BackgroundMindfulness-based interventions have shown to be efficient in managing chronic pain. Cognitive factors play a prominent role in chronic pain complications and negative cognitive contents about pain are often the first issues targeted in cognitive-based therapies, which are known as first-line treatment of chronic pain over the past decades. Little, however, is known about the manner of thinking about pain or pain-related cognitive processing.ObjectivesTherefore, the purpose of this study was to investigate the effect of mindfulness-based cognitive therapy (MBCT) on pain-related cognitive processing and control of chronic pain in patients with primary headache.MethodsA clinical trial was conducted in 2017 - 2018 on 85 Persian language patients with one type of primary headache selected through purposive sampling in Emam Hossein Hospital in Tehran province. To measure the variables of the study, we used the Brief Pain Inventory (BPI) and Pain-related Cognitive Processing Questionnaire (PCPQ). All data were analyzed by independent t-test and chi-square and longitudinal data were analyzed using linear mixed model analysis.ResultsStatistically significant time × group interactions were found in pain intensity (P < 0.001), pain interference (P < 0.001), as well as in three cognitive processing subscales including pain focus, pain distancing, and pain openness (P < 0.001). However, the results of pain diversion were not meaningful.ConclusionsMBCT is a potentially efficacious approach for individuals with headache pain. Regulation and correction of cognitive processing are considered as effective cognitive coping strategies in MBCT treatment.

BackgroundPrimary headaches are the most common cause of absence from work and school and one of the most common reasons for referring to the neurologists.ObjectivesThe present study was designed to investigate the relationship of cognitive processing style and mindfulness with pain intensity and the ultimate aim was to provide the role of pain-related cognitive processes and mindfulness in the prediction of headache intensity.MethodsThe study was conducted descriptively by using the correlation method. The statistical population of this study was composed of 85 patients (56 females and 29 males) with one type of primary headache, which were selected through purposive sampling after the diagnosis of a headache by a neurologist at Imam Hossein Hospital in Tehran province. To measure the variables of the study, the numeric pain rating scale (NRS) and the pain-related cognitive processes questionnaire (PCPQ) were used. All data were analyzed using descriptive statistics (frequency and percentages). Bivariate correlation matrix and hierarchical stepwise linear regression statistics were used.ResultsThe results showed that there was a significant and negative association between pain intensity (NRS) and mindfulness (P < 0.01) and all pain-related cognitive processes, except pain focus (P < 0.01). The results of stepwise linear regression indicated that mindfulness only explains 39% of total score changes in pain intensity (P < 0.05 and ΔF (1 and 83) = 53.63, ΔR = 0.385). Adding cognitive processing styles to the model led to an 18% increase of the explained variance (R2 change = 0.179). In total, the present research model justifies 54% of the severity of headache variance (P < 0.01, ΔR = 0.54).ConclusionsThe results suggest that pain-related cognitive processes and mindfulness are effective on pain intensity prediction. In other words, this result can explain the role of mindfulness and adaptive cognitive processing in primary headache pain management.

BackgroundPrimary headaches are one of the most troubled chronic diseases. Headaches interfere within the various dimensions of the patient’s life. Coping strategies that aim to be attention focused (e.g., mindfulness) may moderate pain-related emotional and physical interference.ObjectivesThis investigation examined the relationship between mindfulness and pain intensity with physical and emotional interference and the subsequent aim was to analyze the role of mindfulness and headache severity combination in the prediction of pain-related interference.MethodsThis correlational study was conducted during years 2017 to 2018 at Imam Hossein Hospital of Tehran province. Eighty-five patients (56 females and 29 males), who had one type of primary headache were selected through purposive sampling after the diagnosis by a neurologist. The data were collected through the brief pain inventory (BPI) and the mindful attention awareness scale (MAAS). All data were analyzed using descriptive statistics. Bivariate correlation matrix and hierarchical stepwise linear regression statistics were used.ResultsThe correlational analysis of the results indicated significant association between mindfulness (MAAS) and pain severity (BPI) (P < 0.01) as well as the findings of the study point to the significant relationship between mindfulness and both physical and emotional pain-related interference (P < 0.01). The results of stepwise linear regression indicated that pain severity explains only 1% of the total score in emotional pain-related interference (P = 0.003 and ΔF (1 and 83) = 9.22, ΔR2 = 0.11). Adding mindfulness to the model led to a 43% increase of the explained variance (R2 Change = 0.34). In physical interference, although pain severity was able to predict pain interference (P = 0.01 and ΔF (1 and 83) = 7.09, ΔR2 = 0.07), a combination model justifies 10% of the interference variance that was not statistically meaningful (P = 0.08, ΔR2 = 0.103).ConclusionsThis result is a further support that Mindful Awareness contributed to emotional pain-related interference prediction. This result can explain the role of attention focused and mindful awareness in primary headache pain adjustment.

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Background: Patients with ischemic heart disease (IHD) gradually reduce their follow-up treatment due to the vulnerable physical condition and high involvement with the disease-related treatment process. The purpose of this research was to investigate the effect of intervention based on the protection motivation theory (PMT) on treatment adherence in patients with IHD. Methods: This quasi-experimental research used a pretest-posttest design with a control group. The statistical population included all patients with IHD referred to the Payambar Azam hospital in Bandar Abbas, Iran for more than once between March 2019 and May 2020. A total of 16 patients were selected through the matched targeted sampling and randomly assigned into two equal groups of experimental and control (n = 8 each). The test group received an intervention based on the PMT in six 90-minute sessions within 45 days. We used the Modanloo Treatment Adherence Questionnaire (TAQ), and the data were analyzed using the analysis of covariance (ANCOVA) in the SPSS23 statistical software. Results: The results of ANCOVA showed that the intervention based on the PMT significantly increased the treatment adherence and its subscales in patients with IHD (P<0.001). Conclusion: Intervention based on the PMT can be used as an effective intervention to increase treatment adherence in patients with IHD, depending on proper nutrition training, self-care skills, awareness-raising, and relaxation exercises.