Burnout

John Kavanaugh et al. (2022) · International journal of environmental research and public health

This randomized controlled trial with 34 physicians and healthcare workers (24 in the forest-bathing group, 10 in a waitlist control group who took a day off instead) explored whether Shinrin-Yoku, Japanese for "forest bathing," a guided practice of mindfully sensing a forest environment rather than exercising through it, could ease professional burnout. Burnout was tracked with two validated tools: the Oldenburg Burnout Inventory (OLBI), which scores exhaustion and disengagement from work, and the Mini-Z, a shorter survey of job satisfaction and burnout risk. Physician burnout affects an estimated 33-50% of doctors and was worsened by the COVID-19 pandemic. Participants, health sciences faculty and medical residents at a New Mexico teaching hospital, were randomized through REDCap. The intervention group completed a 3-hour guided walk of under half a mile through a pinon-juniper forest, led by certified Association of Nature and Forest Therapy guides: a 15-minute grounding exercise, several sensory "invitations" to notice their surroundings, a 20-minute solo "sit spot," and a closing gratitude circle with shared tea. Both groups completed the OLBI and Mini-Z before and after their respective activity. Burnout scores stayed high in both groups throughout: median OLBI and Mini-Z scores never dropped below established burnout thresholds, before or after the walk. On the OLBI, there was no significant difference between the forest-bathing group's before-and-after scores, or between the two groups afterward (meaning the walk did not measurably shift standardized burnout scores). The Mini-Z initially showed a significant post-walk improvement in the intervention group versus control, but after adjusting for multiple comparisons (a standard statistical correction to avoid false positives), that difference was no longer significant. Separately, 34% of all participants said they had some burnout symptoms and 12% said those symptoms never let up. Yet the subjective side told a different story: of 20 participants who wrote in after their walk, 19 described feeling calmer, more relaxed, more appreciative, or less anxious; only one felt no different. This gap, unchanged scores next to strongly positive accounts, suggests one forest-bathing session may ease momentary stress without touching the deeper, cumulative syndrome burnout scales measure. The study was small (34 completers of 56 enrolled, notable dropout) and unblinded, testing only a one-time session; the authors and Shinrin-Yoku's founders note the practice is meant to be ongoing, not a single dose. Larger trials of repeated forest-bathing over months are needed before it can be recommended as a standalone burnout treatment, though it may help as a short-term stress reliever alongside other care.