Nature-based Contemplation and Spiritual Well-being Among Adults With Moderate Prolonged Grief Symptoms: A Randomized Controlled Trial
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 262
- 试验地点
- 1
- 主要终点
- Spiritual well-being measured by Spiritual Attitude and Involvement List-Short Form
研究概览
简要总结
The goal of this randomized controlled trial is to evaluate whether a nature-based contemplation intervention can enhance spiritual well-being and reduce grief symptoms among adults with moderate prolonged grief symptoms. The main questions it aims to answer are:
Does a nature-based contemplation intervention improve spiritual well-being compared to an active control condition (noticing nature) and a waitlist control condition?
Does a nature-based contemplation intervention reduce grief severity and improve mental well-being, nature connectedness, selflessness, ability to adapt, personal recovery, and elevation compared to control conditions?
How do spiritual well-being, ability to adapt, nature connectedness, selflessness, grief reactions, and positive/negative affect change during the intervention period?
Researchers will compare a nature-based contemplation intervention to both a noticing-nature active control group and a waitlist control group to isolate mindfulness-specific effects from possible general nature exposure benefits.
Participants will:
Complete baseline, post-intervention, and follow-up assessments (at one and three months) Engage in either 10 sessions of nature-based contemplation practice or noticing nature activities over a two-week period (intervention and active control groups) Provide daily diary responses about their experiences throughout the 14-day intervention period
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Supportive Care
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Be a family member, spouse, or friend of a person who died at least 6 months prior to study enrollment;
- •Be ≥18 years of age;
- •Report moderate subclinical grief (score range from 47-70) based on the Traumatic Grief Inventory-Self Report Plus (TGI-SR+, Lenferink, Eisma, et al., 2022);
- •Have access to a natural environment suitable for the intervention;
- •Be willing and able to move in nature daily (with or without mobility assistance devices) and engage in brief mindfulness practices;
- •Have sufficient Dutch language proficiency;
- •Have access to Internet and mobile applications.
排除标准
- •Acute suicide risk assessed in the screening step;
- •A score lower than 47 or higher than 70 on TGI-SR+;
- •Physical limitations that prevent moving outdoors for 30 minutes daily, even with mobility assistance devices.
研究组 & 干预措施
Nature-based contemplation
10 minutes walking to a chosen natural location, 10 minutes guided contemplation practice, 10 minutes walking back.
干预措施: Nature-based contemplation (Behavioral)
Noticing-nature
walk in nature for 30 minutes per day and pay attention to how the natural objects/scenes they encounter in their daily surroundings make them feel over the 14-day period.
干预措施: Noticing-nature (Behavioral)
Waitlist
结局指标
主要结局
Spiritual well-being measured by Spiritual Attitude and Involvement List-Short Form
时间窗: 4 months after baseline
Measured using the Spiritual Attitude and Involvement List-Short Form (SAIL-SF; Bohlmeijer et al., 2023). The SAIL-SF measures seven dimensions of spiritual well-being: meaningfulness, trust, acceptance, caring for others, connectedness with nature, transcendent experiences, and spiritual activities. Each dimension is assessed by one item (e.g., "I experience the things I do as meaningful", "I try to take life as it comes"). Items are rated on a 6-point Likert scale ranging from 1 (not at all) to 6 (to a very high degree), with higher scores indicating greater spiritual well-being. The total score is calculated as the mean of all items.
Spiritual well-being measured by Spiritual Attitude and Involvement List-Short Form
时间窗: Baseline
Measured using the Spiritual Attitude and Involvement List-Short Form (SAIL-SF; Bohlmeijer et al., 2023). The SAIL-SF measures seven dimensions of spiritual well-being: meaningfulness, trust, acceptance, caring for others, connectedness with nature, transcendent experiences, and spiritual activities. Each dimension is assessed by one item (e.g., "I experience the things I do as meaningful", "I try to take life as it comes"). Items are rated on a 6-point Likert scale ranging from 1 (not at all) to 6 (to a very high degree), with higher scores indicating greater spiritual well-being. The total score is calculated as the mean of all items.
Spiritual well-being measured by Spiritual Attitude and Involvement List-Short Form
时间窗: 1 month after baseline
Measured using the Spiritual Attitude and Involvement List-Short Form (SAIL-SF; Bohlmeijer et al., 2023). The SAIL-SF measures seven dimensions of spiritual well-being: meaningfulness, trust, acceptance, caring for others, connectedness with nature, transcendent experiences, and spiritual activities. Each dimension is assessed by one item (e.g., "I experience the things I do as meaningful", "I try to take life as it comes"). Items are rated on a 6-point Likert scale ranging from 1 (not at all) to 6 (to a very high degree), with higher scores indicating greater spiritual well-being. The total score is calculated as the mean of all items.
Spiritual well-being measured by Spiritual Attitude and Involvement List-Short Form
时间窗: 2 months after baseline
Measured using the Spiritual Attitude and Involvement List-Short Form (SAIL-SF; Bohlmeijer et al., 2023). The SAIL-SF measures seven dimensions of spiritual well-being: meaningfulness, trust, acceptance, caring for others, connectedness with nature, transcendent experiences, and spiritual activities. Each dimension is assessed by one item (e.g., "I experience the things I do as meaningful", "I try to take life as it comes"). Items are rated on a 6-point Likert scale ranging from 1 (not at all) to 6 (to a very high degree), with higher scores indicating greater spiritual well-being. The total score is calculated as the mean of all items.
次要结局
- Mental well-being measured by Mental Health Continuum-Short Form(4 months after baseline)
- Selflessness measured by Perceived Body Boundaries Scale(4 months after baseline)
- Selflessness measured by Spatial Frame of Reference Continuum(4 months after baseline)
- Grief intensity measured by Traumatic Grief Inventory-Self Report Plus(4 months after baseline)
- Nature connectedness measured by Inclusion of Nature in Self scale(4 months after baseline)
- Nature connectedness measured by Connectedness to Nature Scale(4 months after baseline)
- Selflessness (Spatial Frame of Reference Continuum)(1 month after baseline)
- Elevation measured by Elevating Experiences Scale(4 months after baseline)
- Ability to adapt measured by Generic Sense of Ability to Adapt Scale(4 months after baseline)
- Personal recovery measured by Brief INSPIRE-O(4 months after baseline)
- Daily diary (assessed daily during 14-day intervention period)(From baseline to post-intervention (2-weeks))
- Grief intensity measured by Traumatic Grief Inventory-Self Report Plus(Baseline)
- Grief intensity measured by Traumatic Grief Inventory-Self Report Plus(1 month after baseline)
- Grief intensity measured by Traumatic Grief Inventory-Self Report Plus(2 months after baseline)
- Nature connectedness measured by Inclusion of Nature in Self scale(Baseline)
- Nature connectedness measured by Inclusion of Nature in Self scale(1 month after baseline)
- Nature connectedness measured by Inclusion of Nature in Self scale(2 months after baseline)
- Nature connectedness measured by Connectedness to Nature Scale(Baseline)
- Nature connectedness measured by Connectedness to Nature Scale(1 month after baseline)
- Mental well-being measured by Mental Health Continuum-Short Form(2 months after baseline)
- Nature connectedness measured by Connectedness to Nature Scale(2 months after baseline)
- Mental well-being measured by Mental Health Continuum-Short Form(Baseline)
- Mental well-being measured by Mental Health Continuum-Short Form(1 month after baseline)
- Selflessness measured by Perceived Body Boundaries Scale(Baseline)
- Selflessness measured by Perceived Body Boundaries Scale(1 month after baseline)
- Selflessness measured by Perceived Body Boundaries Scale(2 months after baseline)
- Selflessness measured by Spatial Frame of Reference Continuum(Baseline)
- Selflessness measured by Spatial Frame of Reference Continuum(2 months after baseline)
- Elevation measured by Elevating Experiences Scale(Baseline)
- Elevation measured by Elevating Experiences Scale(1 month after baseline)
- Elevation measured by Elevating Experiences Scale(2 months after baseline)
- Ability to adapt measured by Generic Sense of Ability to Adapt Scale(Baseline)
- Ability to adapt measured by Generic Sense of Ability to Adapt Scale(1 month after baseline)
- Ability to adapt measured by Generic Sense of Ability to Adapt Scale(2 months after baseline)
- Personal recovery measured by Brief INSPIRE-O(Baseline)
- Personal recovery measured by Brief INSPIRE-O(1 month after baseline)
- Personal recovery measured by Brief INSPIRE-O(2 months after baseline)
研究者
Jannis Kraiss
Principal Investigator
University of Twente