Stress, Psychological
Conditions
Keywords
Nature therapy, Stress
Brief summary
The aim of this study is to investigate the effects of regular nature therapy in urban nature with guidance of a licensed nature therapist on stress, quality of life and physical symptoms of subjects with elevated stress levels.
Interventions
BEHAVIORALNature therapy in urban nature
Nature therapy means visits in nature, actively perceiving the flora and fauna
BEHAVIORALCity Walk
City Walk means walking through urban surroundings (houses, streets, concrete..) with as little as possible contact to nature
Sponsors
Charite University, Berlin, Germany
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* stress with at least 4 of 10 points on the Numeric Analogue Scale (NAS) at least 1 month * at least 3 of the following 8 stress-associated symptoms: sleep disturbances, inappetence or increased appetite, shoulder neck tension/back pain, tension headache, concentration disturbances, exhaustion, nervousness/irritability, stress-associated digestive complaints.
Exclusion criteria
* serious acute or chronic diseases * pregnancy or lactation * known serious mental illness * immobility or restriction for gymnastics exercises due to orthopaedic, neurological or other medical cause * participation in another study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Stress questionnaire (Cohen Perceived Stress Scale, CPSS) | Date of Inclusion (Baseline), after 8 weeks and after 16 weeks | Change from Baseline in the CPSS, range from 0 to 4 in each item. Scores are obtained by reversing responses (e.g., 0 = 4, 1 = 3, 2 = 2, 3 = 1 & 4 = 0) to the positively stated items and then summing across all scale items while higher values meaning a higher grade of perceived stress. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Zerssen symptom list (B-LR and B-LR') | Date of Inclusion (Baseline), after 8 weeks and after 16 weeks | Assessing full scale, range 20-80, higher score meaning a better outcome |
| International Physical Activity Questionnaire (IPAQ) | Date of Inclusion (Baseline), after 8 weeks and after 16 weeks | MET minutes represent the amount of energy expended carrying out physical activity. To get a continuous variable score from the IPAQ (MET minutes a week) we will consider walking to be 3.3 METS, moderate physical activity to be 4 METS and vigorous physical activity to be 8 METS; higher score meaning better outcome; range 0 to around 3000 MET minutes a week |
| Maslach Burnout Inventory (MBI) | Date of Inclusion (Baseline), after 8 weeks and after 16 weeks | Assessing full scale, range 0-96, higher score meaning a better outcome |
| Mindfulness (Freiburger Fragebogen zur Achtsamkeit, FFA) | Date of Inclusion (Baseline), after 8 weeks and after 16 weeks | Assessing full scale, range 0-56, higher score meaning a better outcome |
| General Self-Efficacy Short Scale-3 (GSE-3) | Date of Inclusion (Baseline), after 8 weeks and after 16 weeks | — |
| Perceived Benefits of Nature Questionnaire (PBNQ) | Date of Inclusion (Baseline), after 8 weeks and after 16 weeks | mean score of the 11 items, range 1-7, lower score meaning a better outcome |
| Subjective Vitality Scale (SVS-G state) | Date of Inclusion (Baseline), after 8 weeks and after 16 weeks | Assessing full scale, range from 0-28, lower score meaning a better outcome |
| Flourishing Scale (FS) | Date of Inclusion (Baseline), after 8 weeks and after 16 weeks | Assessing full scale, range 8-56, higher score meaning a better outcome |
| Hospital Anxiety and Depression Scale (HADS) | Date of Inclusion (Baseline), after 8 weeks and after 16 weeks | — |
| Sociodemographic Measurements | Date of Inclusion (Baseline) | Age, gender, marital status, number of people in household, education level, employment status, job, personal net income, household income |
| Behavioural questions: doctor visits and health | Date of Inclusion (Baseline), after 8 weeks and after 16 weeks | amount of doctor visits, amount of sick leave days in the last 2 months |
| Expectation questions | Date of Inclusion (Baseline) | for intervention 1 and 2 on a 6-point likert scale from 1 (very strong) to 6 (nothing at all) |
| Behavioural questions: cigarette consumption | Date of Inclusion (Baseline), after 8 weeks and after 16 weeks | Number of cigarettes on average per day in the last month |
| Behavioural questions: alcohol consumption | Date of Inclusion (Baseline), after 8 weeks and after 16 weeks | Number of alcoholic beverages on average per week in the last month |
| Behavioural questions: time in nature | Date of Inclusion (Baseline), after 8 weeks and after 16 weeks | amount of hours spent in nature per week in the last month |
| Behavioural questions: nature as priority | Date of Inclusion (Baseline), after 8 weeks and after 16 weeks | if spending time in nature is seen as a priority on a 6-point likert scale 1 (very strong) to 6 (nothing at all) |
| Heart Rate (HR) | Date of inclusion (baseline), after 8 weeks, after 16 weeks | 24h measuring by faros 180 |
| Heart Rate Variability (HRV) | Date of inclusion (baseline), after 8 weeks, after 16 weeks | 24h measuring by faros 180 |
| Profile of Mood States (POMS) | Date of Inclusion (Baseline), after 8 weeks and after 16 weeks | — |
Other
| Measure | Time frame | Description |
|---|---|---|
| Qualitative interviews in individual interviews | 8 weeks after inclusion | Qualitative assessment will be carried out in 45-minute individual interviews in 20 (randomized selected) patients participating in the study. The interviews will be recorded, transcribed and analyzed with qualitative content analysis. |
Countries
Germany
Contacts
Primary ContactMiriam Rösner
Outcome results
None listed