Nature-Focused Mindfulness and Spiritual Well-being Among Adults with Moderate Prolonged Grief Symptoms

NCT ID: NCT06904976

Last Updated: 2025-04-01

Basic Information

• Recruitment Status: NOT_YET_RECRUITING
• Clinical Phase: NA
• Total Enrollment: 230 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-03-24
• Study Completion Date: 2025-09-09

Brief Summary

The goal of this randomized controlled trial is to evaluate whether a nature-focused mindfulness 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-focused mindfulness intervention improve spiritual well-being compared to an active control condition (noticing nature) and a waitlist control condition?

Does a nature-focused mindfulness 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-focused mindfulness 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-focused mindfulness 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

Conditions

Grief; Spiritual Wellbeing

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: SUPPORTIVE_CARE
• Blinding Strategy: NONE

Study Groups

Nature-focused mindfulness

10 minutes walking to a chosen natural location, 10 minutes guided mindfulness practice, 10 minutes walking back.

Group Type: EXPERIMENTAL

Nature-focused mindfulness

Intervention Type: BEHAVIORAL

The intervention consisted of a daily 30-minute self-guided practice structured in three parts: (1) participants first walked mindfully for 10 minutes in a natural environment of their choosing (e.g., local park, forest, garden), (2) upon reaching a suitable location, they engaged in a 10-minute guided mindfulness practice, and (3) concluded with a 10-minute mindful walk back.

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.

Group Type: ACTIVE_COMPARATOR

Noticing-nature

Intervention Type: BEHAVIORAL

Participants allocated to the noticing-nature active control group will be instructed to 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.

Waitlist

Group Type: NO_INTERVENTION

No interventions assigned to this group

Interventions

Nature-focused mindfulness

The intervention consisted of a daily 30-minute self-guided practice structured in three parts: (1) participants first walked mindfully for 10 minutes in a natural environment of their choosing (e.g., local park, forest, garden), (2) upon reaching a suitable location, they engaged in a 10-minute guided mindfulness practice, and (3) concluded with a 10-minute mindful walk back.

Intervention Type: BEHAVIORAL

Noticing-nature

Participants allocated to the noticing-nature active control group will be instructed to 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.

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

• 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.

Exclusion Criteria

• 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.

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

University of Twente

OTHER

Sponsor Role: lead

Responsible Party

Jannis Kraiss

Principal Investigator

Responsibility Role: PRINCIPAL_INVESTIGATOR

Other Identifiers

250441

Identifier Type: -

Identifier Source: org_study_id