-
- Sarah Blaschke, Clare C O'Callaghan, and Penelope Schofield.
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
- BMJ Open. 2017 Oct 16; 7 (10): e017456.
ObjectiveTo develop recommendations regarding opportunities and barriers for nature-based care in oncology contexts using a structured knowledge generation process involving relevant healthcare and design experts.DesignFour-round modified electronic Delphi study. Oncology patients' nature-based recommendations, uncovered in preceding qualitative investigation, were included in the first round for the expert participants' consideration. Key items (opportunities and barriers) were developed using data aggregation and synthesis, followed by item prioritisation and 10-point Likert scale ranking (1=not important, 10=very important). Descriptive statistics were calculated to assess items of highest importance representing expert recommendations.ContextOnline Delphi process constituting an electronic international survey.ParticipantsA purposive sample of 200 potential panellists (recruitment target n=40) comprising healthcare practitioners, managers, designers, architects and researchers were invited to participate; experts were identified via research networks, snowballing and systematic literature review.Results38 experts across seven countries (Australia, USA, UK, New Zealand, Canada, Denmark and Sweden) returned questionnaire 1, which determined consent and acceptance for participation. Initial response rate was 19%, and subsequent response rates were 84%, 82% and 84% for rounds 2, 3 and 4, respectively. The Delphi panel developed recommendations consisting of 10 opportunities and 10 barriers. The following opportunities were rated to be of highest importance: window views from clinical areas onto nature; outdoor settings, gardens and courtyards with easy and effortless access; and nature-based physical exercise adapted to patient requirements. Highest-rated barriers for nature-based oncology care included lack of knowledge and awareness about benefits of nature engagement and inaccessibility, not considering access requirements for the very sick and frail.ConclusionsExperts suggested and agreed on a set of recommendations, which represent critical considerations for the safe adoption of nature-based oncology opportunities. These findings fill a gap in understanding about helpful nature-based oncology care and may translate into oncology design and innovation.© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Notes
Knowledge, pearl, summary or comment to share?You can also include formatting, links, images and footnotes in your notes
- Simple formatting can be added to notes, such as
*italics*
,_underline_
or**bold**
. - Superscript can be denoted by
<sup>text</sup>
and subscript<sub>text</sub>
. - Numbered or bulleted lists can be created using either numbered lines
1. 2. 3.
, hyphens-
or asterisks*
. - Links can be included with:
[my link to pubmed](http://pubmed.com)
- Images can be included with:

- For footnotes use
[^1](This is a footnote.)
inline. - Or use an inline reference
[^1]
to refer to a longer footnote elseweher in the document[^1]: This is a long footnote.
.