Blue prescription: A pilot study of health benefits for oncological patients of a short program of activities involving the sea

Abstract

Performing outdoor activities in blue spaces can help improve human health and mental well-being by reducing stress and promoting social relationships. The number of people surviving cancer has increased globally to experience this disease as a life-changing and chronic condition with physical and psychosocial symptoms that have negative impacts on their quality of life. While there has been a growth of programs in green spaces to meet the needs of cancer patients, such as follow-up post-treatment care, support groups and physical activity programs, very few studies have examined the effects of activities involving the sea for the health and well-being of oncology patients. This is the first study to evaluate whether different outdoor activities in blue spaces can benefit oncological patients' physical and mental health using smartwatches, sphygmomanometers and Profile of Mood States (POMS) questionnaires. We assessed changes in blood pressure, heart rate, sleep quality and mental health of 16 patients after twelve sessions of three different activities (walking, beach and snorkelling) and four sessions of a control activity. While no significant differences between activities were observed in terms of the data gathered by the smartwatches, a gradient of positive results for human mental health was observed towards exposure to a blue space, assessed through POMS questionnaires. Results show that exposure to blue spaces contributes to tension and anger reduction and improves the vigour mood state of oncology patients. No significant increases in patients' heart rate were recorded after the beach and snorkelling activities, with results similar to the control activity, suggesting that the contribution may be to participants' relaxation.

Fig. 1

Location of Roses and Tossa de Mar in the Mediterranean Sea.

Fig. 2

Schematic representation of the experimental design of the study.

Fig. 3

A) Distribution of overall POMS scores before and after each activity. B) Predicted means of overall POMS scores with 95% confidence intervals from GLMM fit (expressed as rates relative to baseline level).

Fig. 4

A) Distribution of HR values of the participants before and after each activity. B) Predicted means of post-activity HR expressed as rates relative to baseline level, with 95% confidence intervals from LMM fit.

Fig. 5

Distribution of standardized HR values for each activity and time of measurement. Dashed line indicates no difference with baseline mean HR in the control session.

Fig. 6

Distribution of sleep quality scores by activity.

Fig. 7

Distribution of percentages of the different sleep stages analyzed (Light, Deep and REM) for each activity. A) Night before the activity; B) Night after the activity.