Effects of Horticultural Therapy on Acute Stress and Salivary Cortisol Levels in Hemodialysis Patients

The purpose of this study is to evaluate the acute psychological and physiological effects of a single-session structured horticultural therapy program on patients undergoing routine hemodialysis. The study is designed as a two-arm, parallel, pretest-posttest randomized controlled trial conducted at Bingöl State Hospital. Participants are randomized (1:1) to either an experimental group receiving a 45-60 minute individual horticultural therapy session (e.g., planting and caring for Tagetes erecta, Celosia cristata, and Petunia grandiflora) or a control group maintaining standard waiting conditions for the same duration during non-dialysis days. Primary outcomes evaluate acute changes in state anxiety (measured via STAI-1) and physiological stress response (measured via salivary cortisol concentration) before and immediately after the intervention.

ClinicalTrials.gov (PRS) sistemindeki Eligibility Criteria alanına birebir yapıştırabileceğiniz İngilizce format ve Türkçe anlamı aşağıdadır: Sisteme Girilecek Metin (İngilizce Format)PlaintextInclusion Criteria: * Age between 18 and 65 years * Receiving maintenance hemodialysis treatment for at least 6 months * Receiving hemodialysis 3 times a week, 4 hours per session * Cognitive ability to comprehend and complete study questionnaires * Willingness to participate in the study and signing the informed consent form Exclusion Criteria: * Severe physical, motor, or visual impairment preventing participation in horticultural activities * Active acute infection or severe systemic disease flare * Current use of systemic corticosteroid therapy or medications significantly altering cortisol metabolism * Severe psychiatric illness or cognitive impairment (e.g., dementia) diagnosed by a physician * Regular participation in any formal complementary/alternative therapy or plant-ca