The Effect of Recreational Games on Happiness, Life Satisfaction, Loneliness, and Somatisation in Elderly Individuals

As per the United Nations population projections, the percentage of individuals aged 65 and older in the global population is expected to increase from 10% in 2022 to 16% by the year 2050. In response to this demographic shift, the United Nations emphasizes the importance of ageing countries establishing long-term sustainable care institutions and taking measures to ensure the adaptation of the elderly to these institutions. Recreational activities play a crucial role in supporting and encouraging elderly individuals to maintain active and productive lives in their old age while preserving their social roles.

Aim: To measure the influence of recreational games on somatisation, loneliness, happiness and life satisfaction among elderly individuals.

As per the United Nations population projections, the percentage of individuals aged 65 and older in the global population is expected to increase from 10% in 2022 to 16% by the year 2050. In response to this demographic shift, the United Nations emphasizes the importance of ageing countries establishing long-term sustainable care institutions and taking measures to ensure the adaptation of the elderly to these institutions. Recreational activities play a crucial role in supporting and encouraging elderly individuals to maintain active and productive lives in their old age while preserving their social roles.

Aim: To measure the influence of recreational games on somatisation, loneliness, happiness and life satisfaction among elderly individuals.

Method: This study employed a nonrandomized experimental design featuring pretest-posttest control groups. The study was conducted across two distinct nursing homes to prevent potential influence between individuals in the control and intervention groups.

The research was conducted from April to August 2018 within two nursing homes in Turkey. Inclusion criteria comprised individuals meeting the following conditions: 1) aged 65 years and above and residing in the designated nursing homes during the study duration; 2) expressing willingness to participate in the research; 3) attaining a score of 23 or higher (for individuals with five or more years of formal education) or 19 or higher (for those with fewer than five years of formal education) on the Standardized Mini-Mental State Examination for Educated and Uneducated Individuals (SMMSE); and 4) displaying openness to communication.

A power analysis, executed utilizing the G Power 3.0.10 software, determined the requisite number of participants for both the intervention and control groups. Given a type I error rate of 0.05, a type II error rate of 0.80, and an effect size of 0.5, it was established that a minimum of 27 participants were needed for each group. Considering the potential occurrence of missing data during the study, 40 participants meeting the inclusion criteria were applied to participants in both groups.

Data collection tools: The Standardized Mini-Mental State Examination for Educated and Uneducated Individuals (SMMSE) was utilized to ascertain the eligibility of older individuals for participation in the study. Data were collected utilizing a Personal Information Form, the Oxford Happiness Questionnaire Short Form (OHQ-S), the Satisfaction with Life Scale (SWLS), the De Jong Gierveld Loneliness Scale (DJGLS), and the Symptom Check-List Somatisation Subscale (SCL-90-R).

Game selection: After an extensive literature review, the researcher identified 15 games. These games were introduced to participants in the intervention group, enabling them to make informed selections subsequent to receiving instructions.

Interventions: Residents of the nursing homes where the study took place were informed about the research. The SMMSE was administered to individuals who expressed interest in taking part.

Application of pre-tests: OHQ-S, DJGLS, SWLS, and SCL-90-R were applied to a total of 80 individuals in both nursing homes who met the study inclusion criteria.

Selection of the games to be included in the application: One nursing home was allocated as the intervention group to minimize potential interaction between the groups, while the other was designated as the control group. During two sessions, 40 individuals in the intervention group were introduced to 15 games. Researchers conducted these sessions and provided participants with instructions and rules for the games. Then, they were asked to rate the games from 1 to 10. In this form, the elderly individuals evaluated the games by determining the minimum "1" and maximum "10" points according to their interest and willingness to play. Thus, it was ensured that individuals freely choose the games they want to play. As a result, bingo, matching pairs, word challenge and hot-cold games, which received the highest scores from the participants, were selected to be played.

Preparing the playground and organizing the groups: For the elderly to play games, a room on the ground floor of the institution with a sun-drenched, spacious sliding door opening to the garden was preferred. Five groups of 8 people were formed for the games. These groups were determined according to their wishes, taking into account the available hours of the elderly individuals. When one group completed the games, 15-20 minute breaks were given for that group to leave the room and for the other group to gather and prepare for the games.

Playing games: Participants in the intervention group engaged in bingo, matching pairs, word challenges, and hot-and-cold games, organized into groups of eight individuals. They adhered to the game instructions and participated in sessions twice a week for 2 months, totalling 16 sessions. The groups were formed by the requests of the participants, considering their available time. In each session, all individuals in the group played all four games, so one individual played 64 games in a total of 16 sessions. Sessions are planned to last 45 minutes.

Application of posttests: Individuals in the groups underwent administration of OHQ-S, DJGLS, SWLS, and SCL-90-R at two consecutive intervals: 1 week (post-test) and 1 month (follow-up-test) after the conclusion of the game.

Eligibility Criteria:
Inclusion Criteria:

* aged 65 years and above and residing in the designated nursing homes during the study duration,
* expressing willingness to participate in the research,
* attaining a score of 23 or higher (for individuals with five or more years of formal education) or 19 or higher (for those with fewer than five years of formal education) on the Standardized Mini-Mental State Examination for Educated and Uneducated Individuals,
* displaying openness to communication.

Exclusion Criteria:

* Unconscious
* Individuals who decline to participate in the study
* Individuals using antipsychotic medication