Effects of Urban Nature on Stress and Quality of Life

Not Applicable

Recruiting

• Conditions: Stress, Psychological
• Interventions: Behavioral: Nature therapy in urban nature; Behavioral: City Walk

• Registration Number: NCT04780646
• Lead Sponsor: Charite University, Berlin, Germany

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.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2021-02-22
• Study First Submitted QC: 2021-02-28
• Study First Posted: 2021-03-03
• Study Start: 2022-06-29
• Status Verified: 2023-10
• Last Update Submitted: 2023-10-24
• Last Update Posted: 2023-10-25
• Primary Completion: 2024-10-15
• Study Completion: 2024-12-15

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 93

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

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Nature therapy in urban nature	Nature therapy in urban nature	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	City Walk	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.

Primary Outcome Measures

Name	Time	Method
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 Outcome Measures

Name	Time	Method
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
Profile of Mood States (POMS)	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
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
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
Heart Rate (HR)	Date of inclusion (baseline), after 8 weeks, after 16 weeks	24h measuring by faros 180
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
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
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
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
Hospital Anxiety and Depression Scale (HADS)	Date of Inclusion (Baseline), after 8 weeks and after 16 weeks
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 Variability (HRV)	Date of inclusion (baseline), after 8 weeks, after 16 weeks	24h measuring by faros 180

Trial Locations

Locations (1)

Charite University; 🇩🇪 Berlin, Germany