Effects of Nature-Based Educational Therapy on Treatment Adherence and Exercise Capacity in Ischemic Heart Disease Patients

Aims: This study evaluated the effect of nature-based therapy on treatment adherence and exercise capacity in patients with ischemic heart disease.
Materials & Methods: This randomized controlled clinical trial was conducted on 58 patients who were randomly assigned to the intervention and control group (n=29 per group). The intervention group participated in a structured nature-based educational program that included guided walking, group discussions, relaxation techniques, and exercise sessions conducted in a natural environment. The control group received routine face-to-face education. Treatment adherence was assessed using the eight-item Morisky Medication Adherence Scale, and exercise capacity was evaluated using the six-minute walk test before and after the intervention. Secondary physiological outcomes, including blood pressure, heart rate, respiratory rate, and oxygen saturation, were also measured. Analysis of covariance was used to compare post-intervention outcomes between groups while adjusting for baseline values.
Findings: After adjusting for covariates, treatment adherence was significantly higher in the intervention group than in the control group (p<0.01). Exercise capacity was also significantly greater in the intervention group than in the control group (p<0.001). Furthermore, the intervention group showed significant improvements in physiological parameters, including lower systolic and diastolic blood pressure, reduced heart rate, and improved oxygen saturation compared with the control group (p<0.05).
Conclusion: Nature-based therapy significantly improves treatment adherence, exercise capacity, and physiological outcomes in patients with ischemic heart disease in the short term.