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Nature-based supportive care opportunities: a conceptual framework
  1. Sarah Blaschke1,2,
  2. Clare C O’Callaghan1,3,4,5 and
  3. Penelope Schofield1,2,6
  1. 1 Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
  2. 2 Sir Peter MacCallum Department of Oncology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Victoria, Australia
  3. 3 Departments of Psychosocial Cancer Care and Medicine, St Vincent’s Hospital, The University of Melbourne, Melbourne, Victoria, Australia
  4. 4 Palliative and Supportive Care Research, Cabrini Health, Melbourne, Victoria, Australia
  5. 5 Institute for Ethics and Society, The University of Notre Dame, Sydney, Australia
  6. 6 Department of Psychology, Faculty of Health Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia
  1. Correspondence to Sarah Blaschke, Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, VIC 8006, Australia; Sarah.Blaschke{at}


Objective Given preliminary evidence for positive health outcomes related to contact with nature for cancer populations, research is warranted to ascertain possible strategies for incorporating nature-based care opportunities into oncology contexts as additional strategies for addressing multidimensional aspects of cancer patients’ health and recovery needs. The objective of this study was to consolidate existing research related to nature-based supportive care opportunities and generate a conceptual framework for discerning relevant applications in the supportive care setting.

Methods Drawing on research investigating nature-based engagement in oncology contexts, a two-step analytic process was used to construct a conceptual framework for guiding nature-based supportive care design and future research. Concept analysis methodology generated new representations of understanding by extracting and synthesising salient concepts. Newly formulated concepts were transposed to findings from related research about patient-reported and healthcare expert-developed recommendations for nature-based supportive care in oncology.

Results Five theoretical concepts (themes) were formulated describing patients’ reasons for engaging with nature and the underlying needs these interactions address. These included: connecting with what is genuinely valued, distancing from the cancer experience, meaning-making and reframing the cancer experience, finding comfort and safety, and vital nurturance. Eight shared patient and expert recommendations were compiled, which address the identified needs through nature-based initiatives. Eleven additional patient-reported recommendations attend to beneficial and adverse experiential qualities of patients’ nature-based engagement and complete the framework.

Conclusions The framework outlines salient findings about helpful nature-based supportive care opportunities for ready access by healthcare practitioners, designers, researchers and patients themselves.

  • supportive care
  • supportive care environment
  • nature-based design
  • patient experiences
  • healthcare innovation

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  • Contributors The authors have shared the conceptualisation, planning and writing of this paper. The first author led the project, wrote the first manuscript and coordinate the review process.

  • Funding First author was supported by an Australian Government Research Training Program (RTP) Scholarship throughout the study period.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval This study was approved by the Peter MacCallum Cancer Centre Human Research Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.