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Accepted for/Published in: JMIR Research Protocols

Date Submitted: Oct 23, 2025
Date Accepted: Mar 16, 2026

The final, peer-reviewed published version of this preprint can be found here:

Play and Supportive Environments Among Older Adults in the Context of Swedish Municipal Care: Protocol for the Development and Psychometric Evaluation of an Instrument to Measure Playfulness

Westergren A, Bergman A, Knaust Lidén S, Nahlén Bose C, Nivestam A, Norell A, Nilsson Lindström P, Haak M

Play and Supportive Environments Among Older Adults in the Context of Swedish Municipal Care: Protocol for the Development and Psychometric Evaluation of an Instrument to Measure Playfulness

JMIR Res Protoc 2026;15:e86373

DOI: 10.2196/86373

PMID: 41973870

PMCID: 13075629

Play and Supportive Environments (PLAY-SE): Protocol for the Development and Psychometric Evaluation of an Instrument to Measure Playfulness among Older Persons in the Context of Swedish Municipal Care

  • Albert Westergren; 
  • Anna Bergman; 
  • Sofi Knaust Lidén; 
  • Catarina Nahlén Bose; 
  • Anna Nivestam; 
  • Annika Norell; 
  • Petra Nilsson Lindström; 
  • Maria Haak

ABSTRACT

Background:

This research program will provide a theoretically grounded and contextually relevant understanding of playfulness in later life. Playfulness – being and acting playful – is often associated with childhood, yet research shows it remains a meaningful resource throughout life. Among older persons playfulness can, most likely, support social connectedness and emotional well-being, even in contexts of illness or institutional living. Importantly, playfulness is not limited to outwardly playful actions but also reflects an inner disposition (e.g. curiosity, humor, or spontaneity) that may remain unexpressed due to environmental barriers, aging, or functional limitations. Despite its potential significance, playfulness remains underexplored in gerontological and nursing research, and no validated instrument exists to capture it in Swedish municipal care. This program addresses this gap by defining play and playfulness among older persons and developing a psychometrically robust instrument (PLAY-SE) to support research and practice.

Objective:

The overall aim of the program is to clarify and operationalize the interrelated concepts of playfulness and playful activities among older persons receiving municipal care, and to develop an instrument suitable for psychometric testing.

Methods:

The program applies a hybrid model of concept development and an exploratory sequential mixed methods design. In Phase 1, literature reviews and qualitative interviews with older persons and staff will clarify and describe meanings of playfulness. In Phase 2, these findings will inform item generation for the Play and Supportive Environments instrument (PLAY-SE), which will be evaluated through expert panels, cognitive interviews, and psychometric testing.

Results:

Results and Conclusions The research program advances caring science, policy, and practice by offering a validated tool to assess and support playful engagement as a dimension of well-being, dignity, and quality in municipal elder care.

Conclusions:

See above


 Citation

Please cite as:

Westergren A, Bergman A, Knaust Lidén S, Nahlén Bose C, Nivestam A, Norell A, Nilsson Lindström P, Haak M

Play and Supportive Environments Among Older Adults in the Context of Swedish Municipal Care: Protocol for the Development and Psychometric Evaluation of an Instrument to Measure Playfulness

JMIR Res Protoc 2026;15:e86373

DOI: 10.2196/86373

PMID: 41973870

PMCID: 13075629

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