Nature-based mindfulness program for parents and caregivers: a mixed-methods study

Introduction: There is a growing interest in incorporating nature into mindfulness-based programs. This study is unique as it targets parents and family caregivers experiencing caregiving stress.

Methods: A mixed-methods study was conducted to evaluate the outcome of a nature-based mindfulness intervention program. A comprehensive outcome measures targeting benefits of parents and caregivers, including mental health symptoms, wellbeing, physical distress, family functioning, and family conflicts, were assessed over time. The role of nature in overall outcome was investigated through the participants' perceived connectedness to nature and time spent in nature. The program consists of four sessions, totaling 8 h of contact time, held at a retreat center and social care units. A total of 95 participants were recruited, including 40 caregivers of older adults and 55 parents under stress. The study employed a time series design, with assessments conducted 1 month before the program, pre-program, post-program, and at a 3-month follow-up.

Results: For caregivers, significant improvements were observed in multiple outcome measures, including anxiety, stress, physical distress, daily functioning, and wellbeing, following the program. Further improvement in connectedness with nature was noted between the pre-test and the 3-month follow-up, with depression and family functioning approaching significance. For parents under stress, significant improvements were found only in wellbeing after the program. However, additional improvements in anxiety, stress, physical distress, and family conflicts (psychological aggression, corporal punishment, and physical maltreatment) were observed during the follow-up period, with depression and daily functioning approaching significance. Hierarchical regression analysis indicated that connectedness to nature significantly associated with the program's effect on depression. Qualitative analysis revealed that participants benefited from attention restoration, increased awareness, and insights gained from nature and mindfulness practices.

Discussion: Due to the limitations of the study, including the lack of control group and the use of self-reported measures, future study should verify the benefits of nature-based mindfulness programs particularly on the effects on parents and caregivers under stress and at risk of mental health conditions.