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.

Background: Playfulness-being and acting playful-is often associated with childhood, yet evidence suggests that it remains a meaningful resource throughout life. In later life, playfulness may support social connectedness, emotional well-being, and a sense of agency, even in contexts of illness or institutional living. Playfulness encompasses not only observable playful activities but also an inner disposition, such as curiosity, humor, or spontaneity, which may be constrained by environmental barriers, aging, or functional limitations. Despite its potential relevance for health and person-centered care, playfulness remains underexplored in gerontological and caregiving research. No validated instrument currently exists to assess playfulness among older adults in Swedish municipal care. This research program addresses this gap by clarifying the concepts of play and playfulness and by developing and psychometrically evaluating a new instrument, Play and Supportive Environments (PLAY-SE). Objective: The overall aim of the program is to clarify and operationalize the interrelated concepts of playfulness and playful activities among older adults receiving municipal care and to develop an instrument suitable for psychometric testing. Methods: The program applies a hybrid model of concept development combined with an exploratory sequential mixed methods design. Phase 1 involves literature reviews and qualitative studies with older adults and staff to explore and define the lived meanings of playfulness. These findings inform item generation and refinement of the PLAY-SE instrument. Phase 2 includes content validation, cognitive interviews, pilot testing, and large-scale psychometric evaluation using both classical test theory and Rasch measurement theory. Results: Two PhD students were recruited to the program in September 2024 and September 2025, and an expert group was established in autumn 2025. The PhD students are funded, for four years each, by Kristianstad University (from 2024) and Red Cross University College (from 2025). Ethical approval for the qualitative studies in phase 1 was granted by the Swedish Ethical Review Authority (2025-00211-01; decision date: February 3, 2025). Data collection for qualitative interviews with older adults in municipal care was conducted between February and April 2025. Fifteen older adults (aged 68-100 y) were interviewed in nursing home settings. The phenomenological findings from phase 1.1 have been published in March 2026. Additional qualitative interviews and focus groups with staff are scheduled for 2026 to 2027. Pilot testing of the first version of the PLAY-SE instrument is planned for autumn 2026, followed by large-scale psychometric validation between 2027 and 2029. Conclusions: This program establishes a structured and theoretically grounded process for developing and validating an instrument to assess playfulness in later life. By integrating qualitative exploration with modern psychometric approaches, the PLAY-SE instrument is intended to support future research and contribute to the development of person-centered practices in municipal elder care.