RESEARCH

Identifying Opportunities for Nature Engagement in Cancer Care Practice and Design: Protocol for Four-Round Modified Electronic Delphi

The study successfully created a ranked list of the top 10 most important nature-based design opportunities and top 10 barriers, as voted on by healthcare and design experts over four rounds.These results form the foundation for evidence-informed guidelines to help hospitals and cancer care centers include nature in ways that are meaningful, feasible, and patient-centered.

Program Types: Therapeutic

Population Groups: Chronic/Acute Health Conditions

Setting or Context: Hospitals/Clinics, Healthcare Centre

Health and Wellness Outcomes: Improved Mental Health, Enhanced Emotional Well-being, Improved Quality of Life

Allied Profession Intersections: Landscape Design

Evidence Type: Peer-Reviewed Studies

Measurement and Evaluation: Metrics for Mental Health, Patient-Reported Outcomes, Standardized Assessment Tools, Program Effectiveness

Access: Free

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Summary

This article outlines a study designed to identify how nature can be better included in cancer care environments. The researchers planned a structured, four-round survey with experts in healthcare, hospital design, and research to understand what nature-based features should be included in cancer care settings and what challenges might prevent this. Experts reviewed ideas suggested by cancer patients and then generated, ranked, and refined their own ideas through repeated feedback rounds. The aim was to reach agreement on the most important opportunities and barriers for using nature in ways that support recovery and well-being.

Nature-based features—like gardens, views of greenery, and outdoor therapy spaces—have been shown to reduce stress, boost mood, and even encourage healthy habits in cancer patients. This study aimed to combine patient insights with expert knowledge to create practical, evidence-based recommendations for future hospital and clinic designs. The process included over 40 experts from different fields and used anonymous surveys to encourage open and honest input. The findings are expected to help shape better environments that promote healing and emotional support in cancer care settings.

Link

Blaschke, S., O’Callaghan, C.C., & Schofield, P. (2017). Identifying opportunities for nature engagement in cancer care practice and design: Protocol for four-round modified electronic Delphi. BMJ Open, 7(3), e013527.

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