title: The Effect of Reflective Garden Walking on Adults With Increased Levels of Psychological Stress.
abstract: OBJECTIVE
  The purpose of this evaluation was to determine the benefits of a reflective garden walking program on adults with increased levels of psychological stress. Outcomes measured included levels of hopefulness, personal growth, and quality of life.
  
  
  METHODS
  The evaluation used a one-group, pretest-posttest to determine the success of the Stroll for Well-Being to assist participants to overcome psychological stressors. Participants were recruited through local support groups. All participants signed informed consent to participate in the study program. A total of 195 participants completed the 6-week program, attended all meetings, and completed all measurement tools.
  
  
  RESULTS
  All of the outcome measures statistically improved on the posttest compared to the pretest scores. The outcome measure that had the largest change in mean score was the Personal Growth Scale.
  
  
  CONCLUSIONS
  Holistic nursing as a specialty should continue to explore the use of green spaces and nature on patients. More research is needed to increase the amount of evidence regarding spending time in nature and using reflection and journaling as a tool to reconnect with the natural environment.
authors.affiliation: Georgia Baptist College of Nursing at Mercer University mccaffrey_rg@mercer.edu.
authors.forename: Ruth
authors.initials: R
authors.lastname: McCaffrey
authors.affiliation: Florida Atlantic University, Boca Raton.
authors.forename: Patricia
authors.initials: P
authors.lastname: Liehr
mesh_terms: D000328:Adult; D005260:Female; D000072506:Gardens; D006801:Humans; D008297:Male; D013315:Stress, Psychological / Q000523:psychology / Q000628:therapy*; D016138:Walking / Q000523:psychology*
keywords: adults; alternative/complementary therapies; specific conditioning/areas; stress management/relaxation