Abstract
Objectives
Older adulthood presents unique challenges to mental health. We explored how a mindfulness training intervention adapted for older adults addressed these challenges, contributing to a qualitative profile of mindfulness pedagogy for older adults.
Methods
Mindfulness-based stress reduction (MBSR) was adapted for a geriatric community sample with elevated depressive symptoms. Intervention effects were examined through a combination of scale-based assessment and qualitative interviews. Scales measured depressive symptoms, cognitive function, quality of life, and mindful attitudes. Interviews assessed stressors, goals, perceived obstacles, outcomes, and practice habits. A grounded-theory approach was used to identify responses in each category. Multiple regression analyses were used to identify qualitative responses that best predicted symptom reduction.
Results
The program was well-tolerated, positively endorsed, and associated with reduced depressive symptoms. Qualitatively, participants who identified family and mood as their primary stressors benefitted the most from course participation. A focus on present moment awareness was associated with decreased depressive symptoms, whereas a focus on hedonics, i.e., “feeling good,” was associated with poorer treatment outcomes. Participants maintained strong future practice intentions and preferred guided meditations to self-directed practice.
Conclusions
The adapted MBSR program was well-tolerated and efficacious in a geriatric community sample. Efficacy may be improved by emphasizing skill development outcomes rather than achievement of positive feeling states, and by prioritizing program referrals for coping with socioemotional rather than environmental stressors. Future research could extend this mixed-methods approach to deepen our understanding of the relationship between participants’ lived experiences and clinical outcomes.
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Acknowledgements
Thank you to Dr. Julie Irving for her tutelage and support in developing the qualitative techniques employed in this paper.
Funding
This work was supported by a Women of Baycrest fellowship awarded to Dr. Farb. No conflicts of interest are reported.
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NASF: designed and executed the study, performed data analyses, and wrote the manuscript. JM: collaborated with study design, qualitative theory development, and editing the final manuscript. RM: collaborated with study design, and manuscript writing. HG: collaborated with qualitative coding and manuscript editing. CG: collaborated with study design and manuscript editing. DC: collaborated with study design and manuscript editing. NK: collaborated with study design, writing, and reviewed clinical data.
All the authors contributed to the study conception and design. Material preparation was conducted by NASF and JM. Clinical screening was performed by NASF, JM, and NK. Qualitative coding was performed by NASF and HG. Data analysis was performed by NASF, with reports and consultation by all the named authors. The final draft of the manuscript was written by NASF and all the authors commented on previous versions of the manuscript. All the authors read and approved the final manuscript.
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Research activities were approved by the Baycrest Research Ethics Board, Protocol #11–16 entitled “Mindfulness Based Stress Reduction for Older Adults.”
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All participants in this study voluntarily provided informed consent using forms approved by the Baycrest Research Ethics Board.
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Farb, N.A.S., Murchison, J., Madan, R. et al. Mindfulness-Based Stress Reduction Interventions for Mood in Older Adults: How Do Qualitative Experiences Inform Clinical Response?. Mindfulness 12, 1733–1747 (2021). https://doi.org/10.1007/s12671-021-01636-2
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DOI: https://doi.org/10.1007/s12671-021-01636-2