Effects of Forest Healing Program on Depression, Stress and Cortisol Changes of Cancer Patients

Abstract

Patients diagnosed with cancer face mental problems such as alienation, isolation, anxiety about death and fear, recovering from psychological difficulties. In this study, a forest healing program was provided for cancer patients to recover from psychological stress, depression, social isolation and self-esteem caused by cancer and changes in salivary cortisol through psychological and emotional recovery were measured. From September 19 to November 28, 2017, a forest healing program composed of a total of 10 sessions, two hours per session was provided for 12 cancer patients in the Forest of Taegyo located in Yongin. Psychological tests were performed with Social Adaptation Self-evaluation Scale (SASS), Korean-version Perceived Stress Scale (PSS) and Beck Depression Inventory (BDI) and the collected data were analyzed with the SPSS 18.0. The salivary cortisol level was measured along with the psychological tests and were analyzed by a specialized testing agency. The results of the analysis showed that the pre-and post-assessment score of SASS was 29.17 and 25.92, respectively, and that the pre-and post-assessment score of PSS was 30.50 and 23.92, respectively. The pre-and post-assessment score of BDI was 41.00 and 34.83, respectively, which showed significant differences. In addition, the pre-and post-assessment level of saliva cortisol was 3.13 and 1.68, respectively, showing a significant decrease. In short, the forest healing program was found to be effective in reducing physiological changes caused by social isolation and stress due to the emotional and psychological difficulties that the subjects who were diagnosed with cancer and were recovering from it have. In the future, it will be necessary to develop and implement a forest healing program by conducting a forest healing requirement survey on cancer patients.

Experiences of Forest Healing Instructors Who Met Cancer Patients in Forest Healing Programs: FGI Research

“…After being discharged from hospitals, cancer survivors seek healthy lifestyle methods to prevent recurrence and various life problems [25]. Among them, forest activities provide cancer survivors with physiologically and psychologically positive recovery experiences, and the demand for urban forest programs is high [14,26]. Therefore, cancer patients and survivors become interested in and participate in forest healing programs, and the participants of this study experienced unexpected encounters with cancer patients.…”

“…Within this topic, participants had difficulty in applying the program for cancer patients because they did not know about the characteristics of cancer patients. For example, it is difficult to run a forest healing program for cancer survivors owing to fear of emergencies, sensitivity, or lack of knowledge about the participants [14]. Forest healing instructors articulated the need for help from medical and health experts who are well aware of the specific needs of cancer patients.…”

“…Owing to these positive effects, people affected with various types of diseases are visiting urban forests for rest and healing, and the demand continues to increase [13]. Forest healing in cancer patients reportedly reduces the level of cortisol, a stress hormone [14], and improves sleep quality [15]. It has also been reported to improve cancer-related fatigue and emotional fluctuations [16].…”

Priority Analysis of Educational Needs of Forest Healing Instructors Related to Programs for Cancer Survivors: Using Borich Needs Assessment and the Locus for Focus Model

“…Even in the case of forest healing instructors who are skilled in forest healing programs through training process and practice, if the target group is a special group, it may be difficult to engage in professional healing activities if they do not have an understanding of the participants [29]. In particular, forest healing instructors in charge of forest healing programs for cancer survivors require additional competency compared to forest healing instructors who operate general forest healing programs, because of the characteristics of cancer survivors [29,30]. Therefore, when developing forest healing programs for cancer survivors in the future, education about the cancer survivors' overview is necessary, and periodic education is necessary.…”

“…Effective communication is important because it plays an important role in the emotional health of cancer survivors [26]. Therefore, programs for cancer survivors should be led by forest healing instructors with specialized knowledge [30]. It is necessary to develop an education program for forest healing instructors including education on communication, accompanied by continuous education, in the future.…”