ผลของโปรแกรมการปลูกดอกไม้ที่บ้านต่อคุณภาพชีวิตของผู้ป่วยมะเร็งที่ได้รับการดูแลแบบประคับประคอง

Nittaya Thanun; Siriporn Sangsrijan; Pitakpong Punta; Nutnarong Charoensuksirikul

Authors

Nittaya Thanun Ngao Hospital, Lampang Province
Siriporn Sangsrijan School of Nursing, University of Phayao
Pitakpong Punta School of Nursing, University of Phayao
Nutnarong Charoensuksirikul Ngao Hospital, Lampang Province

Keywords:

Home-based flower gardening, Palliative care, Patients with cancer, Quality of life

Abstract

Cancer patients in palliative care frequently experience multidimensional deterioration in quality of life. Home-based flower gardening is an accessible, nature-based therapeutic activity that may positively influence quality of life. This one-group pretest-posttest quasi-experimental study aimed to examine the effects of a home-based flower gardening program on quality of life among patients with cancer in palliative care. The sample consisted of 34 cancer patients who had been diagnosed and referred to early-stage or stable palliative care, with a performance status of 80% or over, at Ngao Hospital, Lampang Province. Thirty-four participants were selected through multi-stage sampling. Research instruments comprised a 12-week home-based flower gardening program, and the handbook of flower-planting and care manual, which demonstrated content validity with indices (CVI) of .86 and .87. Data collection instruments included a personal information questionnaire and a quality-of-life questionnaire with Cronbach's alpha reliability coefficients of .92. Supplementary assessment tools included a palliative care patient-level assessment form and a two-item depression screening questionnaire. Data were analyzed using descriptive statistics and paired t-tests. The findings revealed that after participating in the program, participants’ mean quality of life scores (𝑥̅=105.85, SD=6.07) were significantly higher than the pre-test scores (𝑥̅=95.12, SD=8.57), at a statistically significant level (t=5.27, p<.001). These results indicate that the home-based flower gardening program can enhance the quality of life for patients with cancer in palliative care.

References

American Horticultural Therapy Association. (2025). About horticultural therapy. https://www.ahta.org/

Aqmarini, A. N., Gayatri, D., Nuraini, T., & Yodang, Y. (2022). Perbandingan hasil pengukuran EORTC QLQ-C30 dengan WHOQOL-BREF untuk mengukur kualitas hidup pada pasien kanker: Telaah literatur. Jurnal Keperawatan Muhammadiyah Bengkulu, 10(1), 35-49. https://doi.org/10.36085/jkmb.v10i1.3255

Bach, E. (2018). The twelve healers and other remedies. White Press.

Bail, J. R., Blair, C. K., Smith, K. P., Oster, R. A., Kaur, H., Locher, J. L., Frugé, A. D., Rocque, G., Pisu, M., Cohen, H. J., & Demark-Wahnefried, W. (2022). Harvest for health, a randomized controlled trial testing a home-based, vegetable gardening intervention among older cancer survivors across Alabama: An analysis of accrual and modifications made in intervention delivery and assessment during COVID-19. Journal of the Academy of Nutrition and Dietetics, 122(9), 1629–1643. https://doi.org/10.1016/j.jand.2022.05.005

Biswas, J., Faruque, M., Banik, P. C., Ahmad, N., & Mashreky, S. R. (2022). Quality of life of the cancer patients receiving home-based palliative care in Dhaka city of Bangladesh. PLOS ONE, 17(7), e0268578. https://doi.org/10.1371/journal.pone.0268578

Chang, T-W., Tsai, S-T., Huang, H-Y., Wu, Y-S., Chang, C-C., & Datta, S. (2024). Slow well-being gardening: Creating a sensor network for radiation therapy patients via horticultural therapeutic activity. Sensors, 24(12), 3771. https://doi.org/10.3390/s24123771

Chowdhury, M. K., Saikot, S., Farheen, N., Ahmad, N., Alam, S., & Connor, S. R. (2023). Impact of community palliative care on quality of life among cancer patients in Bangladesh. International Journal of Environmental Research and Public Health, 20(15), 6443. https://doi.org/10.3390/ijerph20156443

Department of Medical Services, Ministry of Public Health. (2020). Manual for palliative and end-of-life patient care (for healthcare personnel). Veteran Welfare Printing Office. https://www.dms.go.th/backend/Content/Content_File/Practice_guidelines/Attach/25640114130713PM_aw คู่มือการดูแลผู้ป่วยแบบประคับประคอง_5.pdf (in Thai)

Department of Mental Health, Ministry of Public Health. (2022). Guidelines for the assessment of depression with 2Q and 9Q. https://dmh.go.th/test/download/files/2Q%209Q%208Q%20(1).pdf (in Thai)

Health Data Center, Ministry of Public Health. (2025). The prevalence of cancer patients in Ngao District, Lampang Province 2024–2025. https://hdc.moph.go.th/lpg/public/standard-report-detail/b57439ff27302ade8c38d1dd189644a4 (in Thai)

Hui, D., Glitza, I., Chisholm, G., Yennu, S., & Bruera, E. (2013). Attrition rates, reasons, and predictive factors in supportive care and palliative oncology clinical trials. Cancer, 119(5), 1098–1105. https://doi.org/10.1002/cncr.27854

Kaewwanta, K. (2023). Effectiveness of palliative care model for the end of life patients from hospital continuing to community, Pak Khad Hospital, Bueng Kan Province. [Research report]. Bueng Kan Provincial Public Health Office. https://bkpho.moph.go.th/ssjweb/bkresearch/index.php?fn=detail&sid=246 (in Thai)

Kondaguli, S. V., Varghese, A., Rai, A., & Navalkar, A. (2023). Gardening as a therapeutic tool for healing mental health issues among terminally ill patients: An opinion review. International Journal of Health Sciences and Research, 13(12), 124-312. https://doi.org/10.52403/ijhsr.20231215

Lee, K. M., & Lee, S.-N. (2023). P352 Effects of horticultural therapy programs on health status, quality of life, psychological symptoms, and self-integration of cancer survivors. Oncology Nursing Forum, 50(2), 199. https://www.proquest.com/openview/93ed443d770df797d933497766f2acc9/1?pq-origsite=gscholar&cbl=37213

Nayakavadi, D. A., & Tashildar, A. B. (2026). Blooming health—Unlocking the healing power of Bach flower remedies in homoeopathy. International Journal of Homoeopathic Sciences, 10(1), 49–52. https://doi.org/10.33545/26164485.2026.v10.i1.A.2166

Pantiru, I., Ronaldson, A., Sima, N., Dregan, A., & Sima, R. (2024). The impact of gardening on well-being, mental health, and quality of life: An umbrella review and meta-analysis. Systematic Reviews, 13(1), 45. https://doi.org/10.1186/s13643-024-02457-9

Pantta, P., Apisitwasana, N., Tana, P., Trichinda. K., Songthitithana, K., & Mala, T. (2022). The effect of a homegrown vegetable gardening program to improve quality of life based on the needs of the elderly. Journal of Health and Nursing Research, 38(2), 175–186. https://he01.tci-thaijo.org/index.php/bcnbangkok/article/view/254718/174280 (in Thai)

Roh, T., Verzwyvelt, L. A., Aggarwal, A., Satkunasivam, R., Hasan, N. T., Trisha, N. F., & Hall, C. (2025). Indoor hydroponic vegetable gardening to improve mental health and quality of life in cancer patients: A pilot study. Frontiers in Public Health, 13, 1670698. https://doi.org/10.3389/fpubh.2025.1670698

Rupang, E. R., Kurniawati, N. D., Tzeng, H.-M., Tarihoran, D. E. T. A. U., Saragih, I. S., & Saragih, I. D. (2025). Effect of home-based palliative care on quality of life in patients with cancer: A systematic review and meta-analysis of randomized controlled trials. Cancer Nursing, 1512. https://doi.org/10.1097/NCC.0000000000001512

Sharma, H., Pankratz, V. S., Demark-Wahnefried, W., Pestak, C. R., & Blair, C. K. (2022). Association between quality of life and physical functioning in a gardening intervention for cancer survivors. Healthcare, 10(8), 1421. https://doi.org/10.3390/healthcare10081421

Timko Olson, E. R., Olson, A. A., Driscoll, M., & Vermeesch, A. L. (2023). Nature-based interventions and exposure among cancer survivors: A scoping review. International Journal of Environmental Research and Public Health, 20(3), 2376. https://doi.org/10.3390/ijerph20032376

Vassanyi, I., Szakonyi, B., Loi, D., Mantur-Vierendeel, A., Quintas, J., Solinas, A., Blažica, B., Raffo, L., Guicciardi, M., Manca, A., Gaál, B., & Rarosi, F. (2024). Impact of information technology supported serious leisure gardening on the wellbeing of older adults: The Turntable project. Geriatric Nursing, 55, 339–345. https://doi.org/10.1016/j.gerinurse.2023.12.014

Wongyai, P. (2024). The effectiveness of a home visit program with community network participation on the quality of life and care outcomes in palliative and end-stage cancer patients at Lampang cancer Hospital. [Research report]. Lampang Cancer Hospital. https://www.lpch.go.th/lpch/uploads/20240718084243037000.pdf (in Thai)

Wood, C. J., Barton, J., & Wicks, C. L. (2025). Effectiveness of social and therapeutic horticulture for reducing symptoms of depression and anxiety: A systematic review and meta-analysis. Frontiers in Psychiatry, 15, 1507354. https://doi.org/10.3389/fpsyt.2024.1507354

World Health Organization. (2020). Palliative care. https://www.who.int/news-room/fact-sheets/detail/palliative-care