Background The practice of Forest Bathing can be described as spending time immersed in nature mindfully using the senses to engage with the natural environment (Miyazaki. Shinrin Yoku: the Japanese art of forest bathing. Timber Press, 2018). Well-established in Japan, this is relatively new within the UK. Many studies have demonstrated positive health outcomes for both mental and physical wellbeing within the general population (Furuyashiki, Tabuchi, Norikoshi, et al. Environ Health Prevent Med. 2019; 24:1–1; Farrow, Washburn. Glob Adv Health Med. 2019; 8:2164956119848654; Ochiai, Ikei, Song, et al. Int J Environ Res Pub Health. 2015;12(3):2532–42). The existing body of evidence suggests immersion into nature can offer a therapeutic way of reducing symptoms of depression, stress, anger, anxiety and additionally improve mood and relaxation (Pritchard, Richardson, Sheffield, et al. J Happ Stud. 2020; 21:1145–67).

Aim(s) Evaluate whether spending time immersed in nature had a positive effect on wellbeing for people who access hospice services. Measure any contrast in results, if any, between guided and unguided Forest Bathing. Study the correlation between nature and impact on wellbeing.

Understand how this therapeutic intervention could enhance service provision.

Methods

• 17 participants.

• 60 minutes immersed in nature.

• Heart rate variability (HRV) measurement.

• The Warwick Edinburgh Wellbeing Scale (Tennant, Hiller, Fishwick, et al. Health Qual Life Outcomes. 2007;5(1):1–3).

• The Inclusion of Self within Nature Scale (Schultz. Psychol Sustain Dev. 2002:61–78).

• Data analysed using analysis of variance and the reliable change index for both psychometric measures and HRV.

Results Improved HRV in both guided and unguided conditions, more improvement in guided condition. Improved Wellbeing and Inclusion in nature scores in both conditions after Forest Bathing, but greater in guided condition. This was a small pilot study, but data suggests that offering Guided Forest Bathing alongside more traditional therapeutic interventions may improve wellbeing, feelings of inclusion in nature and Heart Rate Variability.

Conclusions The study was to test if a nature-based concept could offer a therapeutic intervention alongside standardised care at the hospice. The results show strong evidence that Forest Bathing reduces anxiety, stress levels and blood pressure with improved mental and mood co-ordination.