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Stakeholders’ perceptions of value of nature-based interventions in promoting health in people with stress-related illness: a qualitative study
Luleå University of Technology, Department of Health, Education and Technology, Nursing and Medical Technology.ORCID iD: 0000-0003-1367-2247
Luleå University of Technology, Department of Social Sciences, Technology and Arts, Business Administration and Industrial Engineering. School of Business, Innovation and Sustainability, Halmstad University, Halmstad, Sweden.ORCID iD: 0000-0002-3377-6177
Luleå University of Technology, Department of Health, Education and Technology, Nursing and Medical Technology.ORCID iD: 0000-0001-6244-6401
Luleå University of Technology, Department of Health, Education and Technology, Nursing and Medical Technology.ORCID iD: 0000-0002-7388-069X
2024 (English)In: International Journal of Circumpolar Health, ISSN 1239-9736, E-ISSN 2242-3982, Vol. 83, no 1, article id 2349330Article in journal (Refereed) Published
Abstract [en]

Stress-related illness is a common and increasing cause for sick leave in Sweden. Spending time in nature reduces stress and promotes health and well-being. Accordingly, nature-based interventions (NBI) for people with stress-related illness have been developed and implemented in southern Scandinavia; however, such interventions are uncommon in the Circumpolar North. Previous studies have examined the effects and experiences of participating in NBI, but research about different stakeholders’ perspectives on NBI is lacking. The aim of this study was to explore different key stakeholders’ perceptions of the value of NBI in promoting health in people with stress-related illness. Data were collected through semi-structured interviews with 11 persons with stress-related illness experience, 14 healthcare professionals, and 11 entrepreneurs offering NBI. Qualitative content analysis resulted in four categories: Providing opportunity for recovery, Offering new perspectives and opportunity for reflection, Empowering balance and control in life, and Enabling one to overcome barriers. Although the study was conducted in a region where NBI is not widely implemented, the different stakeholders expressed similar perceptions of the value of NBI, indicating that NBI may be a valuable complement to health care which reaches people with stress-related illness needs and promotes their health. 

Place, publisher, year, edition, pages
Taylor & Francis, 2024. Vol. 83, no 1, article id 2349330
Keywords [en]
Health promotion, nature-based intervention, nursing, qualitative study, stakeholder, stress-related illness, value
National Category
Nursing
Research subject
Nursing; Entrepreneurship and Innovation
Identifiers
URN: urn:nbn:se:ltu:diva-105466DOI: 10.1080/22423982.2024.2349330OAI: oai:DiVA.org:ltu-105466DiVA, id: diva2:1857779
Funder
Interreg NordNorrbotten County CouncilLuleå University of Technology
Note

Validerad;2024;Nivå 2;2024-05-14 (joosat);

Funder: EU;

Full text: CC BY-NC License

Available from: 2024-05-14 Created: 2024-05-14 Last updated: 2024-05-14Bibliographically approved
In thesis
1. Nature-based interventions to promote health in people with stress-related illness
Open this publication in new window or tab >>Nature-based interventions to promote health in people with stress-related illness
2024 (English)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[sv]
Naturbaserade interventioner för att främja hälsa hos personer med stressrelaterad ohälsa
Abstract [en]

Stress-related illness is increasing and is a common cause of sick leave in Sweden. Spending time in nature reduces stress and promotes health and well-being. Consequently, nature-based interventions (NBI) for people with stress-related illness have been developed, implemented and studied in southern Scandinavia. However, such interventions are uncommon in the Circumpolar North with a different climate which affect conditions for outdoor activities. 

The overall aim of this doctoral thesis was to explore NBIs to promote health in people with stress-related illness from the perspectives of previous research, people with stress-related illness, healthcare professionals and entrepreneurs offering NBIs with a specific focus on northern natural conditions.

The thesis includes four studies. An integrative literature review (I) identified and summarised scientific studies of NBIs for people with stress-related illness. Studies using both qualitative and quantitative designs were included. Study II explored key stakeholders’ perceptions of the value of NBIs in promoting health in people with stress-related illness. Semi-structured interviews were conducted with people with stress-related illness experience, healthcare professionals, and entrepreneurs offering NBI and data were analysed through qualitative content analysis. In study III people with stress-related illness experiences of participating in an NBI program in a northern natural setting were explored. A longitudinal case study design was used, and data were collected through repeated semi-structured interviews, diary entries and self-assessment questionnaires. Qualitative content analysis was used to analyse interviews and reflections from diaries and data from self-assessing questionnaires were presented descriptively. Study IV explored people with stress-related illness experiences of nature prescription. Data were collected through interviews with open-ended questions and analysed with a phenomenological-hermeneutic method.

Findings show that natural environments offer unique qualities for individualised, meaningful activities and interactions with others in a non-demanding atmosphere. In NBI people with stress-related illness find a source for recovery, joy, and well-being. Spending time in nature is perceived as calming and facilitates being in the present. NBIs improve health and strengthen self-efficacy and work ability. Time in nature provides new perspectives, supports existential reflections, and empowers people with stress-related illness to find opportunities for change to achieve balance in everyday life. NBIs can be helpful for people with stress-related illness to overcome barriers to going out in nature or to find their way back to nature. 

In conclusion, NBIs seem to be beneficial in promoting health in people with stress-related illness. Different stakeholders have similar perceptions of the value of NBIs, indicating that it could be a valuable complement to health care. NBIs in a northern natural setting seems to have similar health promoting qualities as those seen in studies of NBIs in other natural settings.

Place, publisher, year, edition, pages
Luleå: Luleå University of Technology, 2024
Series
Doctoral thesis / Luleå University of Technology 1 jan 1997 → …, ISSN 1402-1544
Keywords
case study, experience, health promotion, literature review, nature-based intervention, nature prescription, nursing, qualitative research, stress-related illness
National Category
Nursing
Research subject
Nursing
Identifiers
urn:nbn:se:ltu:diva-105465 (URN)978-91-8048-581-4 (ISBN)978-91-8048-582-1 (ISBN)
Public defence
2024-09-20, E632, Luleå University of Technology, Luleå, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2024-05-14 Created: 2024-05-14 Last updated: 2024-05-14Bibliographically approved

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Johansson, GunillaJohansson, JeanethEngström, ÅsaJuuso, Päivi

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