Impacts of Nature-Based Interventions on Healthcare Workers’ Stress, Burnout, and Performance: A Systematic Literature Review

ObjectivesThis systematic review synthesizes evidence on the efficacy of nature-based interventions (NBIs) in mitigating stress and burnout among healthcare workers (HCWs) while enhancing their performance.BackgroundWork-related stress and burnout are major challenges among HCWs, with adverse impacts on HCWs' well-being, patient outcomes, and healthcare systems. Although behavioral and organizational interventions have been widely studied, less attention has been given to NBIs, despite growing evidence of their potential for stress reduction.MethodThis review synthesized findings from 20 empirical studies published through October 2024, examining the types of NBIs used in healthcare settings and their effects on HCWs' stress, burnout, and performance. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, studies were identified across four NBI domains: outdoor activity in nature, virtual reality, real-world sensory stimulation (e.g., nature-themed recharge rooms, natural sounds), and visual access to nature.ResultsNBIs consistently reduced psychological and physiological stress. Evidence for burnout reduction was mixed, with the most evident effects in reducing exhaustion and depersonalization, but insignificant impacts on personal accomplishment. Performance-related outcomes such as mindfulness, resilience, and cognitive functions were generally enhanced, with immersive exposure to natural elements yielding stronger effects.ConclusionOverall, NBIs demonstrated promising results in reducing HCWs' stress and improving performance outcomes, but the impact on burnout was limited. Practical applications should consider feasibility and sustainability. Design strategies may include outdoor green spaces, such as rooftop gardens or courtyards, as well as passive indoor features that provide continuous restorative benefits, including window views of nature, plants, and curated soundscapes.