Nature, HumanNCT06609408
The Effect of Nature and Game Based Activities on Older People
A study testing Nature and Game Based Activities in people with Nature, Human and Older People, run by Ondokuz Mayıs University at 1 site in Turkey (Türkiye).
Trial summary
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. Read more about this study
- Who is it for?
- Ages 65 years and older
- Conditions the study is for
- Nature, Human, Older People, Nursing Home
- What is being tested?
- Nature and Game Based Activities
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 52 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 1 Jul 2025to 1 May 2026
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 65 years and older
- All sexes
- No healthy volunteers
- Older adult
Who may be able to join
- 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.
Who cannot join
- 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.
Trial locations and contacts
1 site in 1 country.
Turkey (Türkiye)1 site
Ondokuz Mayıs University
Samsun, Atakum, 55200
İlknur Aydın Avci, Prof. Dr., 362 312 6341, ilknura@omu.edu.tr
About this study
Official title: 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.
Read more
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.
Read the 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.
- Conditions
- Nature, Human, Older People, Nursing Home, Happiness, Spiritual Well-being, Frailty
- Being tested
- Nature and Game Based Activities
- Keywords
- Nature, Older People, Nursing Home, Happiness, Spiritual Well-Being, Frailty, Cognition
- Medical subject headings
- Frailty
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Nature and Game Based ActivitiesOther
Individuals in experimental group will participate nature and game activities such as terrarium making, planting flowers, making puzzles in intervention.
| Study group | Role | What they receive |
|---|---|---|
| Experimental Group | Experimental | 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. Receives: Other: Nature and Game Based Activities |
| Control Group | No intervention | 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 being measured
The primary outcome is the main question the study is designed to answer.
Subjective Happiness Scale
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.
Measured: This scale will be applied before and after the 8-week experiment.
Standardized Mini Mental State Examination
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.
Measured: This scale will be applied before and after the 8 weeks experiment.
Tilburg Frailty Indicator
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.
Measured: This scale will be applied before and after the 8-week experiment.
Spiritual Well-Being Scale
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.
Measured: This scale will be applied before and after the 8-week experiment.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted24 Sep 2024
- Study start1 Jul 2025 (estimated)
- Primary completion1 Dec 2025 (estimated)
- Study completion1 May 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Nature, HumanStudies of the same condition, open and under way.
- More trials run by Ondokuz Mayıs UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Single blind randomised controlled mixed method trial
- Masking
- Double blind
- Who is masked
- Participant, Outcomes assessor
- Enrolment
- 52 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Ondokuz Mayıs University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Murselcan Kabakcı, Ondokuz Mayıs University
- Investigators
- İlknur Aydın Avci, Prof. Dr., Study director, Ondokuz Mayıs University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06609408
- Sponsor's protocol ID
- OMU-2024-744
- Status last verified
- Sep 2024
- First submitted
- 22 Sep 2024
- Last updated
- 12 Jun 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 12 Jun 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The Effect of Nature and Game Based Activities on Happiness, Spiritual Well-Being, Frailty and Cognitive Status of Older People in Nursing Home
- ClinicalTrials.gov ID
- NCT06609408
- Acronym / sponsor ID
- OMU-2024-744
- Conditions
- Nature, Human, Older People, Nursing Home, Happiness, Spiritual Well-being, Frailty
- Keywords
- Nature, Older People, Nursing Home, Happiness, Spiritual Well-Being, Frailty, Cognition
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 52 participants (estimated)
- Lead sponsor
- Ondokuz Mayıs UniversityUniversity, hospital or other
- Study start
- 1 Jul 2025 (estimated)
- Primary completion
- 1 Dec 2025 (estimated)
- Study completion
- 1 May 2026 (estimated)
- First posted
- 24 Sep 2024 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
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.
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 design
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, outcomes assessor)
- Number of arms
- 2
- Model description
- Single blind randomised controlled mixed method trial
| Arm | Type | Receives |
|---|---|---|
| Experimental Group | Experimental | Other: Nature and Game Based ActivitiesNature 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. |
| Control Group | No intervention | –Individuals in the control group will not participate in the intervention. Individuals in control group will continue their routine activities in nursing home. |
Who may qualify
- Ages
- 65 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Older adult
Key inclusion criteria (4 listed)
- 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.
Key exclusion criteria (3 listed)
- 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.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Nature and Game Based ActivitiesIndividuals in experimental group will participate nature and game activities such as terrarium making, planting flowers, making puzzles in intervention. | Other | Experimental Group |
Primary outcome
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.
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.
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.
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.
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 12 Jun 2025.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
İlknur Aydın Avci, Prof. Dr. study director
Ondokuz Mayıs University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Nature and Game Based Activities in people with Nature, Human and Older People, run by Ondokuz Mayıs University at 1 site in Turkey (Türkiye).
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: status not confirmed, as of the sponsor's last update on 12 Jun 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
Contact Mürselcan Kabakcı, PhD. (537 561 5067, murselcan28@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Subjective Happiness Scale (time frame: This scale will be applied before and after the 8-week experiment.). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 Jun 2025.