The document presents a study on the effectiveness of horticulture therapy in reducing depression among institutionalized elderly individuals in an old age home in Salem, Tamil Nadu. The quantitative evaluative approach included pre- and post-test assessments with a sample of 30 participants, revealing a significant decrease in depression levels after the intervention. The findings suggest that horticulture therapy is a promising therapeutic modality for enhancing mental health in the elderly population.

1. HORTICULTURE THERAPY ON THE LEVEL
OF DEPRESSION AMONG
INSTITUTIONALIZED OLD AGE
POPULATION.
Presented by
Selvaraj.P
Ph.D Scholar
Vinayaka Mission’s Research Foundation
(Deemed to be University)
Salem

2. INTRODUCTION
• Worldwide, one in every nine people is aged 60 years and
above, and by 2050 the proportion is expected to increase
to one in every 5 people.(Guseh-2016)
• During the system of normal aging, there are
neurobiological changes like the loss of neurons and
psychosocial changes that negatively affect cognition and
social connectedness.(Yao; Chen-2017)
• Depression is a common illness worldwide, with an
estimated 3.8% of the population affected, including 5.0%
among adults and 5.7% among adults older than 60
years.(Al-Hamzawi A, et al-2018)
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3. • community-based mental health studies have revealed
that the prevalence of depressive disorders in the
elderly population of the world varies between 10%
and 20%, depending on cultural situations.(Barua: Kar-
2010)
• Depression has also been shown to be associated with
various psychosocial factors, lifestyle and dietary
factors, and the presence of chronic physical illness.
There is limited data on various therapeutic
interventions.
• The review of data suggests that the prevalence of
depression among the elderly in India is high. However,
there is a lack of data on symptom profiles and limited
data is available on various therapeutic interventions
for the management of depression in the elderly from
India. There is an urgent need to conduct large
multicentre studies to fill this void in research.(Grover-
2015) 3/17/2022 Selvaraj@VMRF(DU)

4. • Horticultural activity is aimed at achieving specific
goals. This could be for rehabilitative or vocational
purposes and thus, is often a process involving
active engagement.
• Therapeutic horticulture refers to any activity that
uses horticulture as a therapeutic modality to
support program goals. It describes both active and
passive involvement in plant and plant-related
activities.(AHTA-2018).
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Selvaraj@VMRF(DU)

5. STATEMENT OF PROBLEM
A study to assess the effectiveness
of Horticulture Therapy on the level
of depression among the
institutionalized old age population
in a selected old age home at
Salem. TamilNadu.
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6. MATERIALS AND METHODS
• Research approach: Quantitative evaluative approach
• Research Design: Pre-experimental (one group pre-test
post-test)
• Setting: Present study was carried out at St. Hendry’s
Home for the Aged, Alagapuram, Salem.
• Population: The population of the present study
comprised of older person (≥60yrs) residing in an old-
aged home in Salem.
• Sample: older person (≥60yrs) residing in the selected
old age home, Salem, were selected as samples.
• Sample Size: A total of 30 older persons residing in an
old-aged home were selected in the present study.
• Sampling technique: non-probability convenient
sampling technique was used.
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7. • Inclusion Criteria
• Aged ≥60yrs,
• Residing in a selected old age home, Salem,
• With a mild and moderate level of depression.
• Speak and understand Tamil / English.
• Willing to participate in this study.
• Exclusion criteria
• Not present at the time of collection of data,
• Diagnosed as having a mental illness.
• Having sensory impairments
• Who cannot follow activities for at least 30 minutes.
• Data Collection tool
• In the present study, a standardized TL Brink
Geriatric Depression Scale was used to collect the data
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8. Data collection procedure
Day 1
 Pre-test was conducted for 51 inmates
 30 subjects, who fulfilled inclusion criteria, were selected.
 The maximum time taken by the subject to complete the tool was 15-20
minutes
Day 2
 Provided with an overview of what is horticulture and its benefits, which
plant seedlings was to be used in the program and about the activities to
be carried out on each session.
 The schedule for activities was prepared with the participation of the
samples.
 Samples were divided into 3 groups (A, B & C) of 10 members each.
 The duration of preparatory session was 20- 30 minutes.
Day 3 –
Day 28
 Each group has attended the 30-minutes active session twice a week:
 Group – A: Mondays and Thursdays
 Group – B: Tuesdays and Fridays
 Group – C: Wednesdays and Saturdays
 While one group was attending the active session, others groups indulged
in passive activities

9. Intervention
Session Participants Activities
Day
2
Preparatory
Session
All the 30 samples of the study
- Overview about horticulture and horticulture
therapy
- Explanation of activities to be carried out in each
sessions
- Division of 30 samples into 3 groups of 10 members
(A, B & C).
- Preparation of schedule
Day Group
3
–
Day
28
Active
Session
Monday A
- Preparation of flower bed (session I)
- Planting of seedling (session II)
- Watering (daily)
- Weeding (as needed)
- Fertilizing (once in 2 weeks)
Tuesday B
Wednesday C
Thursday A
Friday B
Saturday C
Passive
Session
Monday B & C
- Walking around
- Admiring other participants’ plants
- Watching and listening to birds, insects and
butterflies
Tuesday A & C
Wednesday A & B
Thursday B & C
Friday A & C
Saturday A & B
en
Club
ion
Every
Saturday
(After 30- A, B & C
- Sharing the experiences, present and past
- Discussing about opinions in making the garden

10. RESULTS
SECTION-I Distribution of samples based on Demographic
Data.
• Out of 30 samples, 20 (66.67%) samples were between 60-69
years old,
• 15 (50%) were male residents,
• 15 (50%) were female residents.
• The educational status shows that 21 (70%) belonged to the
primary level,
• according to the previous occupation showed that majority, 7
(23.33%) were Daily casual labour/ coolie.
• The marital status shows 17 (56.66%) were
widows/widowers.
• Regarding the number of children, 15 (50%) samples had no
children.
• The mode of entry to the old age home shows that 26
(86.67%) were voluntarily admitted.
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11. Section II: Percentage distribution of samples by
their pre-test and post-test score on level of
depression.
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12. SECTION-III Comparison of Mean Pre-Test and Mean Post-
Test Depression Score among Samples
Table 1: Distribution of mean, standard deviation, range, mean score percentage and paired‘t’
value of pre-test and post-test score on level of depression among samples. n=30
Sl.
no
Area
Max.
Possible
score Pre-test depression score
Mean
score
%
Post-test depression
score
Mean
score
%
Paired
‘t’
value
Mean
SD
Range
Mean
SD
Range
1 Depression 30 15.47 3.40 10-22 51.57 11.87 4.71 7-18 39.57
13.58
*
*Significant at P<0.05 level df = 29 t29= 2.045

13. HYPOTHESIS
• Alternate hypothesis H1: The mean post- test score
will be significantly lesser than the mean pre- test
score on level of depression among samples.
• Statistical hypothesis H01: There will be no
significant difference between mean pre-test and
mean post-test score on level of depression among
samples.
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14. Section- III: Association between the pre- test score on level of
depression among samples and their selected demographic variables.
n=30
*- Not Significant at 0.05 level
Sl.
No
Demographic variable
Degree of
freedom
Chi-square
value
Table value
1 Gender 1 2.22 3.84*
2 Previous Occupation 4 3.295 9.49*
3 Marital Status 2 3.09 5.99*

15. DISCUSSION
• The results revealed that the mean score of
depression before the intervention was (15.47 ±
3.40). But after the intervention, the results
revealed that the mean scores of depression were
(11.87±4.71).
The results of the present study were supported by
the following study.
• Alston, Letitcia Y. (2010) conducted a study on
Horticultural therapy as an alternative treatment for
older adults with Major Depressive Disorder. The
results indicate that many depressive symptoms
such as feelings of sadness and low mood
decreased for participants in this group project.
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16. • Chan, H.Y., Ho, R.CM., Mahendran, R. et al.(2017)
conducted a Randomized Controlled Trial (RCT) to
evaluate the efficacy of HT in promoting the Asian
elderly’ mental health, cognitive functioning and
physical health.
• Results reveal that this RCT comprehensively
investigates the efficacy of a non-invasive
intervention, HT, in enhancing mental health,
cognitive functioning and physical health.
• The results have tremendous potential for
supporting future successful ageing programs and
applicability to larger populations.18
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17. • Kyung-Hee Kim, Sin-Ae Park,(2018), conducted an
experimental study to investigate the effect of a
horticultural therapy program on reducing middle-
aged women’s depression and anxiety and
improving their self-identity.
• Results showed that depression and anxiety scores
were significantly lower (p < 0.001) and self-identity
was significantly higher (p = 0.003) among the
experimental group compared to the control.
• The control group showed no significant changes in
study variables. The study Conclude that the
horticultural therapy program was effective at
decreasing depression and anxiety and improving
self-identity in middle-aged women.
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18. CONCLUSION
• A study to assess the effectiveness of Horticulture
Therapy on the level of depression among the
institutionalized old age population in selected old age
homes, Salem district for a period of four weeks.
• The findings revealed that the older adults living in the
old age home were exposed to horticulture therapy
had significant decrease in the post-test depression
score
• it was concluded that the horticulture therapy was
found to be effective in reducing the depression level of
institutionalized older population in the old age home
• In particular, more experimental studies are needed to
investigate between-group effects of HT on older adults

19. ACKNOWLEDGEMENT
• Sincere thanks to my guide Dr.Sasi.V Professor cum
vice-principal Vinayaka mission’s college of nursing,
Pondicherry. Vinayaka Mission’s Research
Foundation (Deemed to be university) Salem for her
valuable and expert guidance, constant advise,
timely support, cooperation throughout the study.
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20. REFERENCE
• Guseh JS. Aging of the world’s population. In:
Shehan CL, editor. Wiley Blackwell Encycl. Fam.
Stud. 1st ed. John Wiley & Sons, Inc.; 2016. p. 1–5.
• Yao, Y.F.; Chen, K.M. Effects of horticulture therapy
on nursing home older adults in southern Taiwan.
Qual. Life Res. 2017, 26, 1007–1014.
• Evans-Lacko S, Aguilar-Gaxiola S, Al-Hamzawi A, et
al. Socio-economic variations in the mental health
treatment gap for people with anxiety, mood, and
substance use disorders: results from the WHO
World Mental Health (WMH) surveys. Psychol Med.
2018;48(9):1560-1571.

21. • Barua, A., & Kar, N. (2010). Screening for depression
in elderly Indian population. Indian journal of
psychiatry, 52(2), 150–153.
https://doi.org/10.4103/0019-5545.64595
• Grover S, Malhotra N. Depression in elderly: A
review of Indian research. J Geriatr Ment Health
2015;2:4-15.
• American Horticultural Therapy Association. AHTA
definitions and positions paper. Available at:
https://www.ahta.org/ahta-definitions-and-
positions. Accessed November 1, 2018.
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22. • Alston, Letitcia Y.(2010) The Effectiveness of
Horticultural Therapy Groups on Adults with a
Diagnosis of Depression. All of SUNY Open Access
Repository http://hdl.handle.net/20.500.12648/4665
• Chan, H.Y., Ho, R.CM., Mahendran, R. et al. Effects of
horticultural therapy on elderly’ health: protocol of a
randomized controlled trial. BMC Geriatr 17, 192
(2017). https://doi.org/10.1186/s12877-017-0588-z
• Kyung-Hee Kim, Sin-Ae Park,(2018),Horticultural
therapy program for middle-aged women’s depression,
anxiety, and self-identify, Complementary Therapies in
Medicine,Volume 39,Pages 154-159,ISSN 0965-
2299,https://doi.org/10.1016/j.ctim.2018.06.008.
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23. Thanks to
All
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