Authors: (including presenting author): :
Yau KSK(1), Cheng SY(1), Kwan WMC(1)(2), Mok KWA (1)(2), Li SYC(1)(3)
Affiliation: :
(1) In-patient Unit, Palliative Care, Bradbury Hospice, (2)Palliative Care Unit, M&G Department, Shatin Hospital, (3) CND, Bradbury Hospice/ Cheshire Home Shatin/ Shatin Hospital
Keyword 1: :
Palliative care
Keyword 2: :
Quality of life
Keyword 3: :
Sensory garden
Keyword 4: :
Horticultural therapy
Keyword 5: :
Caregiver satisfaction
Keyword 6: :
Intervention study
Introduction: :
This study investigates the effects of horticultural therapy (HT) on quality of life (QoL) among palliative care patients and caregiver satisfaction. Sessions were conducted in a sensory garden using validated assessment tools. Palliative care seeks to enhance QoL for patients with life-limiting illnesses by addressing physical, emotional, social, and psychospiritual needs. HT engages individuals in plant-related activities to promote well-being. However, the use of horticultural therapy, especially in the context of a sensory garden, in palliative care settings is limited in Hong Kong.
Objectives: :
This project aims at (1)improving quality of patient centric services by the implementation of a non- pharmacological intervention – horticultural therapy to promote the quality of life of patients in palliative care unit as well as (2)to evaluate the effects of horticultural therapy in affecting the sense of satisfaction of caregivers.
Methodology: :
A pre-post interventional mixed-methods study was conducted from December 2024 to May 2025 at In-Patient Unit of Bradbury Hospice. Ethical approval was obtained from the Joint Chinese University of Hong Kong–New Territories East Cluster Clinical Research Ethics Committee, with written informed consent from all participants. Seventy-five palliative care patients (cancer and non-cancer, aged ≥18 years, cognitively intact) were recruited, along with their volunteering caregivers. Exclusion criteria included age < 18 years, cognitive impairment, or inability to consent. Participants received daily 15-minute horticultural therapy sessions over five consecutive days, tailored to functional ability via activities of daily living and Modified Functional Ambulation Category assessments. Sessions followed a standard sensory route: visual stimulation in a rainbow-colored flower zone; olfactory engagement in an aroma zone; tactile interaction with plants; and tea tasting or smelling followed by leaving messages on a community message board. Evaluation tools included: (1) McGill QoL Questionnaire–Hong Kong (pre/post); (2)open-ended participant feedback; and (3) custom caregiver satisfaction survey. Data were analyzed using SPSS v27 with paired t-tests for QoL changes and descriptive statistics for caregiver satisfaction.
Result & Outcome: :
Of 75 recruited patients, 65 completed the study, 13% attrition due to deterioration, death, or discharge. Mean age was 77 years old (S.D. 12, range 68–96); 64% female. Lung carcinoma was the most common diagnosis. The greatest improvement occurred in physical well-being, with distress scores decreasing from 6.51 (S.D. 3.01) to 4.23 (S.D. 3.77) and the highest t-value =6.075 with a remarkable 66.2% improvement. Overall QoL rose 15% from 6.51 to 7.51/10. Caregivers reported high satisfaction with a mean score of 3.73/4 (S.D. 0.75). Horticultural therapy significantly improves QoL in palliative care patients, particularly physical well-being, while increasing caregiver satisfaction. By reconnecting individuals with nature and fostering emotional or social connections, Horticultural therapy supports holistic palliative care goals and advances patient-centered services.
