The Effect of Nature and Game Based Activities on Older People

June 11, 2025 updated by: Murselcan Kabakcı, Ondokuz Mayıs University

The Effect of Nature and Game Based Activities on Happiness, Spiritual Well-Being, Frailty and Cognitive Status of Older People in Nursing Home

The purpose of this study is determine the effect of nature and game based activities on happiness, spiritual well-being, frailty and cognitive status of older people in nursing home.

Hypotheses of the Research H0: Nature and game-based activities don't affect the happiness, spiritual well-being, cognitive function and frailty of older people in nursing home.

H1a: Happiness levels of older people in nursing home will be an increase after nature and game-based activities.

H1b: Spiritual well-being levels of older people in nursing home will be an increase after nature and game-based activities.

H1c: Cognitive function levels of older people in nursing home will be an increase after nature and game-based activities.

H1d: Frailty status of older people in nursing home will be a decrease after nature and game-based activities.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

The number and proportion of older people is increasing in the world and in Turkey. The number of older people is attracting more attention with the increase in older people health and rates. Ageing leads to an increase in chronic diseases and a decrease in physical functions, activities of daily living, independence, quality of life and general well-being. Older people transition from their living environment to institutions that provide long-term care such as nursing homes or retirement homes due to problems due to aging. The levels of happiness, spiritual well-being and cognitive function may decrease and the level of frailty may increase in older people staying in nursing homes. Various intervention methods are developed due to the increase in health care needs due to health problems occurring in older people in nursing homes. Nature and game based activities are non-pharmacological and low-risk intervention method that has the potential to increase physical, cognitive and psychological health levels and includes many activities. Gardening activities, which are an effective, individual oriented and nature based intervention method that focuses on improving the physical, cognitive, spiritual and emotional health aspects of older people in nursing homes. Gardening activity is supporting active and healthy ageing, provide a difference and innovation to the health services provided to older people receiving long term care. Gardening activity is an effective leisure activity and one of the easiest ways to provide easy access to green spaces. Older people who participate in gardening activities experience simple activities such as touching plants, smelling plants, tasting edible ones and many complex activities such as collecting seeds, sowing, planting, growing plants, cooking with harvested plants. Older people are positively influenced by emotional stimuli such as colours, smells, tastes, sights, sounds and grow products that can be very valuable for them in gardening activities. Experiences in nature is an opportunity to create spiritual meaning for the older people and contribute to the increase in the spiritual well-being levels of the older people. Gardening include different activities according to the functional ability levels of the participants such as manual dexterity and physical strength. Accordingly, gardening activities have the potential to improve the vulnerability of older people staying in nursing homes. Indoor gardening board game which is nature and game based activity are organised for older people who are limited in their daily life activities but can use their physical and cognitive functions. Individual characteristics, environment and weather conditions can affect the applicability of activities in open areas. Therefore, board games are independent of weather conditions and highly suitable activity to prevent cognitive impairments. Older people can easily access plant materials and actively interact with each other during board games. Thus memory, cognitive ability, motivation, speaking skills and social aspects are positively affected. In this context, nature and game based activities which are an effective and individual oriented intervention method contribute to the improvement of physical, cognitive, spiritual, emotional health aspects and support active and healthy ageing of older people in nursing homes. In addition, these activities provide diversity and innovation in health services provided to individuals receiving long-term care.

Study Type

Interventional

Enrollment (Estimated)

52

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

  • Name: İlknur Aydın Avci, Prof. Dr.
  • Phone Number: 362 312 6341
  • Email: ilknura@omu.edu.tr

Study Locations

  • Turkey
    • Atakum
      • Samsun, Atakum, Turkey, 55200
        • Ondokuz Mayıs University
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Older people who have been in a nursing home for at least 6 months,
  • Older people aged 65 years and over,
  • Older people with a Mini Mental State score of 24 and above,
  • Older people who are open to communication and co-operation will be included in the study.

Exclusion Criteria:

  • Older people with physical problems that may prevent them from participating in nature and game based activities (such as stroke, Parkinson's),
  • Older people with visual and hearing loss that may pose an obstacle to nature and game based activities,
  • Older people with mental problems (such as dementia) that would prevent participation in nature and game based activities were excluded from the study.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Experimental Group
Nature and game based activities will be applied to the participants in the experimental group once a week for 60 minutes for 8 weeks in this study.
Other: Nature and Game Based Activities
Individuals in experimental group will participate nature and game activities such as terrarium making, planting flowers, making puzzles in intervention.
No Intervention: Control Group
Individuals in the control group will not participate in the intervention. Individuals in control group will continue their routine activities in nursing home.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Subjective Happiness Scale
Time Frame: This scale will be applied before and after the 8-week experiment.
Subjective Happiness Scale was developed by Lyubomirsky and Lepper (1999) and adapted to Turkish by Akın and Satıcı (2011), and its validity and reliability were performed. This scale consists of 4 items in total and has a 7-point Likert type. The 4th item of the scale is reverse coded, and a total score is obtained by adding the scores of the items. A minimum of 4 and a maximum of 28 points are obtained from the scale. A high score from the scale indicates high perceived general subjective happiness, while a low score from the scale indicates low perceived subjective happiness. Cronbach Alpha coefficient of the scale is 0.86 and test-retest reliability coefficient is 0.73.
This scale will be applied before and after the 8-week experiment.
Standardized Mini Mental State Examination
Time Frame: This scale will be applied before and after the 8 weeks experiment.
Standardized Mini Mental State Examination was developed by Folstein et al. (1975) to be used in dementia screening and adapted into Turkish by Güngen et al. (2002) to assess cognitive status. This scale is examined under five main headings and evaluated as recording memory (3 points), orientation (10 points), recall (3 points), attention and calculation (5 points) and language (9 points). There are two separate forms of the Mini Mental State for educated and uneducated individuals. The scale is evaluated out of 30 points; 24-30 is considered as normal, below 24 as cognitive impairment, 18-23 as mild dementia, 12-17 as moderate dementia and below 12 as severe dementia.
This scale will be applied before and after the 8 weeks experiment.
Tilburg Frailty Indicator
Time Frame: This scale will be applied before and after the 8-week experiment.
Tilburg Frailty Indicator was developed by Gobbens et al. (2010) and adapted into Turkish and its validity and reliability was conducted by Arslan et al. (2018). Tilburg Frailty Scale consists of two parts. Part A includes 10 questions about diseases and sociodemographic factors that determine frailty; Part B consists of three factors that are components of frailty, including a total of 15 questions. The score range varies between 0-15; 5 or more a high score point is considered as frailty in Tilburg Frailty Indicator.
This scale will be applied before and after the 8-week experiment.
Spiritual Well-Being Scale
Time Frame: This scale will be applied before and after the 8-week experiment.
Spiritual Well-Being Scale was developed by Ekşi and Kardaş (2017) for adults in order to determine the process of understanding and living their lives in personal, social, environmental and trascendental aspects in line with human values and ultimate meanings. The scale consists of 29 items and has a five-point Likert type. Seven questions in the scale (3, 7, 11, 15, 19, 23 and 26) are calculated inversely. The score that can be obtained from the scale is between 29-145. The higher the score obtained from the scale, the higher the level of spiritual well-being. Cronbach Alpha coefficient of the scale was found to be 0.886.
This scale will be applied before and after the 8-week experiment.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Ondokuz Mayıs University

Investigators

  • Study Director: İlknur Aydın Avci, Prof. Dr., Ondokuz Mayıs University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

July 1, 2025

Primary Completion (Estimated)

December 1, 2025

Study Completion (Estimated)

May 1, 2026

Study Registration Dates

First Submitted

September 22, 2024

First Submitted That Met QC Criteria

September 22, 2024

First Posted (Actual)

September 24, 2024

Study Record Updates

Last Update Posted (Actual)

June 12, 2025

Last Update Submitted That Met QC Criteria

June 11, 2025

Last Verified

September 1, 2024

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • OMU-2024-744

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

Clinical Trials on Frailty

Clinical Trials on Nature and Game Based Activities

Search Similar Trials

Sponsors and Collaborators

Medical Conditions

Drug Interventions

CROs by country

CROs in El Salvador

Conditions

Rare Diseases

Drug Interventions

Dietary Supplements

Sponsor/Collaborators

Locations

Subscribe