pain immediately after the VR (experienced pain), and recollected pain after one week posttest. | Quasi-experimental randomized between- participants design. Study 1 used a cold pressor test to induce pain, Study 2 was a randomized trial with patients undergoing a dental treatment. In Study 1 and 2, the 3D nature image used as the VR setting included a coastal environment with green landscape and foliage. Measures included experienced and recollected pain measured using the 0–11 numeric rating scale and the McGill Pain Questionnaire. | Applied |
Nearby Nature Buffers the Pain Catastrophizing–Pain Intensity Relation Among Urban Residents With Chronic Pain, Wells et al., 2019, U.S.A. [53] | N = 80 middle-aged adults | To investigate the moderating effects of nearby nature on the association between pain catastrophizing and daily pain intensity, and the association between rumination and daily pain intensity | Quasi-experimental study of secondary data. Measures included proximity to nature, pain scores, measures of pain catastrophizing, rumination, helplessness, and magnification, alongside time spent in nature. | Applied |
Using Nature-Inspired Virtual Reality as a Distraction to Reduce Stress and Pain Among Cancer Patients, Scates et al., 2020, U.S.A. [29] | N = 50 adults | To determine the impact of a virtual nature simulation on stress and pain in 50 adult cancer patients during their IV infusions and/or port access procedures (acute pain). | Mixed methods, repeated measures design. Measures included questionnaires developed by researchers focusing on constructs of stress and pain with open-ended interview questions. | Applied |
Effects of Virtual Reality v. Biophilic Environments on Pain and Distress in Oncology Patients: a Case-Crossover Pilot Study, Verzwyvelt et al., 2021, U.S.A. [54] | N = 33 adults | To investigate the impact of using either a “biophilic Green Therapy or Virtual Reality” exposure environment as compared to a control, to decreasing pain and distress while participants received chemotherapy. | A crossover design pilot study with adult participants experiencing breast, gynecologic, gastrointestinal, pancreatic, and prostate cancers. Participants exposed to 3 settings over 3 different cycles, including a control room, a Green Therapy room, and a VR room to receive chemotherapy. Measures included pain, distress, heart rate, blood pressure, and salivary cortisol. | Described |
Can Residential Greenspace Exposure Improve Pain Experience? A Comparison between Physical Visit and Image Viewing, Li et al., 2021, China [28] | N = 24 young adults | To evaluate the effects of two environments, outdoor greenspace, versus viewing a simulated greenspace, or a control environment (an empty room) on pain perception, pain threshold, and pain tolerance. | Quasi-experimental randomized cross-over design. Pain was induced via electrical pain stimuli. Measures included pain intensity, anxiety, two adjective pairs were used to measure the state of anxiety and subjective stress, as well as heart rate, heart rate variability and blood pressure. A measure of Scenic Beauty Estimation (SBE) was used to assess participants’ preference regarding the experimental environments. | Described |
Effects of Nature-Based Intervention in Occupational Health Care on Stress—A Finnish Pilot Study Comparing Stress Evaluation Methods, Lipponen et al., 2022,Finland [55] | N = 11 middle-aged females | To assess methodologies on Nature-Based Interventions (NBIs) and their limitations for measuring psychological and physiological effects over time. | Quasi-experimental longitudinal pilot. The NBI included six group appointments over six months. Measures included heart-rate variability, self-reported pain, and work exhaustion measured pre and post study period. | Described |
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Jones, R.J.F.; Littzen, C.O.R. An Analysis of Theoretical Perspectives in Research on Nature-Based Interventions and Pain. Int. J. Environ. Res. Public Health 2022, 19, 12740. https://doi.org/10.3390/ijerph191912740
Jones RJF, Littzen COR. An Analysis of Theoretical Perspectives in Research on Nature-Based Interventions and Pain. International Journal of Environmental Research and Public Health. 2022; 19(19):12740. https://doi.org/10.3390/ijerph191912740
Chicago/Turabian StyleJones, Reo J. F., and Chloé O. R. Littzen. 2022. "An Analysis of Theoretical Perspectives in Research on Nature-Based Interventions and Pain" International Journal of Environmental Research and Public Health 19, no. 19: 12740. https://doi.org/10.3390/ijerph191912740