{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T23:33:25Z","timestamp":1777937605228,"version":"3.51.4"},"reference-count":25,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2014,10,28]],"date-time":"2014-10-28T00:00:00Z","timestamp":1414454400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Scand J Public Health"],"published-print":{"date-parts":[[2014,12]]},"abstract":"<jats:p>Aims: Nature-assisted therapy for mental health problems receives increased attention. However, quantitative evaluations are rare. This study evaluates the effects of an all-outdoors vocational rehabilitation program for individuals on long-term sick leave due to sustained stress-related symptoms. Methods: In a comparative pre\u2013post intervention design the intervention group contained 48 participants from Mariendal Gardens (MG), while 45 participants at Stress- &amp; Jobmanagement (SJ) formed the comparison group. At MG all activities took place outdoors, while activities at SJ were mainly indoors. Questionnaires were completed at baseline, 3- and 6-month follow-up. Outcomes included Perceived Stress Scale (PSS-10) and measures of sleep, mindfulness, self-efficacy, daily functioning, and work ability. Data were analyzed using mixed model repeated measures analysis of variance. Results: At baseline the MG-group PSS-10 mean score was 25.15 points (SD=7.20), while the SJ-group mean score was 23.91 (SD=7.48). At 3-months the MG within-group score dropped 4.61 [2.71; 6.52] points ( p&lt;0.01), corresponding to at standardized mean difference (Cohen\u2019s d) of d=0.64 [0.38; 0.91], while the SJ within-group score dropped 4.16 [1.73; 6.59] points ( p&lt;0.01), corresponding to d=0.56 [0.23; 0.88]. The between-group mean difference was not significant ( p=0.77). Similarly, results for sleep, mindfulness, self-efficacy, daily functioning, and work ability demonstrated significant within-group effects and minimal between-group differences. Conclusions: Both interventions demonstrated small to large pre\u2013post effect sizes. Negligible differences were observed between the effects of the two interventions, indicating no added effect of the all-outdoors setting. Results should be interpreted with caution as unequal lost to follow-up rates threatens the comparability of changes in the two groups.<\/jats:p>","DOI":"10.1177\/1403494814551859","type":"journal-article","created":{"date-parts":[[2014,10,29]],"date-time":"2014-10-29T01:12:05Z","timestamp":1414545125000},"page":"719-727","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":16,"title":["Rehabilitation of individuals on long-term sick leave due to sustained stress-related symptoms: A comparative follow-up study"],"prefix":"10.1177","volume":"42","author":[{"given":"Morten Vejs","family":"Willert","sequence":"first","affiliation":[{"name":"Danish Ramazzini Centre, Department of Occupational Medicine, Aarhus University Hospital, Region Midt, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joanna","family":"Wieclaw","sequence":"additional","affiliation":[{"name":"Arbejdsmilj\u00f8Centret, previously at the Centre for Social Medicine and Rehabilitation, Region Midt, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ane Marie","family":"Thulstrup","sequence":"additional","affiliation":[{"name":"Danish Ramazzini Centre, Department of Occupational Medicine, Aarhus University Hospital, Region Midt, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2014,10,28]]},"reference":[{"key":"bibr1-1403494814551859","doi-asserted-by":"publisher","DOI":"10.1080\/13638490410001711416"},{"key":"bibr2-1403494814551859","doi-asserted-by":"publisher","DOI":"10.1108\/MHRJ-02-2013-0007"},{"key":"bibr3-1403494814551859","doi-asserted-by":"publisher","DOI":"10.1177\/1403494810396400"},{"key":"bibr4-1403494814551859","doi-asserted-by":"publisher","DOI":"10.1111\/j.1447-0349.2010.00689.x"},{"key":"bibr5-1403494814551859","doi-asserted-by":"crossref","first-page":"2002","DOI":"10.1111\/j.1365-2648.2010.05383.x","volume":"66","author":"Gonzalez MT","year":"2010","journal-title":"J Adv Nurs"},{"key":"bibr6-1403494814551859","first-page":"60","volume":"13","author":"Stigsdotter U","year":"2002","journal-title":"J Ther Hort"},{"key":"bibr7-1403494814551859","first-page":"38","volume":"14","author":"Stigsdotter U","year":"2003","journal-title":"J Ther Hort"},{"key":"bibr8-1403494814551859","volume-title":"Full Catastrophe Living","author":"Kabat-Zinn J","year":"1990"},{"key":"bibr9-1403494814551859","volume-title":"Mindfulness-based cognitive therapy for depression: a new approach to preventing relapse","author":"Segal Williams","year":"2002"},{"key":"bibr10-1403494814551859","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.2011.01704.x"},{"key":"bibr11-1403494814551859","volume-title":"With people in mind: Design and management of everyday nature","author":"Kaplan R R.","year":"1998"},{"key":"bibr12-1403494814551859","unstructured":"Mariendals haver - arbejdsmarkedsrettet rehabilitering af alvorligt stressramte. Manual (in Danish) at www.aarhus.dk\/\/media\/Subsites\/AMCSyd\/Dokumenter\/Praesentationer\/Stress-rapport.pdf, Job Rehabilitation Centre South, Municipality of Aarhus, Denmark, retrieved August 2014."},{"key":"bibr13-1403494814551859","volume-title":"The Social Psychology of Health, ch. Perceived stress in a probability sample of the United States, 31\u201367","author":"Cohen S","year":"1988"},{"key":"bibr14-1403494814551859","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2869.1995.tb00205.x"},{"key":"bibr15-1403494814551859","doi-asserted-by":"publisher","DOI":"10.1177\/1073191105283504"},{"key":"bibr16-1403494814551859","doi-asserted-by":"publisher","DOI":"10.1177\/1073191107313003"},{"key":"bibr17-1403494814551859","volume-title":"Self-efficacy. 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