Effects Of Forest Bathing (Forest Therapy) And
Diaphragmatic Deep Breathing Exercise on Pre-
Hypertensive/Hypertensive Adults in Hong Kong: A Quasi-
Experimental Feasibility Study
Volume 3 - Issue 4
Katherine Ka-Yin YAU1, RN, MCNS, DHSc, Alice Yuen LOKE2*, RN, MN, PhD
1Senior Lecturer, School of Nursing, Tung Wah College, Hong Kong.
2Honorary Professor, School of Nursing, The Hong Kong Polytechnic University, Hong Kong.
Received: October 18, 2021 Published: November 08, 2021
*Corresponding author: Prof. Alice Yuen LOKE, Director and Professor, Department of Nursing, Hong Kong Adventist College, Hong
Kong
DOI: 10.32474/OAJCAM.2021.03.000170
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Abstract
This study aimed to examine and compare therapeutic effectiveness between forest bathing (FB) and diaphragmatic deep
breathing exercise (DDBE) in middle-aged adults with pre-hypertension or hypertension in Hong Kong. Four sessions each of FB
and DDBE were conducted among eligible participants in a country park (n=21) and a quiet room (n=12), respectively. Systolic
blood pressure (SBP), diastolic blood pressure (DBP), pulse rate (PR), mood states, and state and trait anxiety levels were measured
before (baseline) and immediate before and after each intervention, and eight weeks post intervention. After four consecutive
weeks of intervention, the FB group achieved a significant decrease in SBP 7.4 mmHg and a significant reduce in the scores of state
anxiety level of 11.5, trait anxiety levels of 6.4, the total mood states of 14.8, tension-anxiety of 3.2, depression of 2.0, fatigue of 4.1,
anger of 2.3 and confusion of 2.0. DDBE intervention showed no effect on lowering SBP, DBP and PR, but it showed a significant
decrease in the scores of state anxiety level of 8.0, trait anxiety level 6.2, total mood states 9.0, tension-anxiety 1.6 and confusion
1.8. FB was more effective in lowering SBP, state and trait anxiety levels, and improving negative mood, while DDBE was more
effective in decreasing PR. At eight weeks after intervention, only FB had a significant sustained effect on lowering PR of 6.9 beats/
min. These findings provide preliminary evidence that FB is more effective than DDBE in lowering SBP and anxiety levels in the
study population.
Keywords: forest bathing; diaphragmatic deep breathing exercise; hypertension; prehypertension; anxiety; mood state
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