Analyzing men and women separately, we examined the associations between six key elements of the psychosocial work environment of pink-collar workers (n = 7633) and the risk of depression, using logistic regression analysis with data from the Fifth Korean Working Conditions Survey (KWCS) conducted in 2017. We assessed the risk of depression according to the presence of emotional display rules (EDR), health and safety information (HSI), and emotional labor. In males, the risk of depression increased when there were no EDR and they had to interact with angry customers (OR 1.94, 95% CI 1.14–3.30). For women, the risk of depression increased if they had to interact with angry customers and EDR were present (OR, 1.73; 95% CI, 1.00–3.00), and if they did not receive HSI but had to interact with angry customers (OR, 1.66; 95% CI, 1.02–2.71), or hid their emotions and did not receive HSI (OR, 1.90; 95% CI, 1.50–2.40). The risk of depression increased more in the presence of EDR among women who hid their emotions (OR 1.80, 95% CI, 1.40–2.31) compared to women who did not hide their emotions and in the absence of EDR. Therefore, it is necessary to consider the effects of gender-specific factors on the risk of depression and revise current guidelines accordingly.

Research on forest therapy and health outcomes is insufficient and involves the limited unification of various health indicators. Information on the natural therapeutic elements of forests and forest-therapy programs is insufficient. We investigated forest-therapy programs, the natural therapeutic elements of the forest environment, and health-outcome measures to standardize the health indicators of forest therapy. A systematic review was conducted on the health outcomes of forest therapy from 2010 to 2021. We summarized natural therapeutic elements and forest-therapy sites, characteristics, and health outcomes. Twenty-nine articles were analyzed. Among them, forest therapies of walking and physical activity were conducted most frequently. Additionally, a positive improvement in general sentiment condition was substantial in all vegetation environments, and a reduction in depression, psychological enhancement, stress alleviation; and an enhancement in the cardiovascular system and the endocrine system occurred in both narrow- and broad-leaved forests. Walking, five-senses stimulation, physical activities, and meditation benefited psychological and physiological outcomes. We evaluated natural therapeutic elements of the forest-environment program and health outcomes. This systematic review can be used as a reference for the planning and operation of forest-therapy programs.

(1) Background: Although interest in the health-promoting effects of forest therapy is increasing, few researchers have investigated the mid-long-term impact of such therapy on health indicators or exercise behaviors. We explored changes in physical health, mental health, and exercise behaviors 1, 2, and 4 weeks after a forest therapy program concluded. We sought to establish a solid foundation for such programs and a standardized evaluation system. (2) Method: We measured the blood pressure and heart rate variability of 99 adults before and after participation in a forest therapy program. We used the State-Trait Anxiety Inventory to assess anxiety, the Beck Depression Inventory to evaluate both anxiety and depression, the Profile of Mood States to explore mood, the Euro-Quality of Life-5 Dimension scale to assess the overall quality of life, and the Positive and Negative Effect Schedule to measure positive and negative mood. We employed the Global Physical Activity Questionnaire to determine exercise time, intensity, and changes in exercise type before the program and 1–4 weeks after program completion. (3) Results: Anxiety, depression, mood, quality of life, heart rate, and blood pressure control improved significantly after the program. The reduced depression and increased medium-intensity exercise time persisted for 1, 2, and 4 weeks after the end of the program. (4) Conclusions: We tracked various health indicators and clearly distinguished those that were useful in the short term from those more appropriate for evaluation in the long term. This is the first report to show that a forest therapy program affects exercise behavior; this suggests that health behaviors should be continuously tracked.

Forest therapy is associated with several health advantages, such as stress reduction and improved psychological health. Mindfulness, an important component of forest therapy, is also associated with improved health outcomes. However, few studies have empirically evaluated mindfulness in forest therapy settings. This study translated the Freiburg Mindfulness Inventory (FMI) in the context of forest therapy into Korean and then validated it. (1) Methods: This study included 352 individuals. Four other psychometric tools were administered to ensure criterion validity. Exploratory and confirmatory factor analyses were implemented to determine the factor structure. Furthermore, item validity was assessed using item response theory. (2) Findings: A two-factor structure of the FMI, comprising acceptance and presence, was the most suitable. However, excluding item 13 enhanced the model fit (χ² [df] = 169.9 [64], comparative fit index = 0.93, Tucker-Lewis index = 0.92, root mean square error of approximation = 0.069). The FMI had satisfactory psychometric properties. (3) Conclusion: The FMI was translated into Korean and validated, serving as a valuable instrument for assessing mindfulness in the context of forest therapy. We identified that item 13 should be excluded. Our results demonstrate the potential effects of mindfulness on mental health in forest therapy.

Research is increasingly focusing on the health-promoting effects of forest healing programs. A number of different health indicators are in use, necessitating the establishment of standardized health measurement tools and protocols for forest healing. Also, it is necessary to improve the indicators and protocols by incorporating the opinions of program participants and instructors, so we conducted a qualitative analysis based on focus group interviews (FGIs) and in-depth interviews (IDIs). We collected opinions through interviews conducted for about 1 h with 32 participants in the pilot study and three instructors of the forest healing program. We utilized the MAXQDA program, commonly employed for qualitative research, such as coding and analyzing interview transcripts and literature reviews, as part of the qualitative research process. Three researchers coded and categorized the data, and the first author and corresponding author performed the final coding and categorization. Opinions on the five mental health questionnaires, three physical health measures, and exercise behavior measures used in the forest healing program were solicited. Opinions on the measurement protocol were also solicited. Participants faced challenges in completing the mental health questionnaire due to inappropriate terminology, difficulty in providing truthful responses due to repetitive questions, and the complexity of answering exercise-type questions due to the length of the survey and the absence of clear examples. It was identified that improvements are needed in the future. Some participants commented on the need to measure blood circulation and short-term health changes, and others noted that performing measurements in large groups was difficult, such that there was a need to introduce a measurement protocol for groups. This study is the first to qualitatively evaluate the validity of health measurement tools associated with forest therapy programs. It can contribute to the establishment of standardized health indicators and protocols, as well as serve as a valuable reference for selecting measurement tools to evaluate the effectiveness of forest healing interventions.