Acute effect of orange chromatic environment on perceived health status, pain, and vital signs during chemotherapy treatment



The study is aimed at assessing the acute effect of orange color and natural light exposure on cancer patients during chemotherapy sessions. Warmer environments and rooms receiving more sunlight hours were expected to impact vital signs, quality of life, and pain symptoms.


We used a single-group repeated-measures clinical trial design. For the purpose of the study, chemotherapy rooms were modified based on two experimental factors: color (white vs. orange) and sunlight orientation (south vs. north). On four consecutive sessions, cancer patients were randomly assigned to one of the following conditions: orange-north, orange-south, white-north, and white-south. They received chemotherapy per standard of care. The following outcomes were assessed: blood pressure, body temperature, heart rate, and European Quality of Life Five-Dimension Five-Level Scale Questionnaire (EUROQOL-5D-5L) including the visual analogue scale (EQ-VAS).


Statistically significant beneficial effect of orange color room in self-rated health was found (p = 0.036, d = 0.28). Small differences in other parameters (body temperature, d = 0.34; diastolic blood pressure, d = 0.37; systolic blood pressure, d = 0.28) did not reach statistical significance. No differences were found based on room orientation.


Compared with a cool-color design, a warm-color living environment could have a positive effect on patients’ well-being during chemotherapy sessions. Although the clinical effect size on perceived health status and vital signs could be considered small, the cost-effectiveness analysis would support the use of the proposed configurations. More research is still needed.

Trial registration Identifier: NCT03873519

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Data availability statement

Data will be available upon acceptance of this article.


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The authors would like to thank IOB Institute of Oncology Madrid (Spain) and Dr. Javier Cortés and especially their nurses for their collaboration during the data collection. We would also like to thank Julio Ruben Padilla, who also helped to collect data for this study. Also, we would like to thank Dr. Ana Marcella Rivas for the critical review of the manuscript and Kelsey Jendrzey from the Clinical Research Institute of TTUHSC for the grammar review and editing of the manuscript.

Author information




Conceptualization, methodology: MPR, PGV, ELZ

Data collection: PGV

Data analysis and interpretation: ELZ

Original draft preparation: PGV, ELZ, MPR

Review and editing: ELZ, MPR, JR

Project administration: MPR

Corresponding author

Correspondence to Eneko Larumbe-Zabala.

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Ethical approval

All procedures performed in the study were in accordance with the ethical standards of the institutional research committee (Jimenez-Diaz Foundation, PIC101-18_HRJR) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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The authors declare that they have no conflicts of interest.

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Gómez-Vela, P., Pérez-Ruiz, M., Hernández Martín, M.F. et al. Acute effect of orange chromatic environment on perceived health status, pain, and vital signs during chemotherapy treatment. Support Care Cancer 28, 2321–2329 (2020).

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  • Cancer
  • Chemotherapy
  • Color
  • Healing environment
  • Self-rated health