Effects of a forest therapy camp on cancer survivors' stress, mood and natural killer cells in Korea.

One of the essential treatments for kidney disease patients to survive is hemodialysis, which is the most widely used treatment among patients. However, there can be various side effects associated with hemodialysis. A significant one is sleep disturbance, with 85%-99% of patients reporting sleep disorders according to previous studies []. Most hemodialysis patients experience decreased quality of sleep, leading to an increased risk of accidents, falls, fatigue, and functional decline, with restless legs syndrome (RLS) also occurring in these patients []. Potential causes of muscle cramps in hemodialysis patients include high ultrafiltration, hypotension, hyponatremia, electrolyte imbalance, and impaired muscle energy metabolism due to carnitine deficiency, which is strongly associated with RLS []. RLS is a neurological disorder characterized by an irresistible urge to move the legs, accompanied by unpleasant sensations such as tingling, burning, crawling, or aching feelings []. The prevalence of undiagnosed RLS in hemodialysis patients is reported to be 28%-62% []. RLS is a very uncomfortable sensation that includes pain, tingling, itching, burning, numbness, tingling, or a feeling of discomfort that is not particularly painful []. RLS has also been associated with reduced quality of life, decreased work productivity, and significant social and economic burdens []. As the impact of RLS is negative, intervention for RLS is essential. While pharmacological treatments are often chosen for severe RLS cases, they can sometimes cause side effects []. Therefore, the usefulness of non-pharmacological treatments is increasingly being reported, including exercise, reflexology, massage, and complementary and integrative therapies such as aromatherapy []. Aromatherapy, which utilizes essential oils extracted from aromatic herbs, has a long history and is known to impact on physical and mental health []. One of the essential oils used in aromatherapy is reported to have anti-anxiety, anti-depressant, calming, muscle fatigue reduction, blood circulation, and quality of life improvement effects [,]. There are also reports of its effectiveness in reducing stress and spastic movements []. Aromatherapy is known for its easy absorption through the skin via aromatic oils and plant volatile substances. It has been reported to have calming and muscle relaxation effects without side effects []. It may be effective in managing spasticity and RLS in hemodialysis patients.