title: Spiritual care of cancer patients by integrated medicine in urban green space: a pilot study.
abstract: BACKGROUND
  Psycho-oncological care, including spiritual care, is essential for cancer patients. Integrated medicine, a therapy combining modern western medicine with various kinds of complementary and alternative medicine, can be appropriate for the spiritual care of cancer because of the multidimensional characteristics of the spirituality. In particular, therapies that enable patients to establish a deeper contact with nature, inspire feelings of life and growth of plants, and involve meditation may be useful for spiritual care as well as related aspects such as emotion. The purpose of the present study was to examine the effect of spiritual care of cancer patients by integrated medicine in a green environment.
  
  
  METHODS
  The present study involved 22 cancer patients. Integrated medicine consisted of forest therapy, horticultural therapy, yoga meditation, and support group therapy, and sessions were conducted once a week for 12 weeks. The spirituality (the Functional Assessment of Chronic Illness Therapy-Spiritual well-being), quality of life (Short Form-36 Health Survey Questionnaire), fatigue (Cancer Fatigue Scale), psychological state (Profile of Mood States, short form, and State-Trait Anxiety Inventory) and natural killer cell activity were assessed before and after intervention.
  
  
  RESULTS
  In Functional Assessment of Chronic Illness Therapy-Spiritual well-being, there were significant differences in functional well-being and spiritual well-being pre- and postintervention. This program improved quality of life and reduced cancer-associated fatigue. Furthermore, some aspects of psychological state were improved and natural killer cell activity was increased.
  
  
  CONCLUSIONS
  It is indicated that integrated medicine performed in a green environment is potentially useful for the emotional and spiritual well-being of cancer patients.
authors: Graduate School of Agriculture, Kyoto University, Kyoto, Japan.
authors: Maiko
authors: M
authors: Nakau
authors: Jiro
authors: J
authors: Imanishi
authors: Junichi
authors: J
authors: Imanishi
authors: Satoko
authors: S
authors: Watanabe
authors: Ayumi
authors: A
authors: Imanishi
authors: Takeshi
authors: T
authors: Baba
authors: Kei
authors: K
authors: Hirai
authors: Toshinori
authors: T
authors: Ito
authors: Wataru
authors: W
authors: Chiba
authors: Yukihiro
authors: Y
authors: Morimoto
mesh_terms: D000368:Aged; D002908:Chronic Disease; D000529:Complementary Therapies; D004644:Emotions; D004777:Environment; D005221:Fatigue / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D051639:Gardening; D006801:Humans; D055048:Integrative Medicine; D007694:Killer Cells, Natural / Q000378:metabolism*; D008297:Male; D019122:Meditation; D008875:Middle Aged; D019368:Nature; D009369:Neoplasms / Q000150:complications / Q000276:immunology / Q000523:psychology / Q000628:therapy*; D010166:Palliative Care / Q000379:methods; D010865:Pilot Projects; D011615:Psychotherapy, Group; D011788:Quality of Life; D012944:Social Support; D029181:Spirituality; D014197:Trees; D014505:Urban Population; D015013:Yoga