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      Shinrin-Yoku (Forest Bathing) and Nature Therapy: A State-of-the-Art Review

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          Abstract

          Background: Current literature supports the comprehensive health benefits of exposure to nature and green environments on human systems. The aim of this state-of-the-art review is to elucidate empirical research conducted on the physiological and psychological effects of Shinrin-Yoku (or Forest Bathing) in transcontinental Japan and China. Furthermore, we aim to encourage healthcare professionals to conduct longitudinal research in Western cultures regarding the clinically therapeutic effects of Shinrin-Yoku and, for healthcare providers/students to consider practicing Shinrin-Yoku to decrease undue stress and potential burnout. Methods: A thorough review was conducted to identify research published with an initial open date range and then narrowing the collection to include papers published from 2007 to 2017. Electronic databases (PubMed, PubMed Central, CINAHL, PsycINFO and Scopus) and snowball references were used to cull papers that evaluated the use of Shinrin-Yoku for various populations in diverse settings. Results: From the 127 papers initially culled using the Boolean phrases: “Shinrin-yoku” AND/OR “forest bathing” AND/OR “nature therapy”, 64 studies met the inclusion criteria and were included in this summary review and then divided into “physiological,” “psychological,” “sensory metrics” and “frameworks” sub-groups. Conclusions: Human health benefits associated with the immersion in nature continue to be currently researched. Longitudinal research, conducted worldwide, is needed to produce new evidence of the relationships associated with Shinrin-Yoku and clinical therapeutic effects. Nature therapy as a health-promotion method and potential universal health model is implicated for the reduction of reported modern-day “stress-state” and “technostress.”.

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          Most cited references58

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          A systematic review of evidence for the added benefits to health of exposure to natural environments

          Background There is increasing interest in the potential role of the natural environment in human health and well-being. However, the evidence-base for specific and direct health or well-being benefits of activity within natural compared to more synthetic environments has not been systematically assessed. Methods We conducted a systematic review to collate and synthesise the findings of studies that compare measurements of health or well-being in natural and synthetic environments. Effect sizes of the differences between environments were calculated and meta-analysis used to synthesise data from studies measuring similar outcomes. Results Twenty-five studies met the review inclusion criteria. Most of these studies were crossover or controlled trials that investigated the effects of short-term exposure to each environment during a walk or run. This included 'natural' environments, such as public parks and green university campuses, and synthetic environments, such as indoor and outdoor built environments. The most common outcome measures were scores of different self-reported emotions. Based on these data, a meta-analysis provided some evidence of a positive benefit of a walk or run in a natural environment in comparison to a synthetic environment. There was also some support for greater attention after exposure to a natural environment but not after adjusting effect sizes for pretest differences. Meta-analysis of data on blood pressure and cortisol concentrations found less evidence of a consistent difference between environments across studies. Conclusions Overall, the studies are suggestive that natural environments may have direct and positive impacts on well-being, but support the need for investment in further research on this question to understand the general significance for public health.
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            Trends in research related to "Shinrin-yoku" (taking in the forest atmosphere or forest bathing) in Japan.

            "Shinrin-yoku", which can be defined as "taking in the forest atmosphere or forest bathing", has been receiving increasing attention in Japan in recent years for its capacity to provide relaxation and reduce stress. Since 2004, the authors of this paper have been involved in an investigation designed to ascertain the physiological effects of "Shinrin-yoku" within the framework of the "Therapeutic Effects of Forests" project. We have conducted physiological experiments, both in actual forests and in the laboratory, to elucidate the physiological effects on individuals of exposure to the total environment of forests or to only certain elements of this environment, such as the odor of wood, the sound of running stream water, and the scenery of the forest. We have obtained physiological measurements of central nervous activity, autonomic nervous activity, and biomarkers reflecting stress response that can be applied in this line of approach. Using these measurements, we have summarized the separate elements of forests in terms of the five senses. We have also reviewed a selection of field studies and introduced a number of results from ongoing projects as well as those from early studies. Future perspectives are also discussed.
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              Neighborhood greenspace and health in a large urban center

              Studies have shown that natural environments can enhance health and here we build upon that work by examining the associations between comprehensive greenspace metrics and health. We focused on a large urban population center (Toronto, Canada) and related the two domains by combining high-resolution satellite imagery and individual tree data from Toronto with questionnaire-based self-reports of general health perception, cardio-metabolic conditions and mental illnesses from the Ontario Health Study. Results from multiple regressions and multivariate canonical correlation analyses suggest that people who live in neighborhoods with a higher density of trees on their streets report significantly higher health perception and significantly less cardio-metabolic conditions (controlling for socio-economic and demographic factors). We find that having 10 more trees in a city block, on average, improves health perception in ways comparable to an increase in annual personal income of $10,000 and moving to a neighborhood with $10,000 higher median income or being 7 years younger. We also find that having 11 more trees in a city block, on average, decreases cardio-metabolic conditions in ways comparable to an increase in annual personal income of $20,000 and moving to a neighborhood with $20,000 higher median income or being 1.4 years younger.
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                Author and article information

                Contributors
                Role: Academic Editor
                Role: Academic Editor
                Role: Academic Editor
                Role: Academic Editor
                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                28 July 2017
                August 2017
                : 14
                : 8
                : 851
                Affiliations
                School of Nursing and Health Professions, University of San Francisco, 2130 Fulton Street, San Francisco, CA 94901, USA; rjjones2@ 123456usfca.edu (R.J.); kntocchini@ 123456usfca.edu (K.T.)
                Author notes
                [* ]Correspondence: mhansen@ 123456usfca.edu ; Tel.: +1-014153787577
                Article
                ijerph-14-00851
                10.3390/ijerph14080851
                5580555
                28788101
                3549122e-c681-4fb2-a8c4-646233007e17
                © 2017 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 11 June 2017
                : 21 July 2017
                Categories
                Review

                Public health
                shinrin-yoku,forest bathing,nature therapy,integrative medicine
                Public health
                shinrin-yoku, forest bathing, nature therapy, integrative medicine

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