اثربخشی خاطره‌پردازی بر سرزندگی ذهنی و همجوشی شناختی در سالمندان

Abstract
Background: Mental vitality and cognitive fusion with negative thoughts and emotions are prominent psychological issues during later life that can be influenced by psychological interventions. Therefore, this study aimed to determine the effectiveness of reminiscence on mental vitality and cognitive fusion in older adults.
Method: This quasi-experimental study employed a pretest-posttest design with a control group. The statistical population included all older adults residing in nursing homes, among which one nursing home was selected through convenience sampling. A total of 32 participants were selected based on eligibility criteria and randomly assigned to experimental and control groups. Participants responded to Ryan and Frederick’s Mental Vitality Scale and Gillanders et al.’s Cognitive Fusion Questionnaire. The reminiscence intervention was conducted over two months in eight 60-minute weekly sessions. Data were analyzed using univariate analysis of covariance (ANCOVA) in SPSS-26 software.
Results: In the posttest, the mean scores of mental vitality increased, whereas the mean scores of cognitive fusion decreased. After controlling for pretest scores, a significant difference was observed between the experimental and control groups in the aforementioned variables, indicating that reminiscence was effective in enhancing mental vitality and reducing cognitive fusion (P<.001). Gender did not play a significant role in the differences between the two groups in the posttest scores of mental vitality and cognitive fusion (P>.05).
Conclusion: Reminiscence can be utilized as a beneficial strategy for improving psychological issues in older adults. These findings carry practical implications for the development of reminiscence-based interventions aimed at enhancing mental vitality and reducing cognitive fusion in older people.
EXTENDED ABSTRACT
 Introduction
Mental vitality and cognitive fusion are prominent psychological factors in older adults, playing a key role in enhancing quality of life, preventing mental disorders, and improving physical and psychological health. Consequently, many psychological interventions aim to increase mental vitality, reduce cognitive fusion, and promote defusion from negative thoughts during this stage of life. Reminiscence is one of the effective psychotherapeutic approaches for older adults, focusing on reconstructing and reinterpreting past life experiences. It has demonstrated positive effects on various dimensions, including resilience, sense of meaning and coherence, mental vitality and well-being, cognitive functioning, psychological inflexibility, cognitive fusion, and health-related quality of life. The growing aging population in Iran has led to challenges in multiple domains, such as physical health, psychological issues, isolation and loneliness, and socioeconomic concerns for both older adults and their families. These challenges underscore the importance of addressing the needs of this population, with psychological interventions becoming an essential component of care. Given the gap in previous research and the increasing prevalence of aging-related problems, particularly the decline in mental vitality and heightened cognitive fusion, this study was conducted to examine the effectiveness of reminiscence on mental vitality and cognitive fusion in older adults.
Method
This was a quasi-experimental study with pretest-posttest and a control group design. The statistical population included all older adults residing in nursing homes in Karaj, Iran, in 2023–2024. One center was selected through convenience sampling. Based on a medium effect size from previous studies (0.54), a statistical power of 0.95, considering two covariates, and an alpha level of 0.05, the sample size was calculated using G*Power software to be 32 participants. Inclusion criteria were (1) age over 60, (2) ability to read and write, (3) willingness to participate in the study, and (4) scoring at least 10 on the Mental Vitality Scale and 15 on the Cognitive Fusion Questionnaire. Exclusion criteria were (1) chronic medical conditions, (2) psychiatric or neuropsychological disorders, especially memory disorders, Alzheimer’s dementia, and Parkinson’s disease (based on self-report, physician diagnosis, and medical records), and (3) receiving concurrent psychological interventions or participating in similar psychoeducational programs. Participants completed the Ryan and Frederick’s Subjective Vitality Scale (SVS) and the Gillanders et al.’s Cognitive Fusion Questionnaire (CFQ). The reminiscence intervention was administered to the experimental group over two months in eight 60-minute weekly sessions. The control group did not receive any intervention. Data were analyzed using univariate analysis of covariance (ANCOVA) in SPSS-26 software.
Results
Results indicated that the mean posttest score for mental vitality in the experimental group was M = 20.69, showing an increase compared to the pretest score of M = 19.06. Additionally, the mean posttest score for cognitive fusion in the experimental group was M = 24.75, reflecting a decrease from the pretest score of M = 27.44. Assumptions for statistical analysis were met: Levene’s test (F = 0.263, p > .05) confirmed homogeneity of variance between groups. The Kolmogorov–Smirnov test yielded significance levels of p = .232 and p = .084 for pretest and posttest respectively, while the Shapiro–Wilk test showed values of p = .192 and p = .143, indicating normal distribution of data. The assumption of homogeneity of regression slopes was also satisfied (p = .151, p > .05). Therefore, univariate ANCOVA was used to assess the significance of changes due to the intervention and the effect of pretest scores (Table 1).
Table 1 indicates that reminiscence had a statistically significant effect on mental vitality (p < .05). Based on the η² value, more than 41% of the variance in mental vitality was attributable to the impact of the intervention. Similarly, reminiscence significantly affected cognitive fusion (p < .05), with over 37% of the variance explained by the therapeutic effect. Therefore, the experimental group outperformed the control group in the post-test. Gender, as a covariate, did not have a significant effect on post-test scores of mental vitality or cognitive fusion (p > .05).
Conclusion
The effectiveness of reminiscence in enhancing mental vitality among older adults can be explained by the psychological stability gained when individuals are given the opportunity to revisit and reflect on past life experiences with satisfaction and joy. This process fosters renewed energy for engaging in activities and improves mood. Through cognitive reconstruction and reflection on life events, individuals expand their understanding and interpretation of their personal life history, which directly influences emotional well-being and increases mental vitality. Furthermore, the impact of reminiscence on reducing cognitive fusion can be attributed to its role in improving attitudes toward aging and facilitating emotional, behavioral, and cognitive changes through the release from depressive thoughts. This leads to greater self-awareness and improved quality of life, ultimately reducing cognitive fusion and enhancing overall functioning. Thus, reminiscence, by promoting defusion from maladaptive thoughts and encouraging positive focus on past experiences, serves as an effective psychological intervention for addressing mental health challenges in older adults. These findings offer practical implications for designing reminiscence-based interventions aimed at improving mental vitality and reducing cognitive fusion in this population.
Ethical Consideration
Ethical Code
This study was approved by the Ethics Committee of Alborz University of Medical Sciences (IR.ABZUMS.REC.1400.273).
Financial Support
This study did not receive financial support.
Authors’ Contributions
B. Kh: Software, Validation, Formal analysis, Data curation, Investigation, Writing-Review & editing; I.R.B: Conceptualization, Methodology, Project administration, Supervision, Writing-Review & editing.
Conflict of Interest
The authors had no conflicts of interest.
Acknowledgments
The authors express their sincere gratitude to the staff of Mahya Residential Care Center for their valuable cooperation throughout the study. Special thanks are extended to the older adults who participated with patience, dedication, and generosity, making this research possible.
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