The Effectiveness of Resilience Training on Increasing Mental Health and Reducing Loneliness in the Elderly

Abstract
Background: In today’s world, feelings of loneliness and declining mental health are among the most significant challenges of old age, which can lead to a reduction in the quality of life among older adults. Therefore, the present study aimed to determine the effectiveness of resilience training on mental health and loneliness in older adults.
Method: This quasi-experimental study employed a pretest–posttest design with a control group. The statistical population consisted of all older people residing in nursing homes in Tabriz, Iran. One nursing home was randomly selected, and subsequently, 30 people were recruited using convenience sampling and randomly assigned to experimental and control groups. The experimental group received resilience training in seven sessions, while the control group did not receive any intervention during this period. The Goldberg–Hiller General Health Questionnaire and the Russell Loneliness Scale were used as evaluation instruments. Data were analyzed using univariate analysis of covariance (ANCOVA) in SPSS version 26.
Results: The results showed a statistically significant difference between the two groups in terms of loneliness and mental health (p<.05). The findings demonstrated that resilience training had a significant effect on improving mental health and reducing loneliness in older adults.
Conclusion: The findings of this study suggest that resilience training can be utilized as an effective approach to enhance mental health and reduce feelings of loneliness in older adults.
EXTENDED ABSTRACT
 
Introduction
The growing population of older adults worldwide and in Iran underscores the necessity of addressing their psychological and social needs. In old age, reduced social interactions and changes in individual roles often lead to a decline in mental health and an increase in loneliness, which is considered one of the fundamental challenges of this stage of life. Loneliness can result in depression, anxiety, and diminished quality of life. In this context, resilience—defined as the ability to positively adapt to adverse conditions—may serve as a protective factor against psychological and social problems in the elderly. Previous studies have demonstrated that strengthening resilience enhances self-efficacy, emotional regulation, and social relationships. Accordingly, the present study aimed to examine the effectiveness of resilience training in improving mental health and reducing loneliness among elderly residents of a nursing home in Tabriz, offering a practical educational intervention to improve the psychological and social well-being of this vulnerable group.
 
Method
This study employed a quasi-experimental design with pretest–posttest and a control group. The statistical population included all elderly residents of a nursing home in Tabriz in 2024. Thirty participants were selected through convenience sampling and randomly assigned to experimental and control groups (15 participants per group). Inclusion criteria were age over 65 years, a minimum education level of secondary school, and scores below the mean on mental health and loneliness scales. Exclusion criteria included severe cognitive disorders and participation in other psychological interventions. Data collection instruments consisted of the Goldberg and Hillier General Health Questionnaire (1979) and the Russell Loneliness Scale (1980). The experimental group received resilience training in seven 90-minute sessions based on the Pennsylvania Resilience Training Protocol (Pourrahimi Marni et al., 2015), focusing on cognitive-emotional skills, problem-solving, effective communication, and managing negative thoughts. The control group received no intervention. Data were analyzed using univariate analysis of covariance (ANCOVA) with SPSS version 26. 
 
Results
Descriptive data indicated that the intervention had a positive effect on the general health and loneliness of participants in the experimental group. The mean scores of general health and its subscales (somatic symptoms, anxiety, social functioning, and depression) significantly decreased in the experimental group after the intervention, while no significant changes were observed in the control group. This pattern reflects an improvement in mental health due to the intervention. Similarly, the mean loneliness scores in the experimental group decreased from 47.36 in the pretest to 44.67 in the posttest, whereas the control group showed only a slight change (from 43.73 to 43.87), indicating a significant reduction in loneliness as a result of the intervention. ANCOVA (Table 1), after controlling for pretest scores, revealed significant differences between groups in both general health and loneliness (p < .001). For general health, the pretest effect was also significant (p < .004), suggesting that initial scores influenced posttest outcomes. The group effect was significant, explaining approximately 27% of the variance in general health changes. For loneliness, the pretest effect was not significant (p > .160), but the group effect was strong and significant, accounting for more than 55% of the variance in posttest loneliness scores (p < .001).
 
Both descriptive and inferential analyses indicated that the intervention led to improvements in general health and reductions in loneliness among participants in the experimental group. The effect of the intervention on general health was influenced by pretest scores, whereas the reduction in loneliness was clearly attributable to the intervention and not influenced by initial scores. These findings confirm that the implemented program had a positive and significant impact on enhancing mental health and reducing loneliness.
Conclusion
The findings of this study demonstrate that resilience training plays a significant role in improving mental health and reducing loneliness among older adults. Through enhancing self-awareness, strengthening coping skills, and fostering a positive outlook toward life challenges, resilience training facilitated better adaptation of the elderly to age-related and social conditions. The results are consistent with previous studies, suggesting that resilience can serve as a mediating construct in improving mental health and alleviating loneliness.
From an applied perspective, implementing resilience training programs in nursing homes can contribute to improving quality of life, increasing life satisfaction, and reducing psychological disorders in this population. It is recommended that mental health policymakers incorporate such training into rehabilitation and care programs for the elderly. Given the limitation of conducting the study in a single center with a small sample size, future research should replicate similar interventions with larger samples across different regions of the country.
Ethical Consideration
Ethical Code
Financial Support
This study did not receive financial support.
Authors’ Contributions
A.A: Conceptualization, Methodology, Data Curation, Software, Formal analysis, Writing - Original Draft; R.R: Methodology, Validation, Writing - Review & Editing, Supervision; A.A: Writing - Review & Editing, Supervision
Conflict of Interest
The authors had no conflicts of interest.
Acknowledgments
The authors sincerely appreciate the cooperation of the administrators of Mehr Nursing Home in Tabriz and all elderly participants who took part in this study. 
 
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