Volume 19, Issue 2 (Summer 2024)                   Salmand: Iranian Journal of Ageing 2024, 19(2): 242-257 | Back to browse issues page

XML Persian Abstract Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Sarrami Foroushani N, Mohammadkhani P, Rasti J. The Effectiveness of Mindfulness-Based Cognitive Therapy on the Symptoms of Pain Perception in Older Women. Salmand: Iranian Journal of Ageing 2024; 19 (2) :242-257
URL: http://salmandj.uswr.ac.ir/article-1-2628-en.html
The Effectiveness of Mindfulness-Based Cognitive Therapy on the Symptoms of Pain Perception in Older Women
Nasibeh Sarrami Foroushani1 , Parvaneh Mohammadkhani * 2, Javad Rasti3
1- Department of Psychology, Faculty of Humanities Science and Arts University, Yazd, Iran.
2- Department of Clinical Psychology, Faculty of Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. , pa.mohammadkhani@uswr.ac.ir
3- Department of Biomedical Engineering, Faculty of Engineering University of Isfahan, Isfahan, Iran.
Keywords: Mindfulness-based cognitive therapy, Pain intensity, Older women
Full-Text [PDF 7477 kb]   (621 Downloads)     |   Abstract (HTML)  (1927 Views)
Full-Text:   (507 Views)
Introduction
One of the common problems in individuals over the age of 60 is chronic pain. Pain and its consequences represent a fundamental public health challenge during the elderly years. According to researches, the prevalence of chronic pain in older women is more than twice that of older men [12]. The intensity and perception of pain in the elderly are influenced by various factors, which affect their quality of life. Among the non-pharmacological interventions known to be effective in improving issues related to chronic pain in the elderly, one can mention mindfulness-based cognitive therapy. Utilizing mindfulness techniques leads to an increased level of body awareness. Furthermore, mindfulness emphasizes purposeful, non-judgmental attention, accompanied by acceptance, which results in reducing pain severity and suffering in the elderly [36]. Considering the potential of this approach, the present research aims to investigate the effectiveness of mindfulness-based cognitive therapy on pain perception indicators in older women.

Methods
The present study was semi-experimental research consisting of an experimental group and a control group, evaluated in three stages: pre-test, post-test, and one-month follow-up. The statistical population of the research included all women aged 60 and above residing in Isfahan in the year 2023. From this population, 30 individuals were selected using available sampling and randomly assigned to the experimental and control groups. The research procedure involved selecting participants based on inclusion criteria, and after evaluating them with a Mini-Mental Status Examination test, eligible individuals were allocated to the experimental and control groups. Subsequently, the purpose of the study were explained to the participants, and their questions regarding the session’s process were addressed. After obtaining informed consent forms, the intervention began for the experimental group.
The experimental group received mindfulness-based cognitive therapy in eight weekly group sessions, each lasting 120 minutes. Meanwhile, the control group did not receive any treatment during the study period. After completing the intervention sessions, the intervention was offered voluntarily to the control group. Immediately after the end of the sessions, a post-test was conducted, and a follow-up test was conducted 30 days later. To examine the differences between the pre-test, post-test, and follow-up test stages, repeated measures analysis of variance (ANOVA) was used. Additionally, Benferroni test ‌were employed for pairwise comparisons, and data analysis was conducted using SPSS software, version 25.

Results
The mean age of participants in the experimental group was reported as 37.3±7.64, while in the control group, it was 57.3±20.64. Furthermore, the mean of pain perception scores for the experimental and control groups in the post-test stage were 67.22 and 13.35, respectively, and in the follow-up stage, they were 60.23 and 7.35, respectively. The Shapiro-Wilks test results indicated the normal distribution of data for the post-test and follow-up stages in both groups (test statistic values ranged from 0.88 to 0.90, P>0.05).
Based on the results of the repeated measures ANOVA, the time effect on subscales and the total pain perception score was significant. In other words, there was a significant difference between the mean scores of the three assessment stages (pre-test, post-test, and follow-up) for all subscales and the total score (P<0.01). The interaction effect between group and time was also significant for all subscales and the total pain perception score, indicating that there was a significant difference between the mean scores of the experimental group, which received mindfulness-based cognitive therapy, and the control group in all assessment stages (P<0.05).
Furthermore, considering the significance of the group effect on all subscales and the total score, a significant difference existed between the group receiving mindfulness-based cognitive therapy and the control group (P<0.05). Additionally, the Bonferroni post-hoc test results indicated the effectiveness of the intervention in the post-test and follow-up stages for all subscales compared to the control group (P≤0.05).

Conclusion
The aim of the present study was to investigate the effectiveness of mindfulness-based cognitive therapy on pain perception symptoms in older women in Isfahan. The results indicated the efficacy of this approach in improving overall pain perception scores and its subscales in the experimental group compared to the control group, and this effectiveness was maintained even during the follow-up phase. Mindfulness-based cognitive therapy had an impact on specific brain regions, leading to changes in cognitive patterns and individual attitudes towards pain. Techniques focused on body awareness, mindful breathing, and being present in the moment had positive effects on cognitive and information processing systems [47]. Mindfulness techniques guided individuals towards a therapeutic path where, instead of getting entangled in automatic mental processes, they became aware of their thoughts and bodily sensations in the present moment, leading to greater acceptance and reducing pain catastrophizing in them [48].

Ethical Considerations

Compliance with ethical guidelines
For this study, ethical approval was obtained from the Ethics Committee of Mashhad Academic Center for Education, Culture and Research (Code: IR.ACECR.JDM.REC.1402.003). The study was registered by the Iranian Registry of Clinical Trials (Code: IRCT20230209057367N1).

Funding
This article was extracted from the PhD thesis of Nasibeh Sarrami Foroushani in psychology at the Faculty of Humanities, University of Science and Art, Yazd, Iran. The research has not received any financial resources from government, private and non-profit organizations.

Authors' contributions
Validation: Parvaneh Mohammadkhani and Javad Rasti; Investigation: Parvaneh Mohammadkhani; Draft preparation, visualization, and resources: Nasibeh Sarrami Foroushani; Editing & review: Javad Rasti and Parvaneh Mohammadkhani; Supervision: Javad Rasti; Conceptualization, methodology, and data analysis: All authors. 

Conflicts of interest
The authors declared no conflict of interest.

Acknowledgments
The authors would like to thank to the Retirement Center of Isfahan Province and all senior women who participated in this study for their cooperation.



 
Refrences
  1. Briggs AM, Cross MJ, Hoy DG, Sànchez-Riera L, Blyth FM, Woolf AD, et al. Musculoskeletal health conditions represent a global threat to healthy aging: A report for the 2015 World Health Organization world report on ageing and health. The Gerontologist. 2016; 56(Suppl 2):S243-55. [DOI:10.1093/geront/gnw002] [PMID]
  2. Abdolahrezaee N, Khanmohammadi A, Dadfar M, Rashedi V, Behnam L. Prediction of hope, physical health, and mental health by mediating variable of religious spiritual well-being in elderly. Mental Health, Religion & Culture. 2020; 23(10):928-40. [DOI:10.1080/13674676.2020.1819220]
  3. Cai Y, Song W, Li J, Jing Y, Liang C, Zhang L, et al. The landscape of aging. Science China Life Sciences. 2022; 65:2354–454. [Link]
  4. International Association for the Study of Pain. Task Force on Taxonomy. Classification of chronic pain: Descriptions of chronic pain syndromes and definitions of pain terms. Washington: IASP Press; 1994. [Link]
  5. Macintyre PE, Schug SA. Acute pain management: A practical guide. Boca Raton: Crc Press; 2021. [DOI:10.1201/9780429295058]
  6. Reid MC, Eccleston C, Pillemer K. Management of chronic pain in older adults. BMJ. 2015; 350:h532. [DOI:10.1136/bmj.h532] [PMID] [PMCID]
  7. Cravello L, Di Santo S, Varrassi G, Benincasa D, Marchettini P, de Tommaso M, et al. Chronic pain in the elderly with cognitive decline: A narrative review. Pain and Therapy. 2019; 8(1):53-65. [DOI:10.1007/s40122-019-0111-7] [PMID] [PMCID]
  8. Hatefi M, Tarjoman A, Borji M. Do Religious Coping and Attachment to God Affect Perceived Pain? Study of the Elderly with Chronic Back Pain in Iran. Journal of Religion and Health. 2019; 58(2):465-75. [DOI:10.1007/s10943-018-00756-9] [PMID]
  9. Santos KAS, Cendoroglo MS, Santos FC. Anxiety disorder in elderly persons with chronic pain: Frequency and associations. Revista Brasileira de Geriatria e Gerontologia. 2017; 20(1):91-8. [DOI:10.1590/1981-22562017020.160033]
  10. Zis P, Daskalaki A, Bountouni I, Sykioti P, Varrassi G, Paladini A. Depression and chronic pain in the elderly: Links and management challenges. Clinical Interventions in Aging. 2017; 12:709-20.  [DOI:10.2147/CIA.S113576] [PMID] [PMCID]
  11. Hruschak V, Flowers KM, Azizoddin DR, Jamison RN, Edwards RR, Schreiber KL. Cross-sectional study of psychosocial and pain-related variables among patients with chronic pain during a time of social distancing imposed by the coronavirus disease 2019 pandemic. Pain. 2021; 162(2):619-29. [DOI:10.1097/j.pain.0000000000002128] [PMID] [PMCID]
  12. Ford-Gilboe M, Varcoe C, Wuest J, Campbell J, Pajot M, Heslop L,  Perrin N. Trajectories of depression, post-traumatic stress, and chronic pain among women who have separated from an abusive partner: A longitudinal analysis. Journal of Interpersonal Violence. 2023; 38(1-2):1540-68.‏ [DOI:10.1177/08862605221090595]
  13. Shirazi M, Manoochehri H, Zagheri Tafreshi M, Zayeri F, Alipour V. [Prevalence of chronic pain and its characteristics among elderly people in Ahvaz city: A cross sectional study (Persian)]. Journal of Geriatric Nursing. 2015; 2(1):62-78. [Link]
  14. Ross AR, Al-Aqaba MA, Almaazmi A, Messina M, Nubile M, Mastropasqua L, et al. Clinical and in vivo confocal microscopic features of neuropathic corneal pain. The British Journal of Ophthalmology. 2020; 104(6):768-75. [DOI:10.1136/bjophthalmol-2019-314799] [PMID]
  15. Khanzadeh M, Aminimanesh S, Taheri M, Aghamohammadi S. [The relationship between emotional schema and pain perception in the elderly: The mediation role of emotional regulation (Persian)]. Aging Psychology. 2021; 7(4):343-31. [DOI:10.22126/jap.2021.6351.1525]
  16. El Tumi H, Johnson MI, Dantas PBF, Maynard MJ, Tashani OA. Age-related changes in pain sensitivity in healthy humans: A systematic review with meta-analysis. European Journal of Pain. 2017; 21(6):955-64. [DOI:10.1002/ejp.1011] [PMID]
  17. Murray CB, Patel KV, Twiddy H, Sturgeon JA, Palermo TM. Age differences in cognitive-affective processes in adults with chronic pain. European Journal of Pain. 2021; 25(5):1041-52. [DOI:10.1002/ejp.1725] [PMID] [PMCID]
  18. Kabat-Zinn J. Full catastrophe living (revised edition): Using the wisdom of your body and mind to face stress, pain, and illness. New York: Random House Publishing Group; 2013. [Link]
  19. Hussain N, Said ASA. Mindfulness-based meditation versus progressive relaxation meditation: Impact on chronic pain in older female patients with diabetic neuropathy. Journal of Evidence-Based Integrative Medicine. 2019; 24:2515690X19876599. [DOI:10.1177/2515690X19876599] [PMID] [PMCID]
  20. Sharifi A, Bakhtiyarpour S, Naderi F, Askary P. [Predicting the quality of life of the elderly based on mindfulness with the mediation of death anxiety (Persian)]. Rooyesh-e-Ravanshenasi Journal. 2022; 11(9):135-44. [Link]
  21. Lindayani L, Hendra A, Juniarni L, Nurdina G. Effectiveness of mindfulness based stress reduction on depression in elderly: A systematic review. Journal of Nursing Practice. 2020; 4(1):8-12. [DOI:10.30994/jnp.v4i1.101]
  22. Lutz A, Chételat G, Collette F, Klimecki OM, Marchant NL, Gonneaud J. The protective effect of mindfulness and compassion meditation practices on ageing: Hypotheses, models and experimental implementation. Ageing Research Reviews. 2021; 72:101495. [DOI:10.1016/j.arr.2021.101495] [PMID]
  23. Kabirinasab Y, Abdollahzadeh H. [Effects of training mindfulness-based acceptance and commitment on cognitive flexibility and resilience of the elderly in Behshahr City (Persian)]. Advances in Cognitive Sciences. 2018; 19(4):20-7. [Link]
  24. Kabat-Zinn J. Mindfulness-based stress reduction (MBSR). Constructivism in the Human Sciences. 2003; 8(2):73-83. [Link]
  25. Teasdale JD, Moore RG, Hayhurst H, Pope M, Williams S, Segal ZV. Metacognitive awareness and prevention of relapse in depression: Empirical evidence. Journal of Consulting and Clinical Psychology. 2002; 70(2):275-87. [DOI:10.1037/0022-006X.70.2.275] [PMID]
  26. Rafee M, Sabahi P, Makvand Hosseini S. [Effectiveness of mindfulness-based cognitive therapy on depression, anxiety, stress and quality of life in elderly men living in nursing homes (Persian)]. Medical Journal of Mashhad University of Medical Sciences. 2020; 62(5.1):871-9. [DOI:10.22038/mjms.2020.16262]
  27. Young LA, Baime MJ. Mindfulness-based stress reduction: Effect on emotional distress in older adults. Journal of Evidence-Based Integrative Medicine. 2010; 15(2):59-64. [DOI:10.1177/1533210110387687]
  28. Williams JMG. Mindfulness and psychological process. Emotion. 2010; 10(1):1. [DOI:10.1037/a0018360]
  29. Ghane S, Asadi J, Derakhshanpour F. [Effect of mindfulness training on individual well-being and mental health of elderly women (Persian)]. Journal of Gorgan University of Medical Sciences. 2018; 20(1):71-6. [Link]
  30. Valizadeh H, Parandin S. The effectiveness of mindfulness-based cognitive therapy on irrational beliefs and happiness of the elderly. Aging Psychology. 2022; 8(1):11-24. [Link]
  31. Hazlett-Stevens H, Singer J, Chong A. Mindfulness-based stress reduction and mindfulness-based cognitive therapy with older adults: A qualitative review of randomized controlled outcome research. Clinical Gerontologist. 2019; 42(4):347-58. [DOI:10.1080/07317115.2018.1518282] [PMID]
  32. Day MA. Mindfulness-based cognitive therapy for chronic pain: A clinical manual and guide. Hoboken: John Wiley & Sons; 2017. [DOI:10.1002/9781119257875]
  33. Zeidan F, Vago DR. Mindfulness meditation-based pain relief: a mechanistic account. Annals of the New York Academy of Sciences. 2016; 1373(1):114-27. [DOI:10.1111/nyas.13153] [PMID] [PMCID]
  34. De Jong M, Lazar SW, Hug K, Mehling WE, Hölzel BK, Sack AT, et al. Effects of mindfulness-based cognitive therapy on body awareness in patients with chronic pain and comorbid depression. Frontiers in Psychology. 2016; 7:967. [DOI:10.3389/fpsyg.2016.00967]
  35. Mohammadi F, Mohammadkhani P, Dolatshahi B, Asghari M A. [The effects of “mindfulness meditation for pain management” on the severity of perceived pain and disability in patients with chronic pain (Persian)]. Salmand. 2011; 6(1):59-66. [Link]
  36. Farhangi A. [Effectiveness of mindfulness based cognitive therapy chronic pain management on psycho-social function in women with breast cancer (Persian)]. Journal of Excellence in counseling and psychotherapy. 2019; 8(30):11-28. [Link]
  37. Alemi S, Abolmaali Alhosseini K, Malihialzackerini S, Khabiri M. [Effect of mindfulness therapy and aromatherapy massage on pain perception, quality of life and sleep quality in older women with chronic pain (Persian)]. Salmand. 2021; 16(2):218-33. [DOI:10.32598/sija.16.2.3058.1]
  38. Sarmad Z, Bazargan A, Hejazi E. Research method in the behavioral science (Persian). Tehran: Agah; 1997. [Link]
  39. Kabat-Zinn J, Hanh TN. Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. New York: Random House Publishing Group; 2009. [Link]
  40. Melzack R. The McGill pain questionnaire: Major properties and scoring methods. Pain. 1975; 1(3):277-99. [DOI:10.1016/0304-3959(75)90044-5] [PMID]
  41. Dworkin RH, Turk DC, Revicki DA, Harding G, Coyne KS, Peirce-Sandner S, et al. Development and initial validation of an expanded and revised version of the short-form mcgill pain questionnaire (SF-MPQ-2). Pain. 2009; 144(1-2):35-42. [DOI:10.1016/j.pain.2009.02.007] [PMID]
  42. Akbarzadeh M, Sabahi P, Rafienia P, Moradi A. [Effectiveness of mindfulness-based cognitive therapy separately and combined with TDCs on pain severity and quality of life in fibromyalgia patients (Persian)]. Rooyesh-e-Ravanshenasi Journal. 2022; 11(9):33-44. [Link]
  43. Zare H, Mohammadi N, Motaghi P, Afshar H, Pourkazem L. [The effect of modified mindfulness-based cognitive therapy on catastrophizing, acceptance and pain intensity of patients with fibromyalgia (Persian)]. Health Psychology. 2015; 3(4):97-115. [Link]
  44. Day MA, Thorn BE, Ward LC, Rubin N, Hickman SD, Scogin F, et al. Mindfulness-based cognitive therapy for the treatment of headache pain: a pilot study. The Clinical Journal of Pain. 2014; 30(2):152-61. [DOI:10.1097/AJP.0b013e318287a1dc] [PMID]
  45. Henriksson J, Wasara E, Rönnlund M. Effects of eight-week-web-based mindfulness training on pain intensity, pain acceptance, and life satisfaction in individuals with chronic pain. Psychological Reports. 2016; 119(3):586-607. [DOI:10.1177/0033294116675086] [PMID]
  46. Johannsen M, O'Connor M, O'Toole MS, Jensen AB, Zachariae R. Mindfulness-based cognitive therapy and persistent pain in women treated for primary breast cancer: Exploring possible statistical mediators: Results from a randomized controlled trial. The Clinical Journal of Pain. 2018; 34(1):59-67. [DOI:10.1097/AJP.0000000000000510] [PMID]
  47. Roemer L, Fuchs C, Orsillo SM. Incorporating mindfulness and acceptance-based strategies in the behavioral treatment of generalized anxiety disorder. In: Baer  RA, editor. Mindfulness-based treatment approaches. Amsterdam: Elsevier; 2014. [DOI:10.1016/B978-0-12-416031-6.00005-0]
  48. Masumian S, Shairi MR, Hashemi M. [The effect of mindfulness-based stress reduction on quality of life of the patients with chronic low back pain (Persian)]. Anesthesiology and Pain. 2013; 4(3):25-37. [Link]
  49. Dehnavi SR, Tavakoli G, Montajabian Z. [The Effectiveness of positive psychotherapy on pain perception and death anxiety in the elderly (Persian)]. Aging Psychology. 2020; 5(4):321-32. [Link]
  50. Wiech K, Ploner M, Tracey I. Neurocognitive aspects of pain perception. Trends in Cognitive Sciences. 2008; 12(8):306-13. [DOI:10.1016/j.tics.2008.05.005] [PMID]
  51. Van Damme S, Crombez G, Lorenz J. Pain draws visual attention to its location: Experimental evidence for a threat-related bias. The Journal of Pain. 2007; 8(12):976-82. [DOI:10.1016/j.jpain.2007.07.005] [PMID]
  52. Nicolardi V, Panasiti MS, D'Ippolito M, Pecimo GL, Aglioti SM. Pain perception during social interactions is modulated by self-related and moral contextual cues. Scientific Reports. 2020; 10(1):41. [DOI:10.1038/s41598-020-60647-6] [PMID] [PMCID]
  53. Brandmeyer T, Delorme A, Wahbeh H. The neuroscience of meditation: Classification, phenomenology, correlates, and mechanisms. Progress in Brain Research. 2019; 244:1-29. [DOI:10.1016/bs.pbr.2018.10.020] [PMID]
  54. Gilliam W, Burns JW, Quartana P, Matsuura J, Nappi C, Wolff B. Interactive effects of catastrophizing and suppression on responses to acute pain: A test of an appraisal x emotion regulation model. Journal of Behavioral Medicine. 2010; 33(3):191-9. [DOI:10.1007/s10865-009-9245-0] [PMID] [PMCID]
  55. Dagnino APA, Campos MM. Chronic pain in the elderly: Mechanisms and perspectives. Frontiers in Human Neuroscience. 202; 16:736688. [DOI:10.3389/fnhum.2022.736688] [PMID] [PMCID]
  56. Giovannini S, Coraci D, Brau F, Galluzzo V, Loreti C, Caliandro P, et al. Neuropathic pain in the elderly. Diagnostics. 2021; 11(4):613. [DOI:10.3390/diagnostics11040613] [PMID] [PMCID]
Type of Study: Research | Subject: Psychology
Received: 2023/05/17 | Accepted: 2023/08/01 | Published: 2024/07/01
Add your comments about this article : Your username or Email:
CAPTCHA
Send email to the article author

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2024 CC BY-NC 4.0 | Iranian Journal of Ageing

Designed & Developed by : Yektaweb