اثربخشی درمان کاهش تنیدگی مبتنی بر ذهن‌آگاهی بر تاب‌آوری و استرس ادراک شده سالمندان مقیم در سرای سالمندی

The increase of older population in Iran, along with various problems that threaten their physical and mental health, has led to inappropriate emotional reactions and stress-causing factors such as the reduction of resilience and escalation of stress in older community. Therefore, the present study was conducted with the aim of examine the effectiveness of mindfulness-based stress reduction therapy (MBSRT) on resilience and perceived stress in older residents of nursing homes. This was a quasi-experimental study using a pretest-posttest design with a control group. The statistical population of the research included all the older adults living in nursing homes of Kermanshah in 2023, among whom 30 people were selected using convenience sampling and according to inclusion and exclusion criteria and were randomly assigned into two experimental and control groups. The content of the therapy sessions was taken from Segal et al.’s perspective. The participants responded to the Connor-Davidson resilience scale and the Cohen et al.’s perceived stress questionnaire. The data were analyzed using univariate analysis of covariance (ANCOVA) in SPSS-26 software. The results revealed that the experimental group was significantly different from the control group in post-test in terms of both resilience and perceived stress variables. In other words, MBSRT improved resilience and reduced perceived stress in older adults (P<.05). According to the results of the present study, psychotherapists can use MBSRT for health-related interventions, especially to improve resilience and reduce perceived stress.
EXTENDED ABSTRACT
 Introduction
Aging is considered a natural and inevitable biological phenomenon, marking a sensitive stage in a person’s psychological transformation and bringing about certain physical, cognitive, and social changes. One of the characteristics that diminishes in older adults due to age-related issues is resilience. Resilience is among the most crucial factors for effectively confronting the challenges of any stage of life, particularly old age. Conversely, the decline in physical and mental functions among older adults tends to increase their perceived stress. Stress is perceived when there is a discrepancy between environmental demands and an individual’s perception of their ability to cope with those demands. Among the interventions that significantly impact understanding the psychological issues of older adults is Mindfulness-Based Stress Reduction Therapy (MBSRT). MBSRT is a psychotherapeutic practice involving paying full attention to present experiences in a moment-to-moment manner. Given the changes in the lives of older adults and the rise in their challenges, there needs to be corresponding adaptations in their care, and health caregivers should be able to address their needs. Due to the scarcity of comprehensive research on MBSRT concerning the resilience and perceived stress of older adults, the findings of this study could have practical implications for families with older members, counseling centers, psychological services, and older adults’ care facilities. Therefore, initiating research in this domain and extending it to other psychological aspects could yield valuable insights for enhancing the resilience and reducing the perceived stress of older adults. Consequently, this study aimed to investigate the effectiveness of MBSRT on the resilience and perceived stress of older residents in old age.
Method
This was a quasi-experimental study employing a pretest-posttest design with a control group. The population comprised all older individuals residing in the nursing centers of Kermanshah, Iran in 2023, selected using convenience sampling and according to inclusion and exclusion criteria of the study. Finally, 30 older individuals were randomly assigned to two groups of 15 members in each group. To conduct the current research, permission was obtained from the authorities overseeing the older adults, and the objectives, significance, and necessity of the study were communicated. Subsequently, all older participants were assessed for two variables of resilience and perceived stress. Then, 30 individuals scoring lower on the resilience questionnaire and higher on the perceived stress questionnaire were deemed eligible to participate and were assigned into experimental and control groups. The experimental group underwent eight 90-minute sessions of MBSRT during four weeks. Upon completion of the intervention, both groups were reassessed for resilience and perceived stress. Data from pre-test and post-test questionnaires were analyzed using descriptive statistics and univariate covariance analysis (ANCOVA) in SPSS-26 software.
Results
As indicated in the table below, the F statistic for resilience variables is 997.038, and for perceived stress, it is 538.941. All variables are significant at a level smaller than .001, indicating a significant difference between the two groups in both variables. Furthermore, there is a significant difference between the experimental and control groups regarding resilience. Specifically, MBSRT led to a significant increase in resilience in the experimental group, with an average resilience score of 84.600 compared to 63.46 in the control group. The effect size is .97, suggesting that 97% of individual differences in resilience scores are attributable to MBSRT. Hence, the first hypothesis was confirmed. Similarly, there was a significant difference between the experimental and control groups in terms of perceived stress. MBSRT resulted in a significant reduction in perceived stress in the experimental group, with an average score of 26.53 compared to 40.66 in the control group. The effect size is 0.95, indicating that 95% of individual differences in perceived stress scores are related to the effectiveness of MBSRT Thus, the second hypothesis was confirmed.
Conclusion
The results of ANCOVA demonstrated that mindfulness-based stress reduction therapy significantly influenced the resilience and perceived stress levels in older adults. Overall, this study highlighted the effectiveness of MBSRT in enhancing resilience and alleviating perceived stress among older adults. These findings hold  numerous  practical implications for therapists and healthcare professionals, particularly those working with older populations. Based on these results, therapists and healthcare providers can incorporate MBSRT into their interventions to enhance resilience and decrease perceived stress in older individuals. Furthermore, the outcomes of this study can inform healthcare system managers in implementing psychiatric initiatives aimed at preventing and addressing psychological issues among older adults. By promoting psychiatric services and adopting new educational and therapeutic strategies tailored for older adults, psychological problems can be effectively managed and even reduced within this demographic.
Ethical Consideration
Ethical Code
The present study was conducted independently with the necessary authorization from the Research Deputy of the Islamic Azad University, Islamabadgharb branch.
Financial Support
This study had no financial support
Conflict of Interest
The author had no conflicts of interest.
Acknowledgments
The author of this article extends their gratitude and appreciation to all older individuals residing in the nursing home who patiently participated in this research, as well as older adults’ officials of Kermanshah.
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