Flower Power Revisited
Commentary by: Commentary by Bill Benda, MD
Reference: Park SH, Mattson RH. Ornamental indoor plants in hospital rooms enhanced health outcomes of patients recovering from surgery. J Altern Complement Med. 2009 Sep;15(9):975-980.
Design: Randomized controlled trial
Study Design: 90 patients recovering from hemorrhoidectomy surgery were randomly assigned to either a typical, unadorned hospital room or an identical room with common live houseplants and flowers.
Main Outcome Measures: Various outcome data were collected, including length of hospitalization, need for postoperative analgesics, routine vital signs, and patient ratings of pain intensity and distress as well as anxiety and fatigue. Validated assessment metrics included the State-Trait anxiety Inventory Form Y-1, the Environmental Assessment Scale, and the Patient’s Room Satisfaction Questionnaire.
Key Findings: Post-study evaluation of data revealed that patients assigned to recovery rooms with foliage demonstrated significantly lower systolic blood pressure, perception of postoperative pain, anxiety, and fatigue than those in the control group. Validated surveys also revealed subjective increase in satisfaction with their assigned room, stating that the plants brightened the environment, reduced stress, and evoked more positive impressions of hospital employees engaged in their care.
Practice Implications: The true beauty of this study lies in its simplicity and elegance, reflective of nature itself. The investigators chose to evaluate postoperative pain after a common surgical procedure, and the intervention chosen was inexpensive, nontoxic, and required no randomized controlled trial or FDA approval prior to utilization. Given the current clinical and fiscal need for alternatives to our conventional approach to pain management, this simple intervention holds promise as adjunctive analgesia for simple surgical procedures.
This is not the first attempt to utilize the hospital environment as therapeutic modality. Architects and contractors across this country and abroad have been engaged in a revolutionary movement to redesign hospital buildings both inside and out, with more than 1,500 studies to date demonstrating that architectural design significantly influences rates of medical errors, clinical infections, accidental falls, and levels of stress in both patient and staff. As one example, researchers have documented that the simple addition of sunlight to a hospital room is associated with improvement in mood and affect, diminished mortality in cancer patients, reduced length of stay in patients with myocardial infarctions, and decreased analgesic use and costs after spinal surgery.1 The Center for Health Design, a non-profit based in California, has created the Pebble Project, a partnership of 44 hospitals to investigate the clinical and fiscal benefits of intelligent building design. Their data reveal lower noise levels, improved patient sleep, decreased staff turnover, reduced medication requirements, and declining drug errors.2 Given that the majority of our pharmaceutical medications have been extracted from living botanicals, it is poignant to consider that the original plant may prove a superior therapy in the long run. Future studies should be done to confirm this study’s findings and delineate what aspect of the live plant (eg, visual, olfactory, qi) might be responsible for improved outcomes.
References
1. Walch JM, Rabin BS, Day R, Williams JN, Choi K, Kang JD. The effect of sunlight on postoperative analgesic medication use: a prospective study of patients undergoing spinal surgery. Psychosom Med. 2005;67(1):156-163.2. Pebble Project Data Summary. The Center for Health Design website. Accessed August 18, 2009.
About Bill Benda, MD
Bill Benda, MD, is a practicing emergency medicine physician, lecturer, writer, and researcher committed to the integration of alternative and conventional medicine. He is the first medical doctor to be elected to the Board of Directors of the American Association of Naturopathic Physicians and currently teaches at Southwest College of Naturopathic Medicine. His clinical work has focused on patients with breast cancer, animal-assisted therapy, and physician health and well-being; his research on equine-assisted therapy for children with cerebral palsy has been funded by the National Institutes of Health. He serves as Associate Editor of both the Journal of Alternative and Complementary Medicine and Integrative Medicine—A Clinician’s Journal.
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