Nature Immersion Therapy: During the length of inpatient stay at Changi General Hospital (CGH), which ranges from 5 to 10 days, the patients and caregivers will be enrolled for a set of 3 nature-based sessions. Each session will be conducted in groups of 4 to 6 patients incorporating a relational multi-sensory experience as well as mind-body connectedness while spending time in nature. Each of the 3 sessions will be 45 minutes each. The nature-based therapy/green social prescription plan will be conducted in groups guided by a trained CGH staff (Allied Health Professionals/Nurse). This Green social prescribing plan (Playbook) will be integrated into inpatient's care plan. Caregivers of the enrolled patients will also be part of the therapy group following the necessary consent.
Study summary
Nature-based Therapy, such as forest bathing and horticultural therapy, has been shown to have physical, psychological and emotional health benefits. We posit that personalised and guided Nature-based Therapy, which leverages the benefits of therapeutic gardens in an urban hospital setting, improves the overall wellbeing of elderly inpatients with dementia (aged \>65 years old) and their caregivers, as well as patients undergoing inpatient rehabilitation. To determine the effectiveness of Nature-based Therapy for these two inpatient populations, we designed a pilot study, TGIF, to be conducted at the dementia and rehabilitation medicine wards at Changi General Hospital in Singapore.
Eligibility
Sex
ALL
Min age
21 Years
Max age
100 Years
Healthy volunteers
No
Inclusion Criteria:
Patients with dementia:
1. Age 65-100 years old
2. Have a diagnosis of delirium/ dementia or both.
3. Have diagnosis of dementia with and without behavioural symptoms of dementia (BPSD)
4. Ability to communicate with the Nature-based Therapist (in languages such as English, Mandarin Chinese, Chinese dialects or Malay)
5. Manageable behavioural symptoms and able to focus attention for minimum of 30 minutes
Rehabilitation Medicine patients:
1. Age 21-100 years old
2. Acquired brain injury with residual impairments, which can be either in the i) motor, and/or ii) cognitive domains, and/or iii) suspected or diagnosed mood disorders (including adjustment disorder, depression and anxiety disorders) -patients would then be stratified according to the category(s) of impairments both for consideration of interventions and for outcome measures/analysis
3. Additional Physical/Cognitive Criteria required will depend on range of specific therapeutic activities that could be prescribed/administered (eg.at least 1 upper limb with Manual Muscle Testing (MMT) of at least 3/5, with ability for active grasp/release, ability to sustain attention for the duration of the session, cognitive Functional Independence Measure (FIM) score of at least 25 points etc)
Exclusion Criteria:
1. In isolation due to contact, droplet or airborne precautions
2. Unable to provide consent and lack of surrogate decision maker to provide consent
3. Poorly managed psychiatric or behaviour symptoms with threats to others surrounding them.
4. Age \< 21 years
5. Patients who are haemodynamically unstable.
6. Patients on strict bed rest
Primary outcome measure(s)
Pittsburg Agitation Scale — Baseline and at the end of intervention, an average 7 days The Pittsburgh Agitation Scale (PAS) is a quick, observational tool used to assess the severity of agitation in dementia patients, focusing on four behavioral dimensions: aberrant vocalizations, motor agitation, aggressiveness, and resistance to care
DASS-21 — Baseline and at the end of intervention, an average of 7 days The DASS-21 (Depression, Anxiety, and Stress Scale - 21 Items) is a self-report questionnaire designed to measure the severity of symptoms related to depression, anxiety, and stress in adults. It consists of 21 questions, with seven questions for each of the three scales: depression, anxiety, and stress.
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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