A Healing Garden Therapy Program Exploration in a Hospital Using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) Model: Qualitative Study

https://doi.org/10.33860/jik.v19i2.4217

Authors

Keywords:

Healing Garden Therapy, Hospital, Nurses, Holistic

Abstract

Staying in the hospital for a long period can affect a patient's psychological condition and may cause stress that slows down recovery. Healing Garden Therapy is a hospital program that can help support recovery, especially for patients with non-communicable diseases.  Therefore, this study aims to explore the implementation of the Healing Garden Therapy program in hospitals using assessment model of Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM). This study used a qualitative exploratory design. The participants consisted of two groups: 10 nurses and 8 non-nursing staff who were involved in the implementation of Healing Garden Therapy Program (HGTP), selected using purposive sampling. Data were collected using recorded Focus Group Discussions (FGDs) and using semi-structured guiding questions. The data were analyzed using Colaizzi's method and presented using the COREQ checklist. The study found four main themes: 1) The main targets of the Healing Garden Therapy Program are patients, families, and visitors; 2) Delivering holistic care; 3) The Healing Garden program has positive impacts and therefore should be reactivated; 4) The Healing Garden Therapy program needs management supports and nurses involvement. The Healing Garden Therapy program has shown positive impacts and should be implemented to support holistic nursing care in hospitals.

References

1. Denis JL, WJ, & DH (Eds. ). Organizational Behaviour in Health Care. Palgrave McMilan; 2021.

2. Jamshidi S, Parker JS, Hashemi S. The effects of environmental factors on the patient outcomes in hospital environments: A review of literature. Frontiers of Architectural Research. 2020 Jun;9(2):249–63. Retreived from https://www.sciencedirect.com/science/article/pii/S2095263519300779

3. Kiecolt-Glaser JK, Marucha PT, Mercado AM, Malarkey WB, Glaser R. Slowing of wound healing by psychological stress. The Lancet. 1995 Nov;346(8984):1194–6. Retreived from https://www.sciencedirect.com/science/article/pii/S0140673695928995

4. Erickson M.S. Restorative Garden Design: Enhancing Wellness Through Healing Spaces Art And Design Discourse. 2012;89–102. Retreived from https://www.airitilibrary.com/Article/Detail/P20160129002-201206-201601290001-201601290001-89-102

5. Annalisa Gartman Vapaa. Healing gardens: Creating places for restoration, meditation, and sanctuary What are the defining characteristics that make a healing garden? Virginia Polytechnic Institute and State University; 2002.

6. Hastuti ASO, Lorica J. The Effect of Healing Garden to Improve the Patients Healing: An Integrative Literature Review. Journal of Health and Caring Sciences. 2020 Jun 26;2(1):34–47.

7. Ulrich RS. View Through a Window May Influence Recovery from Surgery. Science (1979). 1984 Apr 27;224(4647):420–1.

8. Alkaisi OF, Ibrahim SAH, Khaleefa HG. The Role of Healing Gardens in the Landscape Sustainability for Public Gardens. In: IOP Conference Series: Earth and Environmental Science. IOP Publishing Ltd; 2021.

9. Aini DN, Marlina A, Pitana TS. The Application Of Healing Garden On The Mother And Child Hospital Design Strategy. Arsitektura. 2018 Oct 31;16(2):267.

10. Hastuti ASO. Healing Garden Therapy: A Phenomenology of Holistic Healing For Patients. In Tuguegarao: Paul University Philippines; 2017. p. 93–9.

11. Brown L, Ospina JP, Celano CM, Huffman JC. The Effects of Positive Psychological Interventions on Medical Patients’ Anxiety: A Meta-analysis. Psychosom Med. 2019 Sep;81(7):595–602.

12. Dijkstra K (Karin), & G. Understanding healing environtments: effects of physical environmental stimuli on patients’ health and well-being. 2009;

13. Mariana Y, Wijaya Y. Healing garden implementation in rehabilitation centre at Jakarta as a concept of eco-architecture design. IOP Conf Ser Earth Environ Sci. 2020 Feb 1;426(1):012081.

14. Ministry of Health Regulation. Technical Standards for Hospital Facilities and Infrastructure. 24 Indonesia: https://peraturan.bpk.go.id/Home/Details/139483/permenkes-no-24-tahun-2016 ; 2016.

15. Glasgow RE, Estabrooks PE. Pragmatic Applications of RE-AIM for Health Care Initiatives in Community and Clinical Settings. Prev Chronic Dis. 2018 Jan 4;15:170271.

16. Polit D, & BC. Data Collection in Quantitative Research. In Nursing Research, Generating and Assessing Evidence for Nursing Practice . 9th ed. Lippincott Williams & Wilkins: Wolters Kluwer Health; 2012. 293–327 p.

17. Speziale HJS, & CDR. Qualitative research in nursing : advancing the humanistic imperative. 3rd ed. 2003.

18. Gammon. Analysis of the stressful effects of hospitalisation and source isolation on coping and psychological constructs. Int J Nurs Pract. 1998 Jun 9;4(2):84–96.

19. Tanja-Dijkstra K. The Impact of Bedside Technology on Patients’ Well-Being. HERD: Health Environments Research & Design Journal. 2011 Oct 1;5(1):43–51.

20. Taylor SE. Hospital Patient Behavior: Reactance, Helplessness, or Control? Journal of Social Issues. 1979 Jan 14;35(1):156–84.

21. Caraballo C, Dharmarajan K, Krumholz HM. Post Hospital Syndrome: Is the Stress of Hospitalization Causing Harm? Revista Española de Cardiología (English Edition). 2019 Nov;72(11):896–8.

22. Pagador F, Barone M, Manoukian M, Xu W, Kim L. Effective Holistic Approaches to Reducing Nurse Stress and Burnout During COVID-19. AJN, American Journal of Nursing. 2022 May;122(5):40–7 .

23. Ramadan F. Diabetes Management and the Role of the Community Nurse: a Holistic Perspective. Br J Community Nurs. 2023 Aug 2;28(8):393–6.

24. Pedrinolla A, Tamburin S, Brasioli A, Sollima A, Fonte C, Muti E, et al. An Indoor Therapeutic Garden for Behavioral Symptoms in Alzheimer’s Disease: A Randomized Controlled Trial. Journal of Alzheimer’s Disease. 2019 Oct 1;71(3):813–23.

25. Zaťovičová M, Kubáňová M. The Positive impact of Greenery on the Mental and Physical Health of the Elderly: A Case Study in the Design of a Hospital Garden. Slovak Journal of Civil Engineering. 2024 Dec 1;32(4):31–41.

26. Sugih Pradifta F, Mutia Ekasari A, Qodariah S, Damayanti V, Ayu Gayatri E, Ernanda Pramadhika M, et al. Redesign of Taman Lansia Bandung as a Therapeutic Garden. KnE Social Sciences. 2023 Oct 30;

27. DOVZHENKO V, KARAMELIEVA M. Principles of design and features of therapeutic garden formation for the treatment and rehabilitation of patients with various types of illneses. Transfer of innovative technologies. 2025 Jan 13;7(2):51–6.

28. Rieuwpassa BF, Bobby Saragih JF, Soebiyan V. Therapeutic garden setting in post stroke rehabilitation building. IOP Conf Ser Earth Environ Sci. 2020 Feb 1;426(1):012084.

29. Akbarinaldi G, Utami FNH. Therapeutic Garden Design at Marzoeki Mahdi Hospital. In: IOP Conference Series: Earth and Environmental Science. Institute of Physics; 2024.

30. Ulrich RS, CM& MB (Eds. ). Effects of gardens on health outcomes: Theory and research. In C. C. Marcus & M. Barnes (Eds.), Healing Gardens: Therapeutic Benefits and Design Recommendations. Whiley. ; 1999.

31. Cordoza M, Ulrich RS, Manulik BJ, Gardiner SK, Fitzpatrick PS, Hazen TM, et al. Impact of Nurses Taking Daily Work Breaks in a Hospital Garden on Burnout. American Journal of Critical Care. 2018 Nov 1;27(6):508–12.

32. Lestari MW, Favurita AL. Healing Garden as a Green Open Space in Hospital. International Islamic Medical Journal. 2024 Jul 19;6(1):25–35.

33. Alsubaie SS, Bukhamseen ZFA, Alyami FSA, Alotaibi MF, Alkahtani FA, Alkhamsan MS, et al. Multidisciplinary Approaches in General Medical Practice: Enhancing Collaboration for Better Patient Care. Journal of Ecohumanism. 2024 Sep 20;3(7):2659–69.

34. Epstein NE. Multidisciplinary in-hospital teams improve patient outcomes: A review. Surg Neurol Int. 2014 Aug 1;5(7Supplement):S295–302.

35. Salenger R, Martin W. Physician Leadership in the Employed Universe. Hosp Top. 2022 Oct 2;100(4):151–8.

36. Landry A, Erwin C. Perspectives on Multidisciplinary Team Processes among Healthcare Executives: Processes that Facilitate Team Effectiveness. J Health Hum Serv Adm. 2015 Sep 1;38(3):350–80.

37. Nair SS, Thomas KA. Relationship between leadership support and operational excellence in health care sector: A study of Indian health care managers. J Healthc Qual Res. 2020 Mar;35(2):117–22.

38. Grochowska A, GA, & BCI. Stress-Inducing Factors vs. the Risk of Occupational Burnout in the Work of Nurses and Paramedics. International of Environmental Research and Public Health,. 2022;

39. Mishrif A. Implications of the Pandemic for Economic Development. In 2024. p. 301–9.

40. Sharma AK, Rai SK. COVID-19 and Sectoral Employment in India: Impact and Implications. The Indian Journal of Labour Economics. 2024 Mar 25;67(1):177–96.

41. Müller R, Drouin N, Sankaran S. Balanced Leadership. Oxford University PressNew York; 2021.

42. Yazid Z. Exploring leadership in self-managed project teams in Malaysia. Directory of Open Access Journals. 2015;22(1):191–206.

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Published

2025-09-24

How to Cite

Hastuti, A. S. O., Effendy, C., & Suminarhati, H. (2025). A Healing Garden Therapy Program Exploration in a Hospital Using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) Model: Qualitative Study. Poltekita: Jurnal Ilmu Kesehatan, 19(2), 296–307. https://doi.org/10.33860/jik.v19i2.4217

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