Effects of Horticulture on Frail and Prefrail Nursing Home Residents: A Randomized Controlled Trial

Objective: Frail nursing home residents face multiple health challenges as a result of their frail status. The aim of this study was to examine the effects of HT on the psychosocial well-being of frail and prefrail nursing home residents. Design: Randomized controlled trial. Setting: Nursing homes. Participants: One hundred eleven participants were randomly allocated into the intervention [horticultural therapy (HT)] and control (social activities) conditions. Intervention: HT group participants attended a weekly 60-minute session for 8 consecutive weeks. Control group activities were social in nature, without any horticulture components. Measurements: The outcome measures include happiness, depressive symptoms, self-efficacy, well-being, social network, and social engagement. The time points of measurement were at baseline (T-0), immediately postintervention (T-1), and 12 weeks postintervention (T-2). A modified intention-to-treat approach was adopted. A multivariate general estimating equation was used to analyze the data. Results: Forty-six and 50 participants received at least 1 session of the intervention and control condition protocol, respectively. A significant interaction effect between group and time was observed only on the happiness scale (beta = 1.457, P =.036), but not on other outcome variables. In a follow-up cluster analysis of those who received HT, a greater effect on subjective happiness (mean difference = 6.23, P <. 001) was observed for participants who were happier at baseline. Conclusion: HT was found to be effective in promoting subjective happiness for frail and prefrail nursing home residents. Its favorable effect suggests that HT should be used to promote the psychosocial wellbeing of those who are frail. (C) 2018 AMDA - The Society for Post-Acute and Long-Term Care Medicine.