# Nature- based nursing intervention: the impact on insomnia and feeling of hopelessness among patients with depression at Nour El-Hikma psychiatric hospital, Egypt (A controlled quasi- experimental study)

## TL;DR

A nature-based nursing program helped reduce insomnia and hopelessness in depressed patients at a psychiatric hospital in Egypt.

## Contribution

This study is one of the first to evaluate the impact of nature-based nursing on insomnia and hopelessness in depression patients in Egypt.

## Key findings

- Nature-based nursing significantly improved insomnia and reduced hopelessness in depressed patients.
- A strong positive correlation between hopelessness and insomnia was observed in the nature-based group after the intervention.
- The intervention showed sustained effects two months after implementation.

## Abstract

Depression is the most prevalent mental disorder in Egypt. It is often accompanied by insomnia and feeling of hopelessness which significantly cause many challenges. Traditional psychotherapy does not alleviate these symptoms. Nature- based nursing intervention, also referred to as a green intervention, that is implemented as program in a natural environment. It has emerged as favorable intervention to enhance mental health outcomes. Conversely, their impact on improving insomnia and hopelessness remain unclear.

The study evaluated how does a nature-based nursing intervention affects insomnia and feelings of hopelessness in patients with depression.

A quasi-experimental research design was handled from half of May 2025 to half of October 2025 on 62 depressed patients classified into study and control groups at the Nour El-Hikma psychiatric hospital, Meet-Khalaf, Shibin Elkom, Menoufia Governorate, Egypt. Insomnia and feeling of hopelessness were measured utilizing a sleep disorders scale, and a Beck Hopelessness Scale, respectively. The SPSS v26 software was chosen to perform the data analysis. Categorical data were expressed as frequencies and percentages, and the Chi-square test was applied to find out group differences.

There was no significant difference between the two groups in terms of sociodemographic variables (P < 0.05). There was a statistically significant difference between depressed patients in the studied groups prior, post, and follow-up after 2 months regarding insomnia level and feeling of hopelessness (p < 0.001). Also, there was a statistically significant positive correlation between hopelessness and insomnia after nature-based nursing intervention among only the nature-based group (r = 0.977*, p = 0.005).

Nature-based nursing intervention had significant benefits on improving insomnia and reducing feelings of hopelessness in patients with depression.

No clinical trial.

The online version contains supplementary material available at 10.1186/s12888-026-07860-1.