2.3. Data Sources and Measures
nausea, anxiety, drowsiness, pain, tiredness, depression, shortness of breath
POSITIVE
Participants completed a questionnaire that assessed their sociodemographic and clinical variables, including their sex, age, location (state, city, country), marital status, education, profession, urban/rural background, intentional relationship with nature, diagnosis, chemotherapy session, time of diagnosis, and their estimated treatment time for sample characterization.To evaluate the affective aspect of the participants’ relationship with the environment, the Connectedness to Nature Scale (CNS) was used. The CNS consists of 14 items, such as “I think of nature as a community of which I am a part” and “My personal well-being is independent of the well-being of nature”. Participants rated their agreement on a scale ranging from 1 (I totally disagree) to 5 (I totally agree). This instrument was translated and validated in Brazil and has demonstrated to be a psychometrically adequate measure to assess the general factor of connection with nature in our environment [The Positive Affect/Negative Affect Scale (PANAS) and the Edmonton Symptom Assessment System (ESAS) were administered pre-and post-intervention to all intervention and control groups to assess the primary outcomes. The PANAS consists of 20 items that describe feelings and emotions and assess a person’s positive and negative traits using a 5-point scale (1 = “very slightly or not at all”; 5 = “extremely”). Higher scores on Positive Affect indicate greater intensity of positive emotions, and higher scores on Negative Affect indicate greater intensity of negative emotions [The Edmonton Symptom Assessment System (ESAS) addresses ten common symptoms: pain, tiredness, nausea, depression, anxiety, drowsiness, appetite, well-being, sleep, and shortness of breath. The severity at the time of assessment of each symptom is rated from 0 to 10 on a numerical scale; with 0 meaning that the symptom is absent and 10 that it is the worst possible severity. For all items, the higher the score, the worse the symptoms [Assessments from the intervention and control groups were collected as follows: participants filled out pre-questionnaires before the session and post-questionnaires after a 20-min interval.