WHY spend time outdoors? Nature can aid psychosocial and emotional wellbeing in those living with or beyond cancer


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Moa Sundström1
1King’s College London (KCL)

Abstract

Background

Although nature-based therapy has been found useful in various patient populations, few interventions are theory-based. WHYoutdoors is a wellbeing course based on the theory of nature connection developed for those living with or beyond cancer. The aim was to investigate the attendee outcomes and share the findings with others providing holistic cancer support services.

Method

In this cross-sectional study, five course-attendees participated in semi-structured Zoom interviews regarding their experiences (thoughts, feelings, suggestions) and were women living beyond breast cancer (n=4) and ovarian cancer, mean age = 57.2 (SD=6.72). Four facilitators (women n=2) participated in semi-structured interviews regarding how they thought WHYoutdoors helped the attendees as well as themselves. They were recruited through purposeful sampling and informed consent was obtained. Thematic analysis was carried out. The study was approved by the charity We Hear You (WHY), no further ethical clearance was required (MSc placement).

Results

Four main themes were created for the attendees: Nature connection and being outdoors, The WHYoutdoors format, Powerful and profound experience, and Psychological impact and healing. The subthemes covered COVID, grounding techniques, and social aspects. All participants had an overwhelmingly positive experience and enjoyed being able to focus solely on themselves.

For the facilitators three main themes were created: WHYoutdoors has something for everyone, Using nature in counselling, and Many life changes, with the final theme including the subtheme Positive and transformative experience. The facilitators felt privileged to be part of WHYoutdoors and thought highly of the course.

Conclusion

WHYoutdoors had a positive impact on emotional wellbeing and acceptance of living beyond cancer and offered something for everyone irrespective of where they were in their cancer journey or previous relationship with nature. Nature was a useful resource for gaining perspective and metaphoric thinking, e.g., comparing one’s hair loss and regrowth to a tree throughout the seasons. WHYoutdoors planted a seed of help-seeking as it made the attendees realise they were not the only ones struggling to live beyond cancer.

Impact statement

Nature-based therapeutic practices can have a positive - sometimes life-changing - impact as the course has something to offer everyone, ranging from reflections on meaning of life to appreciating nature and being alive.