Narrative review: The role of nature, plants, and art in post‐operative outcomes

Abstract

BACKGROUND Recovery from surgery is a stressful experience for patients, both physically and psychologically. Previous research has shown that in- creased stress has effects on post-operative outcomes. Non-pharmacological therapies, such as experiencing nature, may be potential avenues to further improve patient care. METHODS PubMed and Google Scholar were searched for the terms “nature,” “plants,” “surgery,” “post-operative outcomes,” and “pain.” RESULTS There were very limited numbers of studies looking into the effect of plants, nature, and art on post-operative outcomes. Those that did exist were relatively low quality in design. Nevertheless, exposure to plants was associated with a slightly reduced systolic blood pressure and reduced self-reported stress levels and pain intensity. Similarly, a retrospective study found that patients in rooms with views of nature consumed less analgesia on days three to five post-operatively, and had a slightly shorter hospital stay. Views of artwork were associated with increased mobilization distance on day one post-operatively, but this association disappeared from day two onwards. Some evidence exists that nature and images of nature can improve pain tolerance in university students, but this may not generalize well to the clinical population. CONCLUSION There is limited evidence to support the thesis that the view of plants, nature, or art can improve post-operative outcomes. The papers identified in this review were of low quality with limited statistical power. However, enabling access to nature and art could be an avenue for non-pharmacological improvement of patient outcomes, and high-quality studies are warranted.