There have been many studies on nature therapy and how it is especially important to individuals struggling with long-term illnesses. The article, “A Review of Design Recommendations for Outdoor Areas at Healthcare Facilities” (Abdul et al., 2012) discusses how hospitals can be a scary and stressful place, particularly for hospitalized children. Research has also found that the entire family can be negatively affected, not only the patient. Incorporating landscaping that is calming and aesthetically pleasing can help to alleviate stress from the hospital environment and provide comfort during an extremely hard time in a child’s life.

Landscape Greenery Effects
Landscape design has been shown to have positive psychological effects by reducing stress and promoting mental function. The study in the article, “Effect of landscape design elements on promoting neuropsychological health of children” gave questionnaires to children and therapists to examine ideas on how to build the best outdoor space near Akbar Children’s Super Specialty Hospital, located in Mashhad. The study revealed the positive impacts of green landscaping and its positive neuropsychological effects on sick children. The two highest scoring elements were water features and children’s features. These were shown to score the highest with the neuropsychological indicators, which includes emotional, cognitive, and non-symptom indexes (Allahyar & Kazemi, 2021). Improved relaxation, increased attention, and reduced anxiety are some of the variables that were related to the landscape improvement suggestions. Increased happiness was also related to the children’s features and water features when considering outdoor design for the hospital. The study concluded that it is important to gain insight directly from the children, as their opinions sometimes differed from those of their therapists (Allahyar & Kazemi, 2021).
Fairy Gardens
One type of natural environment incorporated by hospitals that has been getting research attention is fairy gardens. Fairy gardens have become a widespread environmental therapy design for children in hospitals and have been shown to support healing in patients struggling with chronic illness. The article, “Family members’ experiences of a ‘Fairy Garden’ healing haven garden for sick children”, van der Riet and colleagues (2017) interviewed parents and grandparents about the positive effects of the fairy gardens for them and their children during their time spent at the hospital. The results were discussed in terms of the “therapeutic modality of healing” (van der Riet et al., 2017), and identified the factors that improved after time spent in the fairy garden. The main positive effects were relaxation, activity, and increased socialization. Being outdoors in the garden allowed the children to not only spend time with their families but take their mind off their illness which can be hard to do as an inpatient in the hospital. Being in the natural environment also displayed signs of lessened psychological and physiological stress and allowed the children to engage with each other which is crucial for social development.

In the article, “Student nurses experience of a “fairy garden” healing haven garden for sick children” (van der Riet et al., 2017), nurses were able to observe the positive healing effects of the fairy gardens on sick children. One of the main outcomes developed from observing and listening to the children’s experience was how the time spent in the garden allowed them to just be a kid. Many children in hospitals become hyper- focused on their illness and are not able to fully relax in the environment they are in. One student nurse in the article stated, “They forgot about being ill” and discussed how they were fully able to feel like a child who is not sick during play and just experienced the life of a healthy child. Another outcome was that children playing in these gardens genuinely seemed happy, something they do not often see within the hospital walls.
“This garden gives families an opportunity to take a step away from the clinical environment and see their children enjoying themselves and allows the children to just be kids. It is beautiful and it brings happiness to the children and sick kids” – Australian student nurse from the article, “Student nurses experience of a ‘fairy garden’ healing haven garden for sick children”
Another example of a fairy garden is discussed in the article, “Hospitalized children’s experience of a Fairy Garden in Northern Thailand” (Riet et al., 2020). Green space is again discussed in this article as having positive health benefits for sick children and improved well-being. The purpose of the study was to examine the experiences of children who engaged in outdoor play using the fairy garden (Riet et al., 2020). The study gained insight from the children from having them draw a picture and be interviewed after playing in the fairy garden. The responses varied from child to child, some more through than others. One child discussed how swinging on the fairy garden made her feel unbothered, and the swaying motion of the swing keeps her from being bored. Another child had a more imaginative experience and discussed how she included an angel in her drawing from the garden, that was able to rid her illness so she can eat the foods she wants (Riet et al., 2020). Fairy gardens have shown to influence a variety of experiences for children and help to create a distracting environment that allows them to play and be creative. Access for these outdoor healing environments is essential in the recovery process for sick and hospitalized children.
Greenery and time spent outdoors has been shown by vast amounts of research to have overall positive effects on humans and their bodies. This article specifically reviewed the effects on hospitalized children, and how spending time outside hospital walls can help aid in the healing process, both mentally and physically.
References
Abdul, S. F., Stigsdotter, U. K., & Nilsson, K. (2012). A review of design recommendations for outdoor areas at Healthcare Facilities. Retrieved from http://www.jstor.org/stable/10.2307/24865221?refreqid=search-gateway.
Allahyar, M., & Kazemi, F. (2021). Effect of landscape design elements on promoting neuropsychological health of children. Urban Forestry & Urban Greening, 65, 127333. https://doi.org/10.1016/j.ufug.2021.127333
Riet, P., Jitsacorn, C., & Thursby, P. (2020). Hospitalized children’s experience of a fairy garden in northern Thailand. Nursing Open, 7(4), 1081–1092. https://doi.org/10.1002/nop2.482
van der Riet, P., Jitsacorn, C., Junlapeeya, P., Thursby, E., & Thursby, P. (2017). Family members’ experiences of a “Fairy garden” healing haven garden for sick children. Collegian, 24(2), 165–173. https://doi.org/10.1016/j.colegn.2015.11.006
van der Riet, P., Jitsacorn, C., Junlapeeya, P., & Thursby, P. (2017). Student nurses experience of a “Fairy garden” healing haven garden for sick children. Nurse Education Today, 59, 88–93. https://doi.org/10.1016/j.nedt.2017.09.002
Image References
Nemes, G. (n.d.). Chicago Lurie Children’s Hospital: Crown Sky Garden: Mikyoung Kim Design – our work brings health and well being to the global environment and local neighborhoods, creating bespoke experiences that improve civic health by engaging the natural world. Chicago Lurie Children’s Hospital: Crown Sky Garden | Mikyoung Kim Design – Our work brings health and well being to the global environment and local neighborhoods, creating bespoke experiences that improve civic health by engaging the natural world. Retrieved April 17, 2023, from https://myk-d.com/projects/crown-sky-garden/
Outhouse Design. (2020, August 25). Sydney Children’s hospital wellness garden. OUTHOUSE design. Retrieved April 17, 2023, from https://www.outhousedesign.com.au/portfolio-items/sydney-childrens-hospital-wellness-garden/#iLightbox%5BFairy%20Garden%5D/7