Today, aging and its consequences have become one of the most common demographic problems [1]. During the aging period, people are at risk of potential threats such as having chronic diseases, loneliness, isolation, and lack of social support [2], and their independence is threatened due to physical and mental disabilities. Therefore, the elderly should be considered due to their age, reduced abilities, and increased vulnerability [3, 2]. Depression and anxiety are the most common problems that affect all aspects of the health of the elderly [4]. According to epidemiological studies, anxiety among the elderly is between 1.2 and 15% [5]. Anxiety in the elderly causes insomnia, forgetfulness, feelings of anxiety with symptoms of irritability, sadness, impaired concentration, and change in appetite [6], so any action to optimize their living conditions can reduce other social and family problems as well [4].
However, stressful events hurt the mental health of individuals. People exposed to stress frequently experience more mental and physical problems than others [7]. Studies show that experiencing anxiety reduces anxiety and happiness, meaning that the more anxiety a person experiences, the less happy he will be, thus threatening his general health. Negative emotions, such as anger, restrict the individual's mind from producing a defensive reaction against the negative emotions. On the contrary, positive emotions widen the individual's mind to the environmental simulations, created opportunities, increasing creativity and happiness [8]. Happiness includes a positive emotion, life satisfaction, and the absence of negative emotions such as depression and anxiety. Happiness can be a significant variable in the quality of life of the elderly [5, 9]. Therefore, paying attention to happiness is a mental category essential in making the elderly hopeful [3].
Increasing happiness helps the elderly control their stressful situations and worries and get rid of negative thoughts. For the elderly to distance themselves from loneliness and anxiety, they must believe in living in happiness and enjoy life until the last moments of life [10]. So far, various medication methods have been used to deal with anxiety and reduce depression associated with physical side effects and addiction to drugs. In some cases, non-pharmacological therapies such as worship, massage therapy, exercise, cognitive therapy, muscle relaxation, acupressure, music therapy, and aromatherapy have been used to tranquilize patients. Non-pharmacological methods or complementary therapies are inexpensive, easy, non-invasive, have fewer side effects and risks, and can be used alone or in combination with other pharmacological methods [11]. Training positive thinking is one of the interventions that can affect the psychological health of the elderly [12]. Lack of a positive outlook on life is an essential cause of depression and anxiety [13].
Positive thinking is an intervention that positively affects physical and mental health, increases happiness, and reduces anxiety. Positive thinking is a prerequisite for Educational, Social, and Professional Success [14]. Cambridge Dictionary defined positive thinking as having lots of hope and focusing on the positive aspects or believing in good events [15].
Ahangarzadeh [14] believes that positive thinking plays a vital role in psychological stability and quality of life, reflects a positive attitude, and plays a vital role in protecting people's mental health in case of fear and crisis. Positive thinking can be promoted through psychological interventions, while lack or absence of positive thinking may affect individual attitudes, increasing the symptoms of depression and anxiety. People need to be hopeful, have positive thinking skills, and have mental abilities to prevent disease.
Several studies have examined the effectiveness of positive thinking on psychological variables; for example, Gallagher et al.'s study on middle-aged cancer survivors showed that positive thinking is associated with improved emotion, adaptation, and health [16]. The results of the study by Thadchai et al. [12] showed that employees who are more adaptable, more positive and happier, outperformed in the face of the retirement crisis. In the study of Ahangarzadeh et al., training positive thinking reduces depression, anxiety, and stress in patients with coronary heart disease [14]. Previous studies have shown the effectiveness of positive thinking program increases the hope and quality of sleep of patients with thalassemia major [17].
An increase in life expectancy in the world has led to the phenomenon of aging, and the elderly population is growing faster than the entire population, and the weakness and disability of this vulnerable group require special attention and care. Considering that the presence of anxiety and depression in the aging period is inevitable and has adverse effects on the physical and mental health of the elderly, and due to the high level of negative thinking among them, they should be given the necessary attention and support. The effect of positive thinking on improving the quality of life of the elderly can be through positive thinking training. Also, the importance of the present study is that little research is done to investigate the effect of positive thinking training on happiness and reducing anxiety in the elderly. Therefore, the present study was designed and conducted to test the hypothesis that training positive thinking skills positively reduces anxiety and increases happiness in the elderly.