Natureach - Client groups and measurments

Last changed: 20 November 2023
Woman with VR glasses

Five client pilots with vulnerable client groups and one pilot for care professionals from several units will be studied. For the different pilots, customised digital nature-based interventions with multisensory experiences will be developed, based on clients needs and preferences. Both VR- and IRL-interventions will make use of nature (e.g. natural environments, gardens, farm environments and animals). The interventions will aim to generate the best possible restorative and rehabilitative effects of nature for each group.

The goal is to apply evidence-based methods to explore the health effects of virtual nature-based interventions. This work package supports and coordinates the client pilots in different care organisations, as well as the assessment and measuring conducted by benchmarking the competence and previous experiences among different actors and regions.

In measuring and assessment of the effects of client pilots, several methods are applied including field observations, structured video-observations, Talking Mats, Photovoice, interviews, structured proxy interviews, Mood survey, Perceived sensory dimensions, quality of life -questionnaires and reflections of experience, well-being and recovery. In addition, with some client groups, discussion/reflections in groups (focus groups) can be used.

Physiological measures to be used are heart rate variability, blood sugar levels, weight, blood pressure and needed dose for diabetes-related drugs. Measuring heart rate variability (HRV) and physical activity will be applied with several client groups in this project.

The Wellbeing Services County of North Ostrobothnia, Support and Competence centre Eskoo, The Care unit and the Support unit of Eskoo: housing services for people with disabilities

Support and Competence Centre Eskoo is a national pioneer in its field in the application of nature-based methods in its services. The pilot creates a virtual technology service model based on the impact of nature-based interventions on clients with reduced mobility and demanding round-a-clock care. The clients need high psychosocial support and support for challenging behaviour and communication. The aim is to reinforce the clients’ functioning, positive experiences, quality of life, well-being, and sense of inclusion through environments and natural elements that are relevant to the client.

Eskoo - Client groups, interventions and measurements

  • Eskoo Care Unit; 24/7 care unit to adults with profound intellectual and multiple disabilities in demanding care for 14 clients
    • Equipment used in interventions: dome with visual and auditive sensations without headsets
    • Multisensory interventions: olfactory and tactile sensations are possible
    • Methods used in assessing the effects: Photovoice, observations, HRV-measurements (Firstbeat)

  • Eskoo Support Unit; adults with needs of high psychosocial support and support in everyday life for 19 clients (incl. intellectual disabilities, neuropsychiatric disorder, autism spectrum disorder, and behavioural challenges). The support unit has long-term housing services for 15 clients. There are five apartments intended for customers of the research and evaluation period. The clients have a variety of motor and communication skills. Multiple AAC methods are used. The clients are supported by a multi-professional team, e.g. doctor, psychiatrist, psychologist, occupational therapist, speech therapist and physiotherapist.

    • Equipment used in interventions: dome and VR glasses with headsets
    • Multisensory interventions: olfactory and tactile sensations are possible
    • Methods used in assessing the effects: Photovoice, observations, HRV-measurements (Firstbeat)
    • IRL interventions included if possible.Eskoo´s employees

  • Nurses and social counsellors work in three shifts at Eskoo. Other staff can also participate in the research.

    • Equipment used in interventions: dome and VR glasses with headsets
    • Multisensory interventions: olfactory and tactile sensations are possible
    • Methods used in assessing the effects: HRV measurements (Firstbeat and Oura), questionnaires and interviews.
    • IRL interventions included if possible.

Vaasa central hospital: Eating disorder clinic (University of Vaasa)

The Eating disorder clinic provides special healthcare by a multi-professional team. They offer both intensive periods and outpatient visits for eating disorder patients. New patients need medical referral from health centre, occupational health or private reception. Incoming referrals are processed at the outpatient team meeting. Patients come to examination period when care begins, and at the end of the period we agree on the continued care and make a care plan. Care methods include support in eating situations, individual and group therapy, couples and family therapy, visits to the nutritional therapist, the doctor's appointments, art therapy and physiotherapy.

Vaasa central hospital - Client groups, interventions and measurements

Palliative medicine, Umeå (Umeå University)

The aim for this pilot is to investigate the possibility to use virtual nature experiences for palliative patients who are treated with advanced home care, and thereby increasing well-being and alleviating pain and anxiety.

Palliative medicine -Client groups, interventions and measurements

Client groups:

  1. Patients with serious illnesses and limited survival who are in need of terminal advanced care. The majority of these patients are treated at home with close support from health care personnel at Palliative Medicine.
  2. Relatives that are close to the patient and assist in the care will also be offered to take part of the VR nature experiences. The aim is to enable for the relatives to share the patients experiences and to get some relaxation of their own.
  • Equipment used in interventions: VR glasses are primarily considered as suitable tools.
  • Multisensory interventions: Films of nature environments that are complemented with sound, scents and tactile sensations.
  • Methods used in measuring the effects: Primarily VAS self-assessments of symptoms such as pain and anxiety and a mood scale. Individual interviews of the patients, their relatives and the employees involved in the care. HRV (heart rate variability) could be considered, but only if it doesnt involve any disturbance or discomfort for the patient.

Österåsen: Lifestyle support services (Region Västernorrland)

This pilot will take place at Lifestyle Medicine Österåsen outside Sollefteå in Västernorrland. This clinic has well-established evidence based therapeutic lifestyle treatments delivered by a multi-professional team. In addition to the ordinary treatment, participants receive a nature-based intervention three times/week during the ordinary three weeks visits at Österåsen. The nature-based intervention means to spend one hour three times/week at a chosen spot in the forest at Österåsen. After the three weeks visits, participants will receive VR-headsets with nature scenes to use at home 30 min/three times per week for six months.

The aim for this client pilot is to use IRL- and VR-nature to improve lifestyle. To introduce VR as a method to bring the nature indoors as a tool to encourage the life style changers and others to be more active and go out in the IRL-nature. Also, to provide some of the VR-tools to nature and health entrepreneurs as a PR-tool and to be used at bad weather.

Österåsen - Client groups, interventions and measurements

Client group: People with diabetes mellitus

  • Equipment used in interventions: VR-glasses, screens and headsets for sounds
  • Multisensory interventions: maybe also olfactory solution and tactile sensation
  • IRL-interventions are included
  • Psychological measures: Mood survey, Perceived sensory dimensions, quality of life
  • Physiological measures: Blood sugar levels, weight, need for diabetes-related drugs, (blood pressure, HRV).

Övertorneå Municipality: Senior care services at Särkivaara-gården (Luleå University of Technology)

Övertorneå Municipality has four elderly care units. Särkivaara-gården is the largest, placed in the centre of Övertorneå with nature view from windows and nearby possibilities to visits outside in the garden. This unit is participating in the NATUREACH project. Särkivaara gården has two caring units placed on two floors. Nurses, assistant nurses, physiotherapist, occupational therapist, VR-technician, and medical doctors make up the staff at this unit. In addition, the unit has close co-operation with the healthcare centre.

Due to previous SALAR-project (2020-2022), the municipality and the units at Särkivaara gården have knowledge and experience of testing and implementing new digital devices in their organisation. This also means that the older persons living at the care units and their relatives has experiences of testing different devices. This is seen as a strength as previous experiences enhance the organizations attitude and interest of testing new innovative solutions such as in the NATUREACH project, to support health among the older people in need of care as well as among their staff. Thus, the aim of this client pilot is to promote healthy homes and sustainable living, as well as to combat loneliness of older adults living in elderly care units.

Övertorneå - Client groups, interventions and measurements

Client group: older adults living in elderly care units

  • Equipment used in interventions: VR-glasses - flexible and possible to use in the elderly persons room, Screens in a room at the units aimed for pauses/recreation for the residents.
  • IRL visits in nearby nature and/or nature view through window.
  • Methods used in measuring the effects: Observations, discussion/reflections in groups, Personal interviews, observations, physiological measurements.