The effect of horticultural therapy on loneliness and life satisfaction in elderly adults living in nursing home

This study was conducted using a randomized controlled experimental design with pre-test, post-test, and follow-up measurements to evaluate the effect of horticultural therapy on loneliness and life satisfaction among older adults residing in a nursing home. The study population consisted of 380 older adults living in a nursing home. The sample size was determined through power analysis (n=48) and increased by 10% to account for potential data loss (n=54). Participants were randomized into a horticultural therapy intervention group (n=27) and a control group (n=27). Data were collected using "Information Form", "Loneliness Scale for the Elderly", and "Life Satisfaction Scale". In data analysis, descriptive statistics (mean, standard deviation, frequency, and percentage) were used. Group homogeneity was assessed with the chi-square test, and normality was evaluated using the Shapiro–Wilk test. As the data were not normally distributed, the Friedman test was used for within-group comparisons of pre-test, post-test, and follow-up measurements; the Wilcoxon Signed-Rank test for determining pairwise differences; and the Bonferroni correction for multiple comparisons. Between-group comparisons were performed using the independent samples t-test for normally distributed variables and the Mann–Whitney U test for non-normally distributed variables. Intent-to-treat (ITT) analysis was conducted prior to statistical analyses to address missing data. The results, in the intervention group receiving horticultural therapy, post-test and follow-up scores for social, emotional, and total loneliness on the Loneliness Scale for the Elderly, as well as Life Satisfaction Scale scores, differed significantly from pre-test scores (p<0.05). Between group comparisons indicated that intervention group had significantly lower emotional and total loneliness scores and significantly higher life satisfaction scores than control group at post-test and follow-up (p<0.05). No significant difference was observed between groups in social loneliness scores (p>0.05). In conclusion, the findings indicate that horticultural therapy is an effective therapeutic approach for reducing loneliness and enhancing life satisfaction among nursing home residents. Horticultural therapy as a novel method to support the mental health of older adults in care institutions would be beneficial.