Pilot Pragmatic Randomized Controlled Trial: Horticultural Therapy for Inpatient Older Adults in an Acute Care Hospital

NCT04654949 | Completed

• 1 other identifier: 2019/00211
• Study Type: interventional
• Target: 80
• Locations: 1 country
• Sites: 1

Brief Summary

This study aims to investigate the feasibility and effectiveness of Horticultural Therapy (HT) on engagement, mood, and quality of life (QoL) of older adults in geriatric acute care in Singapore. Investigators will also assess the effectiveness of HT on mobility and hospitalisation experience. This pilot study could inform how HT can be implemented in geriatric acute care and its effect on hospitalisation experience and recovery of function.

Conditions

Frailty; Hospitalism

Keywords

Horticultural Therapy; Randomized controlled trial

Outcome Measures

Primary Outcomes (4)

• Average Score of Engagement Assessed by Menorah Park Engagement Scale (MPES)

  MPES consists of four different types of engagement: "constructive", "passive", "self" and "none" (Judge, Camp \& Orsulic-Jeras, 2000). Each type of engagement is recorded on five-minutes intervals during the 30-minutes sessions for both intervention and control group. The score of 0, 1 and 2 represent engagement "not observed", "observed for less than two and a half minutes" and "observed for more than two and a half minutes" respectively. The average score of each type of engagement for all sessions during assessment period is compared between the two groups. The assessment period is five days, or from recruitment date to participants' discharge date from the acute care hospital.

  Five days

• Average Score of Mood Assessed by Apparent Affect Rating Scale (AARS)

  AARS consists of five different domains of mood: pleasure, general alertness, anxiety/ fear, anger and sadness (Lawton, Haitsma \& Klapper, 1996). Each domain of mood is recorded on five-minutes intervals during the 30-minutes sessions for both intervention and control group. The score of 0, 1 and 2 represent engagement "not observed", "observed for less than two and a half minutes" and "observed for more than two and a half minutes" respectively. The average score of each domain of mood for all sessions during assessment period is compared between the two groups. The assessment period is five days, or from recruitment date to participants' discharge date from the acute care hospital.

  Five days

• Change in Mobility Performance Assessed by Modified Perme ICU scale

  Change in mobility performance from baseline (before randomization) to last session during the assessment period is measured by the modified Perme ICU scale (Perme, Nawa, Winkelman \& Masud, 2014). The mobility domains of "bed mobility", "transfers" and "gait" are recorded with the score of 0 to 7, indicates for "total assistance", "maximum assistance", "moderate assistance", "minimal assistance", "contact guard", "standby assistance", "supervision" and "independent" respectively. The assessment period is five days, or from recruitment date to participants' discharge date from the acute care hospital.

  Five days

• Change in Quality of Life Assessed by the EQ-5D

  Change in quality of life is measured by the change in the score of the EuroQol EQ-5D from baseline (before randomization) to last session during the assessment period (Brooks \& Charro, 1996). The EQ-5D covers five dimensions on health status - mobility, self-care, usual activities and anxiety/depression using 5 response levels - no problem, slight problem, moderate problem, severe problem and extreme problem. The assessment period is five days, or from recruitment date to participants' discharge date from the acute care hospital.

  Five days

Secondary Outcomes (3)

• Number of Transitions in the Mobility Status

  Five days

• Change in Emotion Assessed by Emoticon Scale

  5 days

• Hospitalisation Experience Questionnaire

  Five days

Study Arms (2)

Horticultural Therapy

EXPERIMENTAL

The Horticultural Therapy group receives 30 minutes of horticultural therapy activities using mobile horticulture kits conducted by therapists or therapy assistants to engage participants at their bedside.

Other: Horticultural Therapy

Existing Care

NO INTERVENTION

The existing Care group receives 30 minutes of routine ward-based engagement leisure activities (e.g. watching television, reading newspapers, etc).

Interventions

Horticultural Therapy OTHER

The horticultural therapy sessions are conducted by the occupational therapists or therapy assistants using the mobile horticultural kits. The horticultural activities are designed to stimulate the senses through interaction with specific tasks and the environment, promote social interaction, mobility and also promote a sense of self-worth through various horticultural activities such as planting seeds, transplanting plants, trimming and watering plants.

Horticultural Therapy

Eligibility Criteria

• Age: 70 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Older Adult (65+)

You may qualify if:

• years old and above
• an inpatient in Khoo Teck Puat Hospital
• able to understand simple instructions (with abbreviated mental test's score of 6 and above)
• have stable vital signs - blood pressure, heart rate and peripheral capillary oxygen saturation - to take part in horticultural therapy activities

You may not qualify if:

• on contact or droplet precaution
• diagnosed with severe auditory-visual impairments
• have major depressive disorder
• have endocrine disorders
• on steroid-based medications such as asthma and allergies that might affect the salivary cortisol level
• on the Dangerously Ill List

Sponsors & Collaborators

• Khoo Teck Puat Hospital: lead

Study Sites (1)

Khoo Teck Puat Hospital

Singapore, 768828, Singapore

Location

Related Publications (1)

• Nicholas SO, Giang AT, Yap PLK. The Effectiveness of Horticultural Therapy on Older Adults: A Systematic Review. J Am Med Dir Assoc. 2019 Oct;20(10):1351.e1-1351.e11. doi: 10.1016/j.jamda.2019.06.021. Epub 2019 Aug 8.

  PMID: 31402135 BACKGROUND

MeSH Terms

Conditions

Frailty

Interventions

Horticultural Therapy

Condition Hierarchy (Ancestors)

Pathologic Processes; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Complementary Therapies; Therapeutics; Psychotherapy; Behavioral Disciplines and Activities

Study Officials

• Thuy-Anh Giang

  Khoo Teck Puat Hospital

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: October 27, 2020
• First Posted: December 4, 2020
• Study Start: August 6, 2019
• Primary Completion: September 5, 2022
• Study Completion: September 5, 2022
• Last Updated: August 28, 2023

Record last verified: 2023-08

Locations

SG (1)