About The Practice Research Evidence Activity The Researchers Contact
Floral photograph by Emma Bass

The Floral
Effect Project

Primavera Auckland City Hospital 9th Floor, Maternity
Design-Led research into the effects of floral art in care environments.
The Project

Exploring the human
response to flowers

In an increasingly fractured world, the human need for beauty is more urgent than ever.

Flowers accompany significant moments across many cultures and traditions – yet how photographic floral imagery affects people in contemporary clinical and care settings remains largely untested.

Physiological and psychological responses to nature, art and imagery have been studied for decades. The Floral Effect Project seeks to extend this research with specific emphasis on the study of the natural and artificial and the impact of naturalistic floral art in clinical and care environments.

The Project is based in Aotearoa New Zealand. It draws on fourteen years of practice in placing floral photography in these settings. It utilises design research methodologies and draws from a growing international evidence base.

The Project is currently developing a formal study to test its ideas and has not yet begun collecting its own research data. It focuses on the following three lines of inquiry:

01

Design Decision Effects

Can choices of scale, placement, and composition in large-scale floral art reduce stress within high-pressure clinical environments?

02

Connection with Life Cycles

Can depicting the full natural life cycle, from pristine bloom to the quiet dignity of decay, support psychological acceptance in palliative care?

03

Effects

Can integrating complex visual imagery into high-fatigue medical workplaces improve cognitive restoration and wellbeing for healthcare staff?

Auckland City Hospital — floral artwork in situ
Auckland City Hospital, 9th Floor – Maternity
The Practice

Artworks in
Clinical Settings

Emma Bass trained as a registered nurse and grew up in hospitals, the child of a cardiologist and radiographer. At ten she painted on the glass windows of a coronary care unit. Fourteen years of placements followed — large-scale floral photographic works placed in hospices, oncology units, hospital wards, aged care facilities, funeral homes, and stillbirth and bereavement units across Aotearoa New Zealand and internationally.

These installations are not commissioned as passive decoration; they are made in response to observed clinical need. The reception of these works by patients, families, and clinical staff has generated a substantial body of qualitative evidence concerning the psychological effects of floral imagery in care contexts. This evidence forms the origin and motivation of our current research.

The Research

What we know.
What we are finding out.

How people respond

Floral and nature imagery is consistently rated as more attractive, calming and pleasant – one of the more reliable findings in this field. A large 2026 replication study found no corresponding difference in physiological recovery, leaving open whether the benefit is mainly about preference rather than a deeper physiological pathway.

Zhang et al. 2023 · Van den Berg et al. 2026

The open question

Across several clinical studies, decorative interventions consistently improved how patients rated their environment; effects on pain, blood pressure or medication use were inconsistent, and none found a shorter hospital stay. Whether floral imagery could do more remains open.

George et al. 2018 · Pati et al. 2016

A modest lift

Floral and nature images are linked to a modest, immediate lift in self-reported mood in laboratory settings. Whether that lift holds outside the lab, or reaches people who can't verbally self-report, is still being worked out.

Mochizuki-Kawai et al. 2020 · Mizumoto et al. 2024

A gap in the evidence

Whether these effects last beyond the moment of viewing, and whether a photograph can substitute for the real thing, are questions this literature has not yet answered – ones The Floral Effect intends to help answer through its own future research.

Kjellgren & Buhrkall 2010 · Fan & Baharum 2024

Literature Review Selected Research Studies These studies sit within a wider conversation about flowers, visual art, nature imagery and healthcare environments – research on real and represented nature, artwork in clinical settings, and the experience of care. They inform the Floral Effect Project's research inquiry and scope through five lenses, and are included because they help frame the questions we're exploring, not as a definitive evidence hierarchy or an endorsement of every method or conclusion.
Flowers: Direct Effects 3 studies
Haviland-Jones, J., Rosario, H.H., Wilson, P., & McGuire, T.R. (2005). An environmental approach to positive emotion: Flowers . Evolutionary Psychology, 3(1).
Real bouquets, given as gifts, were associated with mood lift lasting several days and increased social contact compared with other gifts tested. This is the founding and most-cited study in this specific field, though it has methodological limitations and has not been independently replicated in the twenty years since.
Ikei, H., Song, C., & Miyazaki, Y. (2023). Physiological adjustment effect of visual stimulation by fresh rose flowers on sympathetic nervous activity . Frontiers in Psychology, 14.
A pooled reanalysis of physiological data from viewing fresh roses, drawing together several earlier experiments – including an earlier office-worker study by the same group – across a larger combined sample of 214 participants. Viewing roses had a self-normalising effect: sympathetic activity fell in those who started elevated and rose in those who started low.
Mochizuki-Kawai, H., Matsuda, I., & Mochizuki, S. (2020). Viewing a flower image provides automatic recovery effects after psychological stress . Journal of Environmental Psychology, 70.
This study looked at a flower photograph specifically, using a photograph of the sky as the comparison image. After a stressor, viewing the flower photograph was associated with a modest fall in salivary cortisol relative to the comparison image; the sky photograph produced a similar reduction in the same experiment.
Nature Imagery and Art in Healthcare Settings 6 studies
Mizumoto, T., Ikei, H., et al. (2024). Mood and physiological effects of visual stimulation with images of the natural environment in individuals with depressive and anxiety disorders . Journal of Affective Disorders, 356.
Sixty psychiatric outpatients viewed nature or building photographs for three minutes; nature photographs were associated with a larger immediate mood improvement. One of the few studies in this area to test a clinical population, rather than healthy volunteers or students.
Nielsen, S.L., Fich, L.B., Roessler, K.K., & Mullins, M.F. (2017). How do patients actually experience and use art in hospitals? . International Journal of Qualitative Studies on Health and Well-being, 12(1).
Patients described using art on the ward for distraction, for a sense of home, and to hold on to who they are outside the illness. This is qualitative research, describing patient experience rather than measuring an effect size.
Pati, D., Freier, P., O'Boyle, M., Amor, C., & Valipoor, S. (2016). The impact of simulated nature on patient outcomes: A study of photographic sky compositions . HERD: Health Environments Research & Design Journal, 9(2).
Simulated hospital patient rooms were fitted with ceiling-mounted photographic sky compositions or left without; patients in rooms with the sky compositions reported higher environmental satisfaction and lower diastolic blood pressure.
Teunissen, T., Hendrikx, A., Bourik, Z., van Noort, S., Lindhout, P., Groot, B., & Abma, T. (2025). Visual art in a hospital from patients' and families' perspectives . Journal of Applied Arts & Health, 16(1).
Interviews with patients and family members found hospital artwork was experienced as emotionally moving, evoking a sense of home and stimulating imagination during illness. Like the Nielsen study above, this is qualitative research describing patient experience rather than measuring an effect size.
Trupp, M.D., Howlin, C., Fekete, A., Kutsche, J., Fingerhut, J., & Pelowski, M. (2025). The impact of viewing art on well-being: A systematic review of the evidence base and suggested mechanisms . The Journal of Positive Psychology, 20(6).
A systematic review of 38 studies and 6,805 participants found consistent evidence that viewing art supports wellbeing, with the strongest effects on eudaimonic wellbeing (meaning, purpose and personal growth).
Wichrowski, M.J., Corcoran, R., Haas, F., Sweeney, J., & McGee, C. (2021). Effects of biophilic nature imagery on indexes of satisfaction in medically complex physical rehabilitation patients . HERD: Health Environments Research & Design Journal, 14(3).
Rehabilitation inpatients in rooms with nature imagery rated their rooms significantly more satisfying than patients in standard rooms. Quality of stay and sleep trended in the same direction without reaching statistical significance.
Nature Exposure and Clinical Research 5 studies
Browning, M.H.E.M., Saeidi-Rizi, F., McAnirlin, O., Yoon, H., & Pei, Y. (2021). The role of methodological choices in the effects of experimental exposure to simulated natural landscapes on human health and cognitive performance: A systematic review . Environment and Behavior, 53(7).
A review of 175 experiments testing simulated nature (images, video or virtual reality) on human health and cognitive performance. Studies without a control group or without random assignment reported positive findings more often than studies that used a control group or random assignment.
George, D.R., de Boer, D., Hammer, S., Hopkins, R.O., King, T., & Green, M. (2018). Evaluating the benefits of hospital room artwork for patients receiving cancer treatment: A randomised controlled trial . Journal of Hospital Medicine, 13(8).
A randomised controlled trial of 186 cancer inpatients, with artwork placed in direct line of sight. It changed how patients rated the room – more attractive, more interesting, more pleasant – but not their pain, anxiety, mood, quality of life or length of stay.
Soga, M., & Gaston, K.J. (2025). Health benefits of viewing nature through windows: A meta-analysis . BioScience, 75(8).
A meta-analysis of 28 studies found window views of nature consistently associated with better physiological, psychological and physical health outcomes – the large-scale follow-up to the 1984 Ulrich study above.
Ulrich, R.S. (1984). View through a window may influence recovery from surgery . Science, 224(4647).
The foundational paper for this field of research: a window view of trees was associated with a shorter hospital stay in a small 1984 study. That specific outcome has not been directly replicated since, and a recent large meta-analysis of window views found little pooled effect on physical health outcomes overall.
Van den Berg, A.E., et al. (2026). A large-scale, pre-registered replication of stress recovery theory . Journal of Environmental Psychology, 111.
A pre-registered replication across ten sites and 959 participants, testing whether physiological arousal recovers differently after viewing nature versus built scenes; arousal fell during recovery regardless of scene type.
Alleviate Perinatal Loss and Bereavement 2 studies
Dean, J., Cleary, A., Ma, T., McDaid, L., Pollock, D., & Boyle, F. (2023). Scoping review of nature-based interventions in bereavement care: What are the implications for perinatal loss? . Social Sciences & Humanities Open, 8(1).
A scoping review of nature-based bereavement support, which found that, at the time of the review, no studies had specifically examined nature interventions for perinatal loss.
Zahmatkesh, M., Faal Siahkal, S., Alahverdi, F., Tahmasebi, G., & Ebrahimi, E. (2024). The role of art therapy on quality of life of women with recent pregnancy loss: A randomized clinical trial . PLOS ONE, 19(7).
Sixty women following recent pregnancy loss were randomised to four sessions of art-making plus relaxation, or to routine care; the art therapy group reported higher quality-of-life scores, though the reported size of the effect is larger than typically seen in comparable trials and warrants caution pending further replication.
Represented vs. Real Exposure 4 studies
Fan, L., & Baharum, M.R. (2024). The effects of digital nature and actual nature on stress reduction: A meta-analysis and systematic review . Internet Interventions, 38.
A meta-analysis and systematic review found digital nature produced stress-reduction effects statistically equivalent to actual nature exposure, with no significant difference between the two.
Igarashi, M., Aga, M., Ikei, H., Namekawa, T., & Miyazaki, Y. (2015). Physiological and psychological effects on high school students of viewing real and artificial pansies . International Journal of Environmental Research and Public Health, 12(3).
High school students viewed real pansies, artificial pansies or no flowers; real pansies significantly reduced sympathetic nerve activity and produced greater feelings of comfort and relaxation than artificial pansies.
Kjellgren, A., & Buhrkall, H. (2010). A comparison of the restorative effect of a natural environment with that of a simulated natural environment . Journal of Environmental Psychology, 30(4).
One of the closest existing tests of whether a photograph can substitute for the real thing. Real nature was associated with higher ratings of energy and fascination than a 97-photograph slideshow of the same park; participants viewing the photographs described "longing for real nature."
McMahan, E.A., & Estes, D. (2015). The effect of contact with natural environments on positive and negative affect: A meta-analysis . The Journal of Positive Psychology, 10(6).
A meta-analysis of 32 studies found nature contact associated with a moderate increase in positive affect and a smaller decrease in negative affect, with real nature producing larger positive-affect gains than simulated nature.
The Activities

Research
Activities

Our initial work addresses an under-researched question: what happens, psychologically and physiologically, when people encounter photographic representations of flowers in clinical spaces? Operating from Aotearoa New Zealand, the project is building connections with clinicians, researchers, and institutions across the world.

2026Feasibility Study

Dementia Care Study

A feasibility study examining the psychological response of dementia patients to floral photographic works placed in a London care home. Beginning June 2026.

Commencing Now
2026International Presentation

Surrey, United Kingdom

The inaugural multidisciplinary workshop uniting fragmented research on human responses to flowers across psychology, neuroscience, horticulture, design, and the arts. Organised by the University of Surrey Institute of Advanced Studies, the workshop aims to pioneer a new interdisciplinary field. Emma Bass and Aaron Fry are presenting on the practice of placing large-scale floral photographic art in clinical and care environments.

2026International Presentation

Dunedin, New Zealand

Cumulus — Design at the End of the Earth, Dunedin, 2026. Presenting research on Emma Bass's floral photographic works in clinical spaces, within this year's theme of Hope and Design.

2022Poster Presentation

Gerontology Framework

The Artwork of Emma Bass: Amplifying wellness in aged, clinical and therapeutic care environments. NZ Association of Gerontology, 1 November 2022.

An Open Invitation

Join the
Research Initiative

The Floral Effect Project is building connections with clinical environments, environmental psychologists, and design researchers. If you are interested in our approach, introducing our artwork into care spaces where it can make a meaningful difference, or working in collaboration with us on data collection, we invite you to connect.

The Researchers

The people
behind the research

The Floral Effect Project sits at the intersection of practice and inquiry. The researchers bring together fine art, nursing, and design cognition: disciplines that share a concern with how environments shape human experience.

Emma Bass
Artist

Emma Bass

Fine art photographer & former registered nurse. Auckland, New Zealand.

Emma Bass grew up around hospitals. Her father was a cardiologist, her mother a radiographer. At ten years old she painted on the internal window of a coronary care unit, watching what happened when colour and image entered a clinical space.

She trained and worked as a registered nurse in Auckland before building a twenty-two year career as a commercial photographer. In 2012 she shifted to fine art practice, working exclusively with flowers. Her work has been acquired by private collectors internationally, exhibited twice at the Royal Academy Summer Exhibition, London, and placed in clinical and care environments across Aotearoa New Zealand and internationally. Auckland City Hospital holds over 20 of her works. She collaborates with Breast Cancer Cure New Zealand on a luxury scarf collection, with proceeds directed to research.

Her practice sits at an unusual intersection: fine art, clinical knowledge, and more than fourteen years of direct observation. The Floral Effect Project is the formal attempt to investigate the questions that practice has raised.

emmabass.co.nz

Aaron Fry
Design Researcher

Aaron Fry

Director of MDes, School of Engineering and Design, University of Auckland

Aaron Fry trained as a fine artist at Elam School of Fine Arts, University of Auckland, before completing an MFA at the University of Hawaii at Manoa. He built an international design career that included a tenured faculty position at Parsons School of Design in New York, where he co-directed the Visualizing Finance Lab and developed a research practice around design cognition, information visualisation, and how designed artefacts shape perception and behaviour.

He returned to Aotearoa New Zealand as Director of the MDes programme at the School of Engineering and Design, University of Auckland, and is completing a PhD in Design at Swinburne University of Technology. His research spans design cognition, the psychology of visual artefacts, and the relationship between designed environments and human wellbeing. His central question, what does design do to human experience, is what drew him to The Floral Effect Project. The collaboration with Emma Bass brings design research methodology and academic rigour to a body of qualitative evidence accumulating in clinical settings for over a decade.

linkedin.com/in/aaronafry

Let's work
together

We welcome approaches from researchers, clinicians, institutions and designers with aligned interests, in Aotearoa New Zealand or internationally.

Or write directly aaron.fry@auckland.ac.nz

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Emma Bass — Here Now