This study explores the impact of three solid-color cut carnations (red, yellow, and green) and four geometric fl oral arrangements on the emotions of hospitalized patients with depression through a four-phase fl ower-arrangement experience. The Brief Mood Scale and the Smiley Face Scale were utilized as psychological indicators, while heart rate, blood pressure, and salivary cortisol served as medical indicators. A comparative analysis of stress and emotional changes was conducted between the experimental group (n=86) and the control group (n=24) of hospitalized patients with depression. The results showed that: (1) All four fl ower arrangements signifi cantly improved the emotional states of the experimental group, with the hemisphere arrangement showing the most signifi cant impact (p<0.001). (2) The diffi culty level of creating the target arrangement signifi cantly infl uenced participants’ perceived stress. In particular, the hemisphere and triangular arrangements were the most eff ective at reducing stress, whereas the L-shaped arrangement induced the highest stress levels (X-=11.12 nmol/L). (3) Among the 12 combinations of cut fl ower colors and fl oral arrangements, the yellow triangular arrangement and the green hemisphere arrangement exhibited the best eff ects on stress reduction and emotional relaxation for the experimental group. The study indicates that designing lower-diffi culty activities for hospitalized patients with depression can enhance their engagement in the fl ower arrangement experience and improve emotional outcomes, providing a reference for customizing clinical fl ower arrangement experiences.