1. Introduction
’, cancer, Cancer
CANCER, POSITIVE, CANCER
The incidence of cancer cases is increasing worldwide, and chemotherapy is often necessary as part of the treatment for many of these cases. Nature-based interventions have been shown to offer potential benefits for human well-being. Objective: This study aims to investigate the outcome of nature images on clinical symptom management related to chemotherapy. Methods: A randomized clinical trial was conducted in an outpatient cancer unit of a private hospital in Brazil, with 173 participants over the age of 18 who were undergoing chemotherapy and had signed an informed consent form. The intervention consisted of the presentation of a 12-min video featuring nature images categorized under the themes of Tranquility, Beauty, Emotions Up, or Miscellany. Images were sourced from the e-Nature Positive Emotions Photography Database (e-NatPOEM), a publicly available collection of affectively rated images. Sociodemographic and clinical data, as well as the participants’ connection to nature, were investigated. The Positive Affect/Negative Affect Scale (PANAS) and the Edmonton Symptom Assessment System (ESAS) were applied pre- and post-intervention. Results: Data showed very strong evidence of a reduction in negative affect for the intervention group (An estimated 19.3 million new cancer cases occurred worldwide in 2020, according to data from the World Health Organization and the American Cancer Society [Cancer patients often experience negative emotions at diagnosis and throughout treatment [Since Florence Nightingale, there has been a strong emphasis on creating restorative environments in hospitals. Florence recognized the importance of patients being able to see the sky and sunlight through a window, even if nothing else was possible, stating that such measures were of prime importance for patient recovery [A window with a view of a natural landscape has been identified as a potential adjunct in the recovery of surgical patients, resulting in reduced analgesic consumption and shorter hospital stays [The growing literature on nature-based interventions in various health settings suggests their potential to alleviate disease-related tension and positively impact patients. However, little is known about the role of human-nature interactions in patients’ health and illness experiences and whether nature contributes to recovery, health, and well-being from their perspective [A review study has shown that cancer patients appreciate direct contact with nature and benefit from the opportunities of this connection, experiencing consequent tension relief (related to the diagnosis) and feeling aesthetically enriched by nature through the appreciation of its beauty, peace, tranquility, and solitude [In this study, we evaluated the therapeutic potential of viewing images of nature on the cancer patients’ positive/negative affect and clinical symptoms related to chemotherapy. For the assessments, we employed the Positive Affect/Negative Affect Scale (PANAS) [