The goal of this clinical trial is to investigate the impact of self-guided foresthealing activities and guided forest healing activities on the reduction of psychologicalstress inindividuals diagnosed with the new coronavirus. The main questions aim to answerare: 1. Effectiveness of Forest Healing Activities on Emotional Well-being: Researchers will compare the emotional improvement effects between self-guided and guided forest healing activities to determine their effectiveness. 2. Comparison of Healing Effects in Different Locations: Researchers will compare the effects of forest healing activities conducted in two similar environments, the Taipei Botanical Garden and the Chiayi Arboretum, to assess whether location influences outcomes despite similar altitude and latitude.Participants who have been diagnosed with the new coronavirus will be recived two hoursof guided forest healing activities or self-guided forest healing activities.
In response to the psychosocial conditions arising from the ongoing pandemic, forest
healing offers a corresponding solution. Forest healing activities have shown good
adaptability in addressing conditions such as depression and anxiety. A systematic big
data analysis paper highlights a significant decrease in depression following forest
healing, with a Test overall effect Z=-6.204, as well as a similar significant reduction
in anxiety with a Test overall effect Z=-4.183 (Yeon et al., 2021). For urban dwellers, a
systematic review of big data on healing activities conducted in forest environments
demonstrates significant normalization of systolic and diastolic blood pressure, an
increase in the parasympathetic-to-sympathetic nervous system ratio, and a reduction in
salivary cortisol concentration, with blood pressure shifting closer to normal indicators
and salivary cortisol levels showing a downward trend after activities (Park et al.,
2010; Qiu et al., 2022). Among populations exposed to chronic stressors, cortisol levels
are higher compared to normal groups (Miller et al., 2007), and elevated salivary amylase
activity is also noted compared to control groups (Vineetha et al., 2014). Therefore,
forest healing significantly improves conditions like anxiety and depression, as
reflected in the reduction of salivary cortisol concentrations.
Behavioral: Forest healing activities
The two-hour forest healing activity, led by horticultural therapists from the Taiwan
Horticultural Therapy Association, includes activities such as leaf stacking on stones,
listening to sounds with closed eyes, body stretching, blindfolded tree identification,
"my tree friend," earth mandala creation, tea tasting, and sharing of
reflections.
Other Name: Forest therapy
Inclusion Criteria:
- Individuals who have been diagnosed with COVID-19 (SARS-CoV-2) and have completed
their isolation.
- Participants aged 18 years or older who voluntarily agree to participate in the
study.
Exclusion Criteria:
- Individuals who do not have the capability and stamina to walk for more than 120
minutes.
- Current smokers, betel nut chewers, or individuals who consume alcohol (more than
five standard drinks in any situation).
- Individuals with a history of substance addiction (including both narcotic and
non-narcotic drugs).
- Participants currently involved in another clinical trial or undergoing an
intervention trial follow-up.
- Pregnant or breastfeeding women.
- Situations where participants are unable to cooperate (e.g., inability to
participate after random assignment or refusal to sign the informed consent form).
Branch of Linsen Chinese Medicine and Kunming, Taipei City Hospital
Taipei 1668341, Taiwan
Chung-Hua Hsu, MD., PhD., Study Chair
Branch of Linsen Chinese Medicine and Kunming, Taipei City Hospital