EFFECT OF FACE-TO-FACE AND VIRTUAL REALITY-BASED SALUTOGENESIS NURSING CARE IN PATIENTS WITH DEMENTIA

Overview

The purpose of this clinical study is to examine the effects of nursing care based on the Salutogenesis Model on the sense of coherence (meaningfulness, comprehensibility, and manageability) and quality of life of people living with dementia. The study will also evaluate whether delivering this nursing care face-to-face or through virtual reality leads to similar or different benefits, and whether these benefits are maintained over time. The main questions this study aims to answer are: Does face-to-face nursing care based on the Salutogenesis Model help people living with dementia strengthen their sense of coherence, cope better with daily life, and improve their quality of life? Does delivering the same nursing care using virtual reality lead to similar or different effects on sense of coherence and quality of life compared to face-to-face care? Do the positive effects of this nursing care continue after the intervention has ended? Researchers will compare three groups to answer these questions: a group receiving face-to-face nursing care based on the Salutogenesis Model, a group receiving the same nursing care using virtual reality, and a control group receiving usual care. Participants will take part in the study over a period of several months. During the study, participants will be asked to: Take part in nursing care sessions once a week for eight weeks Complete questionnaires that assess sense of coherence and quality of life Complete these questionnaires at the start of the study, after the eight-week nursing care program is completed (mid-term follow-up), and approximately three months after the interventions have ended (final follow-up) These assessments aim to evaluate both the short-term effects of the nursing care and whether these effects are sustained over the longer term. The results of this study are expected to contribute to the development of more supportive and innovative nursing care approaches for people living with dementia and to provide evidence on the use of virtual reality as a supportive tool in nursing care.

DETAILED DESCRIPTION This study is a randomized controlled experimental trial designed to evaluate the effects of nursing care based on the Salutogenesis Model on sense of coherence and quality of life in individuals living with mild to moderate dementia. The study compares the effectiveness of the same nursing care delivered through two different methods-face-to-face and via virtual reality (VR) headsets-against usual care. The Salutogenesis Model focuses on individuals' capacity to understand their life situations, manage daily challenges, and find meaning in their experiences. The central concept of the model is sense of coherence, which consists of three components: comprehensibility, manageability, and meaningfulness. This study applies the Salutogenesis Model as a holistic nursing framework to support people living with dementia by strengthening these components despite cognitive decline. Study Design and Setting The study will be conducted in Niğde Bor district, Türkiye, and coordinated through Bor State Hospital. All assessments and interventions will be carried out in participants' home environments to increase comfort, reduce barriers to participation, and reflect real-life conditions. Participants with mild to moderate dementia will be randomly assigned to one of three groups: Intervention Group 1 (MG1): Receives face-to-face nursing care based on the Salutogenesis Model Intervention Group 2 (MG2): Receives the same nursing care supported by virtual reality headsets Control Group: Receives usual care without additional structured nursing intervention Randomization will be performed using a computer-based simple randomization method by an independent researcher to minimize allocation bias. Intervention Procedures Both intervention groups will receive an eight-week nursing care program based on the Salutogenesis Model. Sessions will be conducted once per week and will last approximately 40-60 minutes. The content of the nursing care program is identical for both intervention groups and is structured to support: Meaningfulness: through life review, reminiscence activities, meaningful memories, music, and personalized activities Comprehensibility: through structured routines, clear explanations, environmental organization, and supportive communication Manageability: through problem-solving strategies, daily activity planning, medication routines, and strengthening personal and social resources In the VR-supported group, selected components of the intervention (such as reminiscence activities, meaningful environments, music, and visual stimuli) will be delivered using VR headsets, allowing participants to experience these elements in an immersive digital environment. The face-to-face group will receive the same content using traditional, in-person methods without VR. Data Collection and Follow-Up Outcome measures will be collected at three time points: Baseline assessment (before intervention) Post-intervention assessment (after the eight-week nursing care program) Follow-up assessment approximately three months after the intervention ends These follow-up assessments are designed to evaluate both short-term effects and the sustainability of the intervention outcomes over time. Primary outcomes include changes in sense of coherence (comprehensibility, manageability, and meaningfulness) and quality of life. Data will be collected using validated assessment tools administered through face-to-face interviews. Significance By comparing face-to-face and VR-supported delivery of Salutogenesis Model-based nursing care, this study aims to provide evidence on whether digital health technologies such as virtual reality can be used as effective and supportive tools in dementia nursing care. The findings are expected to contribute to the development of holistic, innovative, and sustainable nursing interventions that enhance quality of life and sense of coherence in people living with dementia.