This research was planned to determine the effect of structured sandplay activities on positive and negative affect and levels of meaning in life in elderly individuals. The research will be conducted as a single-blind, randomized controlled trial with a pre-test, post-test design at the Gül Kokulu Çınarlar Vefa Konağı of the Isparta Municipality Health Affairs Directorate between July 2026 and July 2027. Prior to the research, ethical committee approval and institutional permission for implementation will be obtained. The research population consists of 400 individuals registered with the institution. The sample will consist of 60 individuals (30 in the intervention group and 30 in the control group) who meet the inclusion criteria, are selected using block randomization, and provide informed consent. The control group will receive no intervention; a pre-test will be administered on the first day, and a post-test will be administered on the day the intervention for the experimental group ends. The intervention group will participate in sandplay activities twice a week for a total of four sessions; a pre-test will be administered on the first day, and a post-test will be administered in the last session. Data collection is planned for the period between July 2026 and July 2027 using the Personal Information Form (PIF), the Positive-Negative Affect Scale (PANAS), and the Meaning in Life Scale (MLS). Data will be analyzed using the SPSS (Statistical Program for Social Sciences) statistical analysis package, and statistical significance will be accepted at p \< 0.05.
Old age is a period of life characterized by intense cognitive, physical, psychological, and social changes, where an individual's functionality may decrease and their psychosocial needs increase. The increasing elderly population worldwide and in Türkiye increases the need for effective interventions to protect the mental health of older individuals. During the aging process, factors such as chronic diseases, loss of physical function, retirement, loss of loved ones, loneliness, and reduced social roles can negatively affect individuals' psychological well-being, emotions, and sense of meaning in life. In addition, increased social isolation and the thought of approaching the end of life make the process of questioning the meaning of life more pronounced in older individuals. Current studies show that loneliness and decreased social participation negatively affect psychological well-being; conversely, meaningful social relationships and psychological resilience support life satisfaction and meaning in life. Meaning in life is a fundamental psychological resource that enables individuals to perceive their lives as purposeful, valuable, and holistic, and it is an important protective factor supporting mental health and successful aging in old age . Research shows that individuals with a high level of meaning in life have higher psychological well-being, life satisfaction, and positive affect; Studies show that depression, loneliness, and psychological distress are lower in this group. Jung's analytical psychology theory describes the second half of life as a crucial developmental period in which individuals re-evaluate their lives, integrate past experiences, and intensify their search for meaning in life. However, age discrimination, negative perceptions of aging, and unmet psychosocial needs can negatively impact this process; therefore, Neuroscience and expressive arts-based approaches demonstrate that nonverbal expression processes support emotional processing, the restructuring of life experiences, and psychological well-being . Meaning-focused interventions such as life assessment and expressive writing have been reported to increase meaning in life, reduce depressive symptoms, and support emotional well-being in older individuals. However, the number of experimental psychosocial interventions that address both meaning in life and positive-negative affect is limited. Sandplay is a creative psychosocial intervention that allows individuals to externalize, reinterpret, and express their inner experiences in a safe environment through symbols, addressing emotions, thoughts, and life experiences that they have difficulty expressing verbally. While it is stated that sandplay can support the restructuring of life experiences and the strengthening of meaning in life in older individuals, most studies in this area are limited to case reports or qualitative research . The lack of randomized controlled trials evaluating the effect of sandplay on meaning in life and positive and negative affect in older individuals constitutes a significant knowledge gap. Furthermore, in psychiatric nursing, it is necessary to address the individual's psychological, social, and existential needs holistically, not just their physical needs; It is recommended that creative interventions supporting therapeutic communication and emotional expression be integrated into the care process. In this context, evaluating the impact of structured sandplay activities on meaning in life and positive and negative affect in older adults will contribute to the development of evidence-based psychiatric nursing practices and the creation of alternative psychosocial interventions for older adults.holistic psychosocial interventions aimed at strengthening meaning in life are needed.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
SINGLE
Enrollment
60
Sandplay-Act Older (Structured Sandplay Activity for Older Individuals) is a structured sandplay activity developed to support older individuals in expressing their emotions, thoughts, and life experiences symbolically. The intervention consists of structured sessions where participants create scenes in a sand tray using miniature figures and make sense of their life experiences through these scenes. The program will be conducted twice a week for a total of four sessions. Each session will last approximately 60 minutes.
Participants in the control group will not participate in structured sand play activities during the study period. Participants will continue with the institution's routine care and social activities; however, no psychosocial interventions will be applied within the scope of the study.
Suleyman Demirel University
Isparta, Turkey (Türkiye)
Positive-Negative Emotion Scale (PANAS)
In this study, this scale was used to determine positive and negative emotions. The scale was created by Watson et al. (1988) and adapted into Turkish by Gençöz (2000). This scale, which has a total of 20 items and no reverse items, has 10 items that determine positive emotions and 10 items that determine negative emotions. In the Turkish form of the scale, it is a 5-point Likert type and is rated between "very little or none (1) and very much (5)". In the original form of the scale, the Cronbach's alpha reliability coefficient was reported as 0.88 and 0.85 for positive and negative emotions, respectively. Gençöz (2000), on the other hand, calculated the Cronbach's alpha values as 0.83 and 0.86 for positive and negative emotions in his research. In the study, Cronbach's alpha value was calculated as 0.81 for positive emotion and 0.79 for negative emotion.
Time frame: At baseline and immediately after completion of the fourth intervention session.
Meaning in Life Scale (MLS)
The level of meaning in life of adult individuals was measured using the Meaning in Life Scale (MLS), developed by Steger et al. (2006) and adapted into Turkish by Demirbaş (2010). The MLS consists of 10 items, comprising two sub-dimensions: the presence of meaning in life and the search for meaning in life. Participants rate the appropriateness of each item on a seven-point Likert scale ranging from definitely not true (1) to definitely true (7). Scores on the scale range from 10 to 70, with higher scores indicating a higher level of meaning in life. Demirbaş (2010) reported the internal consistency of the entire MLS as .86 in a sample of university students. The Cronbach alpha internal consistency reliability coefficient calculated in this study was .75, indicating an acceptable level of reliability (Yockey, 2011). An example item from the scale is, "I am aware of the meaning of my life."
Time frame: At baseline and immediately after completion of the fourth intervention session.
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