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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Nature therapy in urban nature | Experimental | Subjects receive a 90-minute nature therapy session once per week for 8 weeks with a licensed nature therapist, who explains exercises on perceiving nature and the connection between nature and health. |
|
| City Walk | Active Comparator | Subjects receive a 90-minute city walk through urban sourroundings once per week for 8 weeks with a city guide, who talks about city architecture and gives information about the history of the surroundings. |
|
| Waiting List | No Intervention | Subjects don't receive any therapy. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Nature therapy in urban nature | Behavioral | Nature therapy means visits in nature, actively perceiving the flora and fauna |
|
| Measure | Description | Time Frame |
|---|---|---|
| Stress questionnaire (Cohen Perceived Stress Scale, CPSS) | 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. | Date of Inclusion (Baseline), after 8 weeks and after 16 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Zerssen symptom list (B-LR and B-LR') | Assessing full scale, range 20-80, higher score meaning a better outcome | Date of Inclusion (Baseline), after 8 weeks and after 16 weeks |
| International Physical Activity Questionnaire (IPAQ) |
| Measure | Description | Time Frame |
|---|---|---|
| Qualitative interviews in individual interviews | 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. | 8 weeks after inclusion |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Miriam Rösner | Contact | 00493080505682 | m.roesner@immanuel.de |
| Name | Affiliation | Role |
|---|---|---|
| Andreas Michalsen, Prof. Dr. | Charité Hochschulambulanz für Naturheilkunde am Immanuel Krankenhaus | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Charite University | Recruiting | Berlin | 14169 | Germany |
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| ID | Term |
|---|---|
| D013315 | Stress, Psychological |
| ID | Term |
|---|---|
| D001526 | Behavioral Symptoms |
| D001519 | Behavior |
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| ID | Term |
|---|---|
| D012064 | Relaxation Therapy |
| ID | Term |
|---|---|
| D026441 | Mind-Body Therapies |
| D000529 | Complementary Therapies |
| D013812 | Therapeutics |
| D001521 | Behavior Therapy |
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| City Walk | Behavioral | City Walk means walking through urban surroundings (houses, streets, concrete..) with as little as possible contact to nature |
|
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
| Date of Inclusion (Baseline), after 8 weeks and after 16 weeks |
| Maslach Burnout Inventory (MBI) | Assessing full scale, range 0-96, higher score meaning a better outcome | Date of Inclusion (Baseline), after 8 weeks and after 16 weeks |
| Mindfulness (Freiburger Fragebogen zur Achtsamkeit, FFA) | Assessing full scale, range 0-56, higher score meaning a better outcome | Date of Inclusion (Baseline), after 8 weeks and after 16 weeks |
| 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) | mean score of the 11 items, range 1-7, lower score meaning a better outcome | Date of Inclusion (Baseline), after 8 weeks and after 16 weeks |
| Subjective Vitality Scale (SVS-G state) | Assessing full scale, range from 0-28, lower score meaning a better outcome | Date of Inclusion (Baseline), after 8 weeks and after 16 weeks |
| Flourishing Scale (FS) | Assessing full scale, range 8-56, higher score meaning a better outcome | Date of Inclusion (Baseline), after 8 weeks and after 16 weeks |
| Hospital Anxiety and Depression Scale (HADS) | Date of Inclusion (Baseline), after 8 weeks and after 16 weeks |
| Profile of Mood States (POMS) | Date of Inclusion (Baseline), after 8 weeks and after 16 weeks |
| Sociodemographic Measurements | Age, gender, marital status, number of people in household, education level, employment status, job, personal net income, household income | Date of Inclusion (Baseline) |
| Behavioural questions: doctor visits and health | amount of doctor visits, amount of sick leave days in the last 2 months | Date of Inclusion (Baseline), after 8 weeks and after 16 weeks |
| Expectation questions | for intervention 1 and 2 on a 6-point likert scale from 1 (very strong) to 6 (nothing at all) | Date of Inclusion (Baseline) |
| Behavioural questions: cigarette consumption | Number of cigarettes on average per day in the last month | Date of Inclusion (Baseline), after 8 weeks and after 16 weeks |
| Behavioural questions: alcohol consumption | Number of alcoholic beverages on average per week in the last month | Date of Inclusion (Baseline), after 8 weeks and after 16 weeks |
| Behavioural questions: time in nature | amount of hours spent in nature per week in the last month | Date of Inclusion (Baseline), after 8 weeks and after 16 weeks |
| Behavioural questions: nature as priority | if spending time in nature is seen as a priority on a 6-point likert scale 1 (very strong) to 6 (nothing at all) | Date of Inclusion (Baseline), after 8 weeks and after 16 weeks |
| Heart Rate (HR) | 24h measuring by faros 180 | Date of inclusion (baseline), after 8 weeks, after 16 weeks |
| Heart Rate Variability (HRV) | 24h measuring by faros 180 | Date of inclusion (baseline), after 8 weeks, after 16 weeks |
| D011613 |
| Psychotherapy |
| D004191 | Behavioral Disciplines and Activities |