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

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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
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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.



 
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Type of Study: Research | Subject: Psychology
Received: 2023/05/17 | Accepted: 2023/08/01 | Published: 2024/07/01
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