The Echo of the Stagnation or Struggle to Rediscover Life: Stories of Positive and Negative Coping Strategies among Older Adult Empty Nesters in Iran

The Echo of the Stagnation or Struggle to Rediscover Life: Stories of Positive and Negative Coping Strategies among Older Adult Empty Nesters in Iran | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article The Echo of the Stagnation or Struggle to Rediscover Life: Stories of Positive and Negative Coping Strategies among Older Adult Empty Nesters in Iran Fatemeh Raeesi Dehkordi, Mehdi Nakhodaeezadeh, Sara Noruzi This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6427726/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 5 You are reading this latest preprint version Abstract Background Empty Nest Syndrome (ENS) presents significant emotional challenges for older adult, especially in cultures with strong family bonds like Iran. This qualitative study explores the coping strategies, both positive and negative, employed by empty nesters in Iran, offering insights into how aging individuals navigate the emotional consequences of their children leaving home. Methods We conducted semi-structured individual interviews with 40 empty nesters, a mix of men and women aged 60–97 years, were selected through purposeful sampling. Data collection and analysis occurred concurrently. Thematic analysis revealed two main themes: "Struggle to Rediscover Life" and "Echo of Stagnation," which reflect opposing coping strategies related to aging and family dynamics. Results The themes highlight two distinct sets of strategies: one focused on active engagement, resilience, and personal growth, while the other reflects emotional stagnation and a sense of loss. Positive coping strategies included perseverance, hope, humor, spiritual reliance, and proactive social engagement. In contrast, negative strategies involved emotional rumination, social isolation, and harmful behaviors such as substance abuse. Discussion These results tell us a lot about how complicated Iranian empty nesters feel. They also show how important it is for healthcare and policies to be sensitive to different cultures in order to help older people deal with the mental effects of empty nest syndrome. Knowing both the good and bad ways that this group of people copes can help people come up with personalized interventions that improve their mental health. Empty Nest Syndrome Coping Strategies Iran Aging Cultural Context Background Understanding Empty Nest Syndrome in an Aging Population The global population is aging at an unprecedented rate. According to the World Health Organization, the number of individuals aged 60 and older is expected to double by 2050, raising new challenges and opportunities associated with late adulthood. One significant psychological phenomenon affecting older adults is Empty Nest Syndrome (ENS), which describes the emotional and psychological transitions parents undergo when their children leave home( 1 , 2 ). Traditionally viewed as a period marked by sorrow and loss, ENS has increasingly been recognized as a complex life stage that encompasses both positive and negative emotional aspects. The Psychological and Sociocultural Dimensions of ENS ENS primarily affects middle-aged individuals, particularly women, who often experience deep emotions such as grief, isolation, and even an existential reevaluation of their identity following their children’s departure ( 3 , 4 ). Stage theories of family development suggest that families undergo distinct transitions, each associated with unique parenting challenges( 5 ). The empty nest phase—often referred to as the "third age," occurring between ages 60 and 80—has significant implications for emotional well-being and mental health. The increasing prevalence of ENS is observed across various cultural contexts, including Europe, the United States, India, and China. In China, for example, the incidence of ENS has reached 25%, with urban centers such as Beijing reporting rates as high as 35%. Projections indicate that by 2030, this figure could rise to 90%, particularly in rural regions affected by urbanization and economic migration( 6 – 8 ). Risk Factors and Psychological Consequences Multiple factors influence the onset and severity of ENS, including gender, educational background, parenting style, and cultural values( 9 ). Research consistently highlights the negative consequences of ENS, including increased rates of depression, alcohol dependency, identity crises, and marital discord ( 10 ). Parents frequently experience a profound sense of sadness and loss when their children leave home, often leading to diminished psychological well-being. While the return of adult children to the parental home may temporarily alleviate some of these emotional challenges, it also presents unique difficulties. In Iranian society, where high housing costs are common, intergenerational cohabitation can lead to a loss of privacy and increased familial tensions. Stay-at-home mothers, in particular, may struggle with this transition, as their strong emotional investment in child-rearing increases their vulnerability to feelings of loneliness and loss. In some cases, ENS may negatively impact marital dynamics and even sexual health( 11 ). Potential Positive Aspects of ENS Despite the challenges, ENS also presents opportunities for personal growth. The transition can create time for parents to engage in social, recreational, or educational pursuits. Studies indicate that women who successfully adjust to the empty nest phase often report increased marital satisfaction( 12 , 13 ). Dennerstein's research suggests that the departure of children does not necessarily diminish quality of life, and Australian mothers, for example, view ENS as a normal and expected part of their children's development ( 14 ) ( 15 ). Additionally, some studies report that couples experience improved intimacy following the departure of their children( 11 ). Financial stability and strong social support networks further contribute to a more positive adjustment( 16 ). While ENS is often associated with maternal distress, men also experience emotional challenges following their children's departure. However, due to societal expectations, their expressions of distress may differ. Both men and women face adjustment difficulties, underscoring the need for further exploration of gender differences in ENS( 17 ). Coping Strategies: Adaptive and Maladaptive Responses to ENS Coping strategies play a crucial role in navigating ENS. Adaptive coping mechanisms, such as cognitive reframing, problem-solving, and social support, contribute to better psychological outcomes. Conversely, maladaptive coping strategies—including emotional suppression, avoidance behaviors, and substance use—can exacerbate distress and negatively impact overall well-being( 18 – 20 ). Parents’ social roles and cultural expectations significantly shape their responses to ENS, affecting their long-term emotional adjustment ( 8 ). ENS in Eastern Cultural Contexts: The Case of Iran Although ENS is a global phenomenon, cultural factors play a critical role in shaping its impact. In Eastern cultures, particularly in Iran, the strength of familial bonds may heighten the emotional challenges associated with ENS. In Iranian society, where Islamic traditions emphasize strong intergenerational ties, older adults are highly regarded within the family and community structure. The increasing prevalence of ENS in Iran, coupled with shifting demographic patterns, underscores the need for targeted research to better understand its impact in this cultural context( 21 , 22 ). The Gap in Research and the Need for Qualitative Inquiry Despite growing recognition of ENS, most research conducted in Iran has relied on quantitative methodologies, often focusing on symptom management rather than exploring the lived experiences of parents. There is a critical gap in qualitative research that examines how Iranian parents navigate ENS within their sociocultural framework ( 21 ). Understanding these coping mechanisms is essential for developing culturally sensitive interventions that support individuals during this life transition. This study aims to fill this gap by exploring the coping strategies of Iranian empty nesters through a qualitative approach. By examining their lived experiences, this research seeks to contribute to a deeper understanding of ENS and inform interventions that enhance emotional well-being among aging parents. Methods Study Design This study employs qualitative methods to gain deep insights into complex, culturally embedded phenomena that are not easily quantifiable. Prior research indicates that ENS and its associated coping strategies remain underexplored in developing countries, particularly in Asian contexts where cultural dynamics differ significantly from Western societies ( 16 ). To capture the nuanced perspectives of Iranian participants, we utilized semi-structured interviews to explore their lived experiences and coping strategies. Research Questions The study sought to answer the following questions: What are the lived experiences of empty nesters? What coping strategies do empty nesters employ to navigate ENS? Given the subjective nature of these experiences, we employed thematic analysis to describe, analyze, and report emerging themes and patterns( 23 ). The flexibility of thematic analysis allows for multiple qualitative frameworks to be used in analyzing data ( 24 ). Data collection and analysis were conducted concurrently, allowing emerging themes from early interviews to inform subsequent ones ( 23 ). Participant Selection The participants were community-dwelling empty nesters aged 60 and above, residing in Isfahan, Iran's third-largest city. The selection process was guided by UN aging criteria, which recognize that aging begins approximately five years earlier in Iran compared to advanced nations ( 25 ). Participants were selected based on maximum variation sampling, ensuring diversity in the following aspects: Age groups: Young-old (60–74 years), old (75–90 years), and old-old (90 + years) ( 26 ). Occupational background: Retirees, working professionals, and homemakers. Marital status: Married, widowed, or divorced. Residential settings: Private homes, retirement facilities, physicians’ offices, city parks, workplaces, health centers, and mosques. A total of 39 participants (aged 60–97 years) voluntarily participated, having met the following inclusion criteria: Fluent in Farsi. Cognitive function score of seven or higher on the Persian version of the Abbreviated Mental Test (AMT) ( 27 ), Completion of a written informed consent form, including agreement to audio recording and transcription. At least two years since children had left home. No diagnosis of severe mental disorders such as psychosis, confirmed through an initial diagnostic interview. Exclusion criteria included : Severe physical or psychological conditions that could influence study outcomes. Recent bereavement. Withdrawal from the study at any point. Ethical Considerations To ensure confidentiality, participants’ identifying information was excluded from the analysis and presentation of findings. Signed consent forms were stored separately from interview transcripts and audio files. This study was approved by the Ethics Committee of Isfahan University of Medical Sciences under approval number 395911, date 2018. All procedures followed ethical standards in accordance with the Declaration of Helsinki. Data Collection Interview Process Data collection was carried out between February 2021 and June 2022 using a semi-structured interview protocol specifically developed by the research team. The interview guide was informed by a review of relevant literature and expert consultations in the field of aging and mental health ( 28 ). A translated English version of the guide has been provided as a supplementary file. Interviews were conducted in Persian to eliminate language barriers and followed a flexible format that began with general, open-ended questions (e.g., “Tell me about your typical day/week”) and gradually moved toward more specific topics (e.g., “What do you do after your children leave home?”). A total of 40 interviews were held at participant-selected locations such as homes, gardens, and mosques. The average duration was 85 minutes (range: 30–140 minutes). All sessions were audio-recorded with participant consent, transcribed verbatim, and securely managed. Audio files were permanently deleted prior to October 1, 2022, to ensure confidentiality Data Analysis Thematic analysis (TA) was employed to identify concepts, categories, and themes within the data ( 29 ). Analysis followed an iterative coding process, involving three levels: codes, categories, and themes. Stages of Thematic Analysis Stage I: Familiarization with Data Researchers transcribed interviews in Persian, ensuring fidelity to participants’ narratives. Data was read and re-read to identify initial ideas and meaning patterns. Stage II: Generating Codes Open coding was conducted through line-by-line reading. Key phrases and words were identified and extracted using New Comment. Initial codes were categorized based on similarities and differences. Ambiguous responses were clarified through follow-up questions. Stage III: Searching for Themes Codes were grouped into initial themes. The research team collaboratively developed, tested, and reviewed candidate themes. Data was revisited to ensure consistency between themes and coded extracts. Stage IV: Reviewing Themes Themes were further refined by cross-referencing supporting data extracts. The research team ensured coherence across the dataset. Stage V: Defining and Naming Themes Themes and subthemes were clearly defined. The analysis remained iterative, moving between theoretical concepts and empirical data to explore emerging patterns. Saturated themes were identified through memo writing and team discussions. Stage VI: Producing the Report The final report integrated narratives, data extracts, and arguments to illustrate relationships between themes. Findings were triangulated using multiple verification techniques ( 30 ). Ensuring Rigor To ensure reliability and validity, the study employed the following methods: Prolonged engagement : Sufficient time was allocated for data collection and analysis. Triangulation : Multiple data sources and perspectives were examined. Peer debriefing : Two Ph.D. students in social work with qualitative research expertise independently coded the data. Intercoder agreement : Codes were compared and refined through discussion. Member checking : Summaries of findings were shared with participants to confirm accuracy and representation of their experiences Results This qualitative research sought to explore the personal coping mechanisms of empty nesters within a particular cultural setting. We performed semi-structured interviews with 40 empty nesters (both male and female) aged between 60 and 97 years, with a mean age of 75.56 years. The participants' socio-demographic status (Table 1) varied, offering a wide range of viewpoints on dealing with ENS. Table 1. Socio-Demographic Characteristics of Participants (N=40) Characteristic Category Number (N) Percentage (%) Age Young old (60-74) 11 27.5% Old (75-89) 16 40.0% Old old (over 90) 13 32.5% Marital Status Married 20 50.0% Widowed 15 37.5% Divorced 5 12.5% Thematic Categories Based on the experiences shared by the empty nesters, two themes emerged: Struggle to Rediscover Life and Echo of the Stagnation . These themes encapsulate positive and negative coping strategies used by the participants in responding to changes that ENS has brought into their lives (Table 2). Struggle to rediscover life. This theme reflects how participants adapted to the significant changes brought about by their children's departure. This is a reciprocal process where participants reconstructed, reframed, and redefined goals and freedom while facing the challenges of ENS. They used positive coping methods, such as self-control and ease, at the psychological level. They combined these strategies with independent, participatory, and interactive approaches. Many of them aspired to enhance or advance their lives by seizing new opportunities, a perspective rarely acknowledged in the literature. Table 2: Themes and Sub-Themes of Coping Strategies among Empty Nesters Main Theme Theme Sub-Theme Struggle to rediscover life Inner Alchemy Practices Perseverance through hardship Progress through strength Worrying in silence Mental avoidance Creating meaningful perspective strategies Positive thinking and self-encouragement Hope for the future Humor Focus and mindfulness Reliance on spirituality and transcendence (belief in divine destiny, gratitude, engaging in religious rituals, altruism, acceptance of death, and reframing solitude as purposeful) FlexiMorph Strategies Maintaining a positive self-concept Adapting to change Behavior modification Nested (Education) Strategies Efforts to be useful Going beyond stereotypes Active time management Engaging in teaching-learning activities (Innovative initiatives, reinforcing previous skills Musical engagement and learning modern technologies) Autonomy Preservation Strategies Maintaining an independent identity Functional independence Proactive Engagement Voluntary and informal activities (social cooperation, practical support to family) Continuation of Professional Roles (monetary engagement, informal vocational counseling, and Institutional participation) Interaction-Oriented Strategies Maintaining family networks Social bonding Echo of the Stagnation Amplifying Turmoil Rumination and exaggerating problems Regretfully comparing oneself with others Residing in nursing homes Engagement in obsessive behaviors Denial of children's moving out Emotional ventilation Restarting smoking and substance abuse Getting Deadlock Behavioral disengagement Isolation and seclusion Self-blame Dependency on neighbors Suicidal rumination Inner Alchemy Practices ) Will for Enduring the Difficult in Life (: Research participants demonstrated inner strength by enduring life's challenges, turning pains into growth, and utilizing perseverance, silence, and mental avoidance to progress through hardships. Perseverance through hardship: Participants recognized that perseverance was essential for continuing to live meaningfully, even without the presence of their children. "Standing on your feet is just that—enduring your limitations and loneliness. Coping with loneliness and the kids leaving means enduring, persisting, and surviving. If you dwell on the issue, it becomes twice as difficult. That way, you can't endure." (65y) Progress through Strengths and Hardships: Learning from past difficult experiences contributed significantly to participants' resilience in the face of empty nest challenges. This resilience helped them maintain independence and even improved their mental health. "Look, I know that when someone wants something and strives to achieve it, they can endure hardships better. When you fight and strive, you achieve things. " (72 y) Worrying in silence . Participants, despite feeling anxious about their children leaving home, they tried to appear composed and calm in various situations. "I didn't want my wife and children to know about my concern, as they would also become worried." (74 y) Mental avoidance: Some participants used the strategy of not dwelling on current and past losses, weaknesses, and difficulties following their children's departure to cope with ENS. "If I continue to worry about what might happen now that my son has gone abroad, I'll lose my mind." I'll get nervous and upset. Nothing will change. I try not to think about it. If you dwell on something excessively, it will eventually surface. (63 y) Creating Meaningful Perspectives: Participants used coping strategies like positive thinking, hope, and self-encouragement to find new meaning in life after leaving children, fostering a renewed sense of purpose. Positive Thinking and Self-Encouragement: Participants emphasized the significance of focusing on positive aspects of life and practicing positive thinking to combat life's hardships, comparing them to a dark tunnel. "Hardships in life are like a dark tunnel. Now that I've passed through it, this mindset has greatly helped me endure problems better."(60y) Hope for the Future: A participant struggling with arthritis compared despair to sinking into darkness, saying, "If I lose hope now, I won't be able to move. I refuse to be depressed and desperate. When someone at home feels hopeless, it impacts everyone. (83y) Humor: Some participants adapted to loneliness by infusing humor and joy into their lives. Engaging in friendly gatherings, sharing jokes, and creating lighthearted moments brought them happiness. "Why should I be upset? Now I'm relieved. I have no small children or job to worry about. I enjoy outings with friends, and we have fun. We even gather at each other's houses, making life easier for ourselves."(71y) Focus and Mindfulness: This strategy involved directing thoughts toward specific goals, which helped reduce anxiety and kept participants mentally active. "Often, chaotic thoughts overwhelm me, bringing worry and turmoil, like the fear of being sick alone. But when I wake up, I focus on positive things to keep myself busy."(83y) Reliance on spirituality and transcendence: Spiritual beliefs and practices were significant sources of strength and resilience during late-life challenges, helping participants find meaning, maintain hope, and manage life's complexities.. Belief in divine destiny: Faith provided hope and strength, enabling participants to respond more adaptively to loneliness. " Relying on God helped me cope with loneliness. Despite receiving a lymphoma diagnosis, I placed my trust in God, perceiving these challenges as his test ”.(80y) Gratitude: Practicing gratitude helped participants shift focus from past losses, allowing them to evaluate their lives positively. "Every night, I look up at the sky and thank God for everything—what He has given, taken, and withheld. I believe loneliness is my destiny, and I accept it as wisdom." ”.(85y) Engaging in religious rituals: Individual and communal spiritual practices helped alleviate emotional and psychological stress while fostering community engagement., "I start my day relying on God, sending blessings, and reading the Quran whenever I miss my children." ”.(65y) Transcendence: Transcendence reflected a shift in self-perception, incorporating concepts like altruism, acceptance of death, and reframing solitude as purposeful Altruism: Altruism, despite financial constraints, has been found to enhance participants' aging experience, providing a sense of peace and readiness for the afterlife. "Helping others is like helping myself. These beneficial deeds will remain for my afterlife. I always ask God for the strength to help others." ”.(76y) Reframing Solitude as Purposeful: Some participants viewed solitude favorably, using it for reflection, reading, or listening to music. "I now prefer being alone, reflecting on my life, reading books, or enjoying music." (76y) Acceptance of Death: Acceptance of death, strengthened by a sense of closeness to God, was another coping mechanism. A participant who had lost his wife and child in an accident shared, "Losing loved ones is hard, but I've come to terms with it. I gradually found myself again. After all, death is inevitable for everyone." (79y) FlexiMorph Strategies Participants utilized FlexiMorph Strategies to adapt their behavior, self-concept, and routines to new situations, reshaping their lives and discovering new roles in the world. Maintaining a Positive Self-Concept: For many participants, a positive self-concept became a hallmark of wisdom, reflecting their ability to adapt and find meaning in adversity without succumbing to hopelessness. "When you get on the bus, everyone respects you. Wherever I feel kindness, I understand and feel proud of myself."(60y) Adapting to Change: Participants demonstrated remarkable adaptability to life changes, especially after their children left, by adopting a realistic outlook and maintaining internal cohesion. A participant, who found herself alone after her children married, remarked, "I try to handle my affairs. Life is like this—children grow up, get married, and start their own lives. You can't expect them to always be with us; they have problems. If I keep dwelling on why my children left and why I'm alone, I'll be destroyed ." (80 y) Behavior Modification: Individuals adapted or abstained from harmful activities after children's departure, altering daily tasks or finding alternate means to maintain routines, such as changing a sewing profession due to eye strain. "For years, I profited from stitching, but suddenly my eyes began to trouble me." I recognized that I could not proceed due to the pressure on my eyes. After raising my children, I transitioned to a new role.” (61 y) NestEd (Education) Strategies Participants gained new life significance through educational frameworks, acquiring knowledge and skills to compensate for lost time with children, fostering personal and societal growth. Efforts to Be Useful: The participants' approach to managing ENS emphasized productivity and relevance, emphasizing the importance of family and community involvement." I want to convey that even in retirement, I can still embrace life, be productive, and contribute to others. This is a facet of my obligation on this planet ." (66 y) Going Beyond Stereotypes: Participants faced negative stereotypes and inappropriate attitudes towards older, lonely individuals, but chose to ignore them and pursue activities that provided pleasure and satisfaction. " When one is alone at home, others anticipate one's decline. However, upon commencing painting classes, my neighbors remarked on my age. I was indifferent—I found it captivating ." (63 y) Active Time Management: Participants actively managed their leisure time by visiting parks, playing games, caring for animals and plants, sewing, and traveling, enhancing their skills and enhancing their leisure time. "I'm not much into TV, except for programs interpreting Rumi's poems. Now that I am alone, I have raised my level and am listening attentively." (83 y) Engaging in Teaching-Learning Activities: Participants utilized their life experiences for personal growth and empowerment through teaching, innovative initiatives, skill enhancement, music engagement, and modern technology learning. Teaching Activities: Despite experiencing loneliness, some participants found fulfillment in sharing their knowledge and skills with others, even in retirement. "Since last year, I began a small sewing workshop with six machines. This has helped me overcome loneliness. I don't think society should exclude retirees ." (81 y) Innovative Initiatives: Participants engaged in creative activities, despite physical limitations, boosted their self-efficacy, displayed flexibility, and purposefulness, contributing to their overall well-being. Reinforcing Previous Skills: For some seniors, retirement provided an opportunity to rekindle skills and passions that had been dormant for years. "While teaching physics was my career, I've always had a deep love for theater. Despite pursuing a different field, I remained involved with theater intermittently. I've returned to it now that I have no other obligations." (79 y) Musical Engagement: Music served as a powerful tool for finding solace and enjoyment in solitude. Participants who viewed music as a divine gift used it to elevate their spirits and combat loneliness. "When I feel low, I retreat to my room, play an instrument, and forget my worries. Music is a divine gift that wards off loneliness." (86 y) Learning Modern Technology: Technological advancements such as cell phones, text messaging, and the Internet significantly improved communication between parents and their children, particularly for those living apart "My children have lived abroad for several years. I stay in touch with them via online video calls, which makes me feel like they're nearby. When I'm idle, I read economic news or research my medications. This keeps me occupied, even when I'm alone ." (89 y) Autonomy Preservation Strategies : Strategies for preserving autonomy emphasize self-sufficiency and the ongoing effort to maintain a feeling of autonomy as fundamental components in reclaiming life on their own terms. Maintaining an Independent Identity: ENS can be mitigated by maintaining an independent identity, which is tied to self-reliance and autonomy within society. One participant described this loss of autonomy using the metaphor of a "bird in a cage," stating, "My spouse complains every morning, treating me as if I know nothing. I lived independently my whole life, and now I have to wait for decisions on what to buy and wear. It feels like being in a cage where I have no power, like a bird waiting for someone to give it food and water. I long for the freedom and autonomy to do what I want." (75 y) Functional Independence: Functional independence enhances daily activities, authority, self-care, and self-efficacy, while losing it can be distressing and negatively impact life satisfaction. "I try to stand on my own feet. Even when I have guests, I prefer to do more chores myself. I sweep and cook. I strive to manage my tasks. I don't want to burden anyone; I want to be self-sufficient." (81 y) Proactive Engagement During empty nest period, seniors tried to re-engaged socially and professionally to restore a sense of belonging . they used participation-oriented strategies, spanned from informal volunteer activities to the maintenance of ongoing professional jobs Voluntary and Informal Activities: These activities were crucial for social engagement in aging, including Social Cooperation and practical Support to family. Social Cooperation : Participants engaged in volunteer endeavors to assist strangers, including supporting those with disabilities and supplying essential resources such as food, clothes, and financial assistance. "At the Khaghani Cultural and Literary Center, we helped a center for disabled individuals by offering financial and material assistance. To me, helping others means being active." (88 y) Practical Support to Family: Caring for grandkids and and aiding with familial duties enabled participants to experience fulfillment and uphold their parental obligations. "Even though the children have moved out, I still handle their administrative tasks and look after their children. It keeps me connected to them." (81 y) Continuation of Professional Roles: Participants found solace in continuing professional roles, which included monetary engagement, informal vocational counseling, and institutional participation, thereby avoiding feeling burdened. Monetary Engagement: Engaging in work, such as opening a small business, helped participants stay busy, ease boredom, and cope with loneliness. "Having a job helps me feel useful and productive, much better than being unemployed." (74 y) Informal Vocational Counseling: Drawing on their skills and experiences, some participants voluntarily took on new professional roles, enhancing their social participation and well-being. " After retirement, I utilized my experience in cultural events to keep connected and retain my autonomy," said one participant. (79y) Institutional Participation : Participants' involvement ranged from simple membership in religious and social institutions to participation in political activities, contributing to a sense of belonging and active social engagement. "I am involved in a couple of clubs, engaging without any particular obligations." (80 y) Interaction oriented strategies : Interaction-oriented techniques involved intentional endeavors to cultivate relationships with family, friends , restore a feeling of belonging and emotional satisfaction and mitigate the isolation and loneliness generated by ENS. Maintaining Family Networks: Family connections were maintained to alleviate emptiness and grief after children's departure, through frequent visits, communication, and collaborative activities, facilitating the transition to a new life stage." familial connections were an organized aspect of her routine post-retirement, enabling her to manage the emotional intricacies of ENS more proficiently . " (71y) Social Bonding: Interviewees emphasized the importance of fostering connections with friends and neighbors, as participating in social events restores normality and satisfaction, focusing on community and collective experience. Echo of the Stagnation: The participants in the ENS state perceive it as emotionally paralyzing and psychologically declining, resembling a lonely winter filled with confusion and despair. The echo of cold isolation lingers, and harmful coping mechanisms deepen their sorrows, creating a self-reinforcing cycle of emotional upheaval and psychological passivity. This theme is crucial in understanding the participants' experiences . Amplifying Turmoil : Amplifying Turmoil refers to the increase in mental and emotional stress among the participants undergoing ENS. The sub-theme explains that,negative ways of coping instead of decreasing distress, amplify it . Regretful Comparison of Self with Others: A good number of empty nesters made unfavorable comparisons between themselves and others, like siblings or peers, thereby feeling inferior and increasing their mental distress. " My siblings are well-off, and sometimes I ask myself why I am not like them, why I am lower than them. Since the kids have gone, I notice their comfortable life while I am struggling ." (89 y) Engagement in Obsessive Behaviors: Some participants developed obsessive behavior, such as excessive shopping and over-preparing food, to cope with anxiety and distress. This disrupted daily routines and increased the emotional load. " I must wash everything several times. Now that my hands hurt and I have arthritis, I can't be as active, and it bothers me a lot." (73 y) Rumination and Exaggerating Problems: Most participants exaggerated their problems and focused on them until they consumed them. Rumination created a complicated and painfully emotional state, "I felt abandoned when I lost my husband. He died and buried my motivation and joy.” (81 y) Restarting Smoking and Substance Abuse: Some participants returned to smoking or substance abuse as a misguided way to cope with the emotional shock of their children's moving out and ensuing loneliness. " Loneliness hurts a lot. At times, I gather with my friends and indulge in drug use, which serves as a temporary escape from the pain of loneliness ." (77 y) Denial About Children Moving Out: Many of these respondents grappled with the idea of leaving home with their children, expressing feelings of emptiness and a sense of closing a stage in their lives. " I have found it difficult, or perhaps unwilling, to acknowledge that this child has transitioned into a new stage of life . " (69 y) Residing in Nursing Homes: Some individuals, unable to care for themselves, either made the decision to enter nursing homes. One of the participants shared that this decision was typical, feeling both defeatist and filled with relief. " After my husband died, I decided to enter the nursing home. Now, I have found my place and intend to remain here for the remainder of my life." (88 y) Emotional Ventilation: some times, sharing of the emotional outburst very intense caused caught listeners off guard, straining relationships with others. " Sometimes we get caught in emotional whirlwinds, and my relatives were irritated, overwhelmed by the forcefulness of my words ." (80 y) Getting Deadlock: The concept describes a state of nonaction experienced by individuals overwhelmed by life changes and setbacks, often characterized by maladaptive behaviors and thought processes that perpetuate feelings of helplessness and hopelessness, akin to a train at a standstill, unable to move forward. Behavioral Disengagement: Behavioral disengagement involves individuals intentionally withdrawing activities they once enjoyed, especially social interactions. This withdrawal is characterized by canceling plans, leaving early, and retreating into solitary activities. Although it serves as a coping mechanism, it can lead to further isolation and a deeper sense of loneliness. Self-Blame: Self-blame emerged as a particularly paralyzing aspect of this deadlock. Participants often internalized their perceived failures, leading to feelings of shame and self-devaluation. This self-directed negativity prevented them from engaging in new activities and trapped them in a cycle of guilt. "I curse myself for the way things have turned out. I feel like a failure, and it's all my fault that my children have left me." (83 y) Isolation and Seclusion: Long periods of separation from their children, led many participants to choose isolation and seclusion. Despite opportunities to reconnect, such as invitations from family, they often preferred to remain alone and satisfied from their seclusion . "My son invites me to join them, but I prefer to stay at home, feeling lonely. It seems easier to remain isolated." (75 y) Dependency on Others: Participants experienced emotional dependency, which threatened their independence and created a sense of vulnerability due to their insatiable need to be close to certain people, unable to break these ties. This Dependency often left them feeling abandoned and unsure of their ability to survive on their own. "I feel like they think it's all over now, so they're distancing themselves." (90 y) Suicidal Rumination: For some participants, the inability to maintain an independent living status led to intense anxiety and suicidal rumination. These participants, burdened by stressors and feelings of hopelessness, fixated on thoughts of ending their lives as a way to escape their suffering. "Many times I've thought about dying and ending this life, but then I come to my senses and..." (74 y). Discussion The present qualitative study investigated the lived experiences of Iranian empty nesters in the culturally diversified setting of Isfahan. The findings offer a comprehensive analysis of how these individuals navigate the emotional and psychological challenges that accompany ENS. The data analysis resulted in two major themes: the struggle for rediscovery and the echo of stagnation. These themes encapsulate the dual coping strategies employed by participants, as some sought new meaning in life, while others remained mired in patterns of emotional and psychological stagnation. On the theory of the empty nest perspective, it assumes that an empty nest is of significance as an event in the lives of older adult parents and a natural stage in the journey of parenting( 31 ). This work, therefore, spotlights that the experiences of ENS span a broad spectrum because of cultural, gender, and individual differences. In fact, some argue that "even in similar cultural contexts, this experience is highly gendered, with mothers experiencing more distress than fathers due to their deeper involvement in child-rearing and greater emotional connection." However, as the present research demonstrates, in Iran, the above gendered experiences closely relate to the pressure of cultural tradition, which puts women in a challenging position and complicates their identity work ( 32 ). This theme revealed a striking finding about inner alchemy practices, where participants demonstrated extraordinary inner strength by overcoming life's challenges and relying on resilience rooted in deep cultural and religious beliefs. This research aligns with the theory of the Season of Change, which posits that life transitions trigger both positive and negative coping strategies, by highlighting the culturally specific coping mechanisms used by Iranian empty-nesters. Participants from more traditional backgrounds often relied on religious practices such as Sabr (patience) and faith in divine wisdom, while those from more modern or urbanized environments were more likely to seek professional mental health support or engage in lifelong learning. This dichotomy aligns with existing literature that emphasizes the role of cultural and individual differences in shaping ENS experiences. This finding resonates with literature pointing to the role of spirituality in coping with life adversities ( 33 , 34 ). The subgroup Creating Meaningful Perspectives underlines participants' proactive efforts toward the ENS problem. Consequently, they maintained hope and optimism by concentrating on positive thoughts, seeking self-encouragement, and drawing upon their spirituality. This finding agrees with other studies indicating the role of spirituality in emotional and psychic support during life transitions( 21 ). Most striking about this reliance on spirituality and transcendence is that it occurs within the Iranian context, where religious practices and beliefs are integral to daily life ( 35 ). Participants derived meaning and sense from this connection, enabling them to navigate the complexities of ENS with resilience. FlexiMorph strategies is significant in Iranian culture, which links old age to status and autonomy loss ( 35 ). This theme of maintenance of independence is replicated in studies across different cultures, where the transition to an empty nest often requires a redefinition of self and a reaffirmation of personal autonomy( 36 ). The theme of the NestEd paradigms also emerged as a critical strategy for rediscovering life after ENS. People viewed lifelong learning and education not as a mere passing of time, but rather as opportunities for personal growth and reinvention. This stress on efforts to be helpful and go beyond the stereotypes reflects a more considerable cultural change underway in Iran—a perception of older adults as valuable members of society through which a lot can be contributed. This proactive engagement in education and skill development is indicative of active aging ( 35 , 37 ). This finding is consistent with other cultural contexts studies, where maintenance of purposefulness through continuing education and professional engagement made very substantial differences in the well-being of older adults. For example, studies of older adults in Korea and Thailand have equally emphasized that lifelong learning and community involvement could be essential remedies against the effects of ENS ( 38 , 39 ). In contrast, the theme of Echo of Stagnation captures the experiences of participants who struggled to cope with ENS, leading to emotional and psychological stagnation. This theme is particularly poignant in the Iranian context, where the transition to an empty nest can be deeply isolating, especially for those who have dedicated their lives to their families. The subtheme of Amplifying Turmoil highlights how maladaptive coping mechanisms, such as rumination and regretful comparisons with others, exacerbated participants' distress. These findings are consistent with studies that document similar patterns of negative coping in other cultural contexts, where unresolved grief and denial have been linked to deteriorating mental health outcomes ( 31 ). There is previous research that documents, as in this case, similar maladaptive coping patterns amongst older adults experiencing significant life changes( 40 ). Abi-Habib and Luyten note that individuals who have the tendency to fall into such rumination act hostile and biased, unable to contain their anger, which often leads to disputes within interpersonal relationships ( 41 ). Some participants experienced psychological stagnation, characterized by feelings of entrapment and inability to progress, as captured by the theme of Getting Deadlock. Behavioral disengagement, self-blame, and isolation exacerbated their helplessness, as they conformed to societal expectations that older adults should withdraw from society. This stagnation parallels the "cul-de-sac" phenomenon observed in other studies ( 42 ), where aging individuals, burdened by functional limitations, lose their sense of agency and meaning aspects( 43 ). The suicidal rumination subtheme is particularly alarming, reflecting profound psychological distress and underscoring the urgent need for mental health support in contexts like Iran, where discussing mental health remains taboo. Similar concerns are observed in other cultural contexts, including the Caribbean and Southeast Asia, often where the stigma surrounding mental health deters individuals from seeking help, exacerbating their struggles. This issue underscores the critical need for mental health interventions that respect cultural and social norms ( 39 , 44 ). Policymakers should be aware of the need for programs that foster opportunities for older adults to remain socially engaged through lifelong learning, given the rapid social changes in Iran due to the rise of single-child families and migration. This would include community-organized educational programs, mental health campaigns, and support for older adult parents in dealing with the challenges of ENS. By promoting active aging in a society where older adults can connect and remain socially relevant in Iran, these interventions could contribute to mitigating the adverse effects of ENS. The arrival of Generation Z, with their emphasis on individualism and technological know-how, meant new challenges for older generations in general but especially in the context of ENS. As young Iranians more and more compromise adherence to traditional family structures for personal and career goals, the risk of social isolation for older parents has grown. The study labels this as a "technological empty nest", where the pervasiveness of technology creates a sense of alienation between parents and children, even when they are physically proximate. In this regard, policymakers would do well to design culturally sensitive strategies to bridge this intergenerational gap. Digital literacy programs are among the strategies that will ensure older adults stay in touch with their children and grandchildren in this digital era. We would design the strategies to maintain respect and uphold traditional family values, all while adapting to the evolving dynamics of modern Iranian society. Conclusion This research emphasizes the complex dynamics of dealing with ENS among Iranian parents, influenced by cultural norms, individual resilience, and the difficulties associated with aging. Some parents manage this shift with resilience and proactive engagement, others experience stagnation and despair. The generation of children who prioritize individualism and are highly proficient with technology adds new challenges to ENS for older parents in Iran. As family structures evolve and trends like single-child families and migration increase, feelings of loneliness and isolation among older adult parents have intensified. These findings emphasize the need for culturally sensitive interventions that promote positive coping strategies, lifelong learning, and mental health support. Policymakers should address the challenges posed by intergenerational differences and societal changes to ensure that the older adult in Iran remain connected and socially relevant. Developing the concept of healthy aging and planning for its realization in the society is also very important. Encouraging the older adult to psychosocial self-care and developing a social support network can also be among the suggestions of this study. Limitations One of the limitations of this study was the fatigue and impatience of the older adult. In this context, we tried to conduct the interviews in short time intervals, and whenever the older adult did not want to answer, the interview was stopped. Whenever the older adult persons were emotionally unable to respond, empathy was given to them. Recommendations for Future Research Future research should explore coping strategies among empty nesters in Iran, considering psychological, social, and cultural factors. Comparative analyses of urban and rural situations could reveal unique challenges and resources. Creating culturally specific therapies could improve overall well-being. Abbreviations ENS Empty Nest Syndrome TA Thematic Analysis AMT Abbreviated Mental Test Declarations Ethics approval and consent to participate This study was approved by the Ethics Committee of Isfahan University of Medical Sciences (approval number: 395911, date: 2018). All participants provided written informed consent prior to participation, including permission for audio recording and anonymized data usage. Consent for publication Not applicable. Availability of data and materials The data supporting the findings of this study are available from the corresponding author upon reasonable request. To protect participant confidentiality, full transcripts are not publicly accessible. Competing Interests The authors declare that they have no competing interests. Funding This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. Authors' contributions FRD contributed to data collection, transcription, and initial analysis. MN led the study design, conducted the final analysis, and drafted the manuscript. SN assisted in the interpretation of findings and manuscript editing. All authors read and approved the final manuscript. Acknowledgements The authors would like to thank all participants for sharing their experiences, as well as the local health and social service centers that facilitated the interview process. Special thanks to Dr. Sodabeh Zaree for methodological consultation. References He W, Goodkind D, Kowal PR. An aging world: 2015. United States Census Bureau Washington, DC; 2016. Lau AL, Chi I, Cummins RA, Lee TM, Chou K-L, Chung LW. The SARS (Severe Acute Respiratory Syndrome) pandemic in Hong Kong: Effects on the subjective wellbeing of elderly and younger people. Aging and mental health. 2008;12(6):746-60. Young C. Empty Nest Syndrome and Parent Engagement in Activities following the Last Adult Child Leaving Home: A Multiple Case Study: Keiser University; 2021. Abdul Aziz NA, Mohd Ariffin NF, Ismail NA, Alias A. 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Spiritual counselling mitigates loneliness and promotes affect balance for older empty nester couples: A study in some international cities. Counselling and Psychotherapy Research. 2021;21(2):269-80. Manning L, Ferris M, Narvaez Rosario C, Prues M, Bouchard L. Spiritual resilience: Understanding the protection and promotion of well-being in the later life. Journal of religion, spirituality & aging. 2019;31(2):168-86. Raeesi Dehkordi F, Eslami AA, Zamani Alavijeh F, Matlabi H. Gerotranscendence and active aging: the lived experience. Journal of Religion, Spirituality & Aging. 2021;33(3):271-97. Harkins EB. Effects of empty nest transition on self-report of psychological and physical well-being. Journal of Marriage and the Family. 1978:549-56. Lindsay-Smith G. Active Ageing in The Community. Exploring the Role of Community Activity Groups for Older Adults for Physical Activity, Health and Wellbeing: Victoria University; 2019. 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Encyclopedia of gerontology and population aging: Springer; 2022. p. 1637-42. Agimudie T. Caribbean mothers and the empty nest: A qualitative study: Capella University; 2021. Additional Declarations No competing interests reported. Supplementary Files SemiStructuredInterviewGuideFinal.doc Cite Share Download PDF Status: Under Review Version 1 posted Reviewers invited by journal 21 May, 2025 Editor assigned by journal 13 May, 2025 Editor invited by journal 25 Apr, 2025 Submission checks completed at journal 25 Apr, 2025 First submitted to journal 25 Apr, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6427726","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":460499291,"identity":"7e8fd596-b47d-4717-943f-dc380b44906d","order_by":0,"name":"Fatemeh Raeesi Dehkordi","email":"","orcid":"","institution":"Nutritional Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran.","correspondingAuthor":false,"prefix":"","firstName":"Fatemeh","middleName":"Raeesi","lastName":"Dehkordi","suffix":""},{"id":460499295,"identity":"a63946e2-7f95-46ed-b9f9-05dcf6c5a379","order_by":1,"name":"Mehdi Nakhodaeezadeh","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABDUlEQVRIiWNgGAWjYBACgwNsbAwMbBCOBGMDgxyIceABHi0W6FqMwVoS8GixQdeS2ABi4dVy/Fjagw9ldnL8/Icf3vi4Y1v6/LDDD4G22MnpNmDXYnYm7bjhjHPJxpINx4wtZ565nbvxdpoBUEuysdkBHFoOpLdJ87YxJ2442GAGZAC1zE4AaTmQuA2HFuPzz0Fa6uv3H2b/Jv237Xa64ez0D3i1GN5IOwbUcjjBgI3HTJqx7XaCvHQOflsMbzxLk5xxDuifMzzFlr1ttw03SOcUHEgwwO0Xg/NpZhIfyqrl+fuPb7zxs+22vPzs9M0fPlTYyeHSgsUQsEoDYpWDgHwDKapHwSgYBaNgJAAA6vRqjzr6ri0AAAAASUVORK5CYII=","orcid":"","institution":"Shahrekord University of Medical Sciences","correspondingAuthor":true,"prefix":"","firstName":"Mehdi","middleName":"","lastName":"Nakhodaeezadeh","suffix":""},{"id":460499297,"identity":"6466ecbd-2812-44f5-b660-bd65590f60e4","order_by":2,"name":"Sara Noruzi","email":"","orcid":"","institution":"Lorestan University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Sara","middleName":"","lastName":"Noruzi","suffix":""}],"badges":[],"createdAt":"2025-04-11 11:08:08","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6427726/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6427726/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":83326814,"identity":"e745b99b-3e3a-42e9-bb36-f5c46cd96f59","added_by":"auto","created_at":"2025-05-23 06:50:03","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1779028,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6427726/v1/62e49ee6-8578-45c1-a09a-4193582a7147.pdf"},{"id":83326649,"identity":"37a4fcc7-c21d-4834-9a4e-bc08651b3f13","added_by":"auto","created_at":"2025-05-23 06:42:02","extension":"doc","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":88064,"visible":true,"origin":"","legend":"","description":"","filename":"SemiStructuredInterviewGuideFinal.doc","url":"https://assets-eu.researchsquare.com/files/rs-6427726/v1/288216ca01f32d6a727db0e7.doc"}],"financialInterests":"No competing interests reported.","formattedTitle":"The Echo of the Stagnation or Struggle to Rediscover Life: Stories of Positive and Negative Coping Strategies among Older Adult Empty Nesters in Iran","fulltext":[{"header":"Background","content":"\u003cdiv id=\"Sec2\" class=\"Section2\"\u003e \u003ch2\u003eUnderstanding Empty Nest Syndrome in an Aging Population\u003c/h2\u003e \u003cp\u003eThe global population is aging at an unprecedented rate. According to the World Health Organization, the number of individuals aged 60 and older is expected to double by 2050, raising new challenges and opportunities associated with late adulthood. One significant psychological phenomenon affecting older adults is Empty Nest Syndrome (ENS), which describes the emotional and psychological transitions parents undergo when their children leave home(\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). Traditionally viewed as a period marked by sorrow and loss, ENS has increasingly been recognized as a complex life stage that encompasses both positive and negative emotional aspects.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eThe Psychological and Sociocultural Dimensions of ENS\u003c/h2\u003e \u003cp\u003eENS primarily affects middle-aged individuals, particularly women, who often experience deep emotions such as grief, isolation, and even an existential reevaluation of their identity following their children\u0026rsquo;s departure (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). Stage theories of family development suggest that families undergo distinct transitions, each associated with unique parenting challenges(\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). The empty nest phase\u0026mdash;often referred to as the \"third age,\" occurring between ages 60 and 80\u0026mdash;has significant implications for emotional well-being and mental health. The increasing prevalence of ENS is observed across various cultural contexts, including Europe, the United States, India, and China. In China, for example, the incidence of ENS has reached 25%, with urban centers such as Beijing reporting rates as high as 35%. Projections indicate that by 2030, this figure could rise to 90%, particularly in rural regions affected by urbanization and economic migration(\u003cspan additionalcitationids=\"CR7\" citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eRisk Factors and Psychological Consequences\u003c/h3\u003e\n\u003cp\u003eMultiple factors influence the onset and severity of ENS, including gender, educational background, parenting style, and cultural values(\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). Research consistently highlights the negative consequences of ENS, including increased rates of depression, alcohol dependency, identity crises, and marital discord (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). Parents frequently experience a profound sense of sadness and loss when their children leave home, often leading to diminished psychological well-being. While the return of adult children to the parental home may temporarily alleviate some of these emotional challenges, it also presents unique difficulties. In Iranian society, where high housing costs are common, intergenerational cohabitation can lead to a loss of privacy and increased familial tensions. Stay-at-home mothers, in particular, may struggle with this transition, as their strong emotional investment in child-rearing increases their vulnerability to feelings of loneliness and loss. In some cases, ENS may negatively impact marital dynamics and even sexual health(\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e).\u003c/p\u003e\n\u003ch3\u003ePotential Positive Aspects of ENS\u003c/h3\u003e\n\u003cp\u003eDespite the challenges, ENS also presents opportunities for personal growth. The transition can create time for parents to engage in social, recreational, or educational pursuits. Studies indicate that women who successfully adjust to the empty nest phase often report increased marital satisfaction(\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). Dennerstein's research suggests that the departure of children does not necessarily diminish quality of life, and Australian mothers, for example, view ENS as a normal and expected part of their children's development (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e) (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). Additionally, some studies report that couples experience improved intimacy following the departure of their children(\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). Financial stability and strong social support networks further contribute to a more positive adjustment(\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). While ENS is often associated with maternal distress, men also experience emotional challenges following their children's departure. However, due to societal expectations, their expressions of distress may differ. Both men and women face adjustment difficulties, underscoring the need for further exploration of gender differences in ENS(\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e).\u003c/p\u003e\n\u003ch3\u003eCoping Strategies: Adaptive and Maladaptive Responses to ENS\u003c/h3\u003e\n\u003cp\u003eCoping strategies play a crucial role in navigating ENS. Adaptive coping mechanisms, such as cognitive reframing, problem-solving, and social support, contribute to better psychological outcomes. Conversely, maladaptive coping strategies\u0026mdash;including emotional suppression, avoidance behaviors, and substance use\u0026mdash;can exacerbate distress and negatively impact overall well-being(\u003cspan additionalcitationids=\"CR19\" citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). Parents\u0026rsquo; social roles and cultural expectations significantly shape their responses to ENS, affecting their long-term emotional adjustment (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e).\u003c/p\u003e\n\u003ch3\u003eENS in Eastern Cultural Contexts: The Case of Iran\u003c/h3\u003e\n\u003cp\u003eAlthough ENS is a global phenomenon, cultural factors play a critical role in shaping its impact. In Eastern cultures, particularly in Iran, the strength of familial bonds may heighten the emotional challenges associated with ENS. In Iranian society, where Islamic traditions emphasize strong intergenerational ties, older adults are highly regarded within the family and community structure. The increasing prevalence of ENS in Iran, coupled with shifting demographic patterns, underscores the need for targeted research to better understand its impact in this cultural context(\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e).\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eThe Gap in Research and the Need for Qualitative Inquiry\u003c/h2\u003e \u003cp\u003eDespite growing recognition of ENS, most research conducted in Iran has relied on quantitative methodologies, often focusing on symptom management rather than exploring the lived experiences of parents. There is a critical gap in qualitative research that examines how Iranian parents navigate ENS within their sociocultural framework (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eUnderstanding these coping mechanisms is essential for developing culturally sensitive interventions that support individuals during this life transition. This study aims to fill this gap by exploring the coping strategies of Iranian empty nesters through a qualitative approach. By examining their lived experiences, this research seeks to contribute to a deeper understanding of ENS and inform interventions that enhance emotional well-being among aging parents.\u003c/p\u003e \u003c/div\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003eStudy Design\u003c/h2\u003e \u003cp\u003eThis study employs qualitative methods to gain deep insights into complex, culturally embedded phenomena that are not easily quantifiable. Prior research indicates that ENS and its associated coping strategies remain underexplored in developing countries, particularly in Asian contexts where cultural dynamics differ significantly from Western societies (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). To capture the nuanced perspectives of Iranian participants, we utilized semi-structured interviews to explore their lived experiences and coping strategies.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eResearch Questions\u003c/h2\u003e \u003cp\u003eThe study sought to answer the following questions:\u003c/p\u003e \u003cp\u003e \u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eWhat are the lived experiences of empty nesters?\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eWhat coping strategies do empty nesters employ to navigate ENS?\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003c/p\u003e \u003cp\u003eGiven the subjective nature of these experiences, we employed thematic analysis to describe, analyze, and report emerging themes and patterns(\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). The flexibility of thematic analysis allows for multiple qualitative frameworks to be used in analyzing data (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). Data collection and analysis were conducted concurrently, allowing emerging themes from early interviews to inform subsequent ones (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eParticipant Selection\u003c/h2\u003e \u003cp\u003eThe participants were community-dwelling empty nesters aged 60 and above, residing in Isfahan, Iran's third-largest city. The selection process was guided by UN aging criteria, which recognize that aging begins approximately five years earlier in Iran compared to advanced nations (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eParticipants were selected based on maximum variation sampling, ensuring diversity in the following aspects:\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eAge groups: Young-old (60\u0026ndash;74 years), old (75\u0026ndash;90 years), and old-old (90\u0026thinsp;+\u0026thinsp;years) (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e). Occupational background: Retirees, working professionals, and homemakers.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eMarital status: Married, widowed, or divorced.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eResidential settings: Private homes, retirement facilities, physicians\u0026rsquo; offices, city parks, workplaces, health centers, and mosques.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003eA total of 39 participants (aged 60\u0026ndash;97 years) voluntarily participated, having met the following inclusion criteria:\u003c/p\u003e \u003cp\u003e \u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eFluent in Farsi.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eCognitive function score of seven or higher on the Persian version of the Abbreviated Mental Test (AMT) (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e), Completion of a written informed consent form, including agreement to audio recording and transcription.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eAt least two years since children had left home.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eNo diagnosis of severe mental disorders such as psychosis, confirmed through an initial diagnostic interview.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eExclusion criteria included\u003c/b\u003e:\u003c/p\u003e \u003cp\u003e \u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eSevere physical or psychological conditions that could influence study outcomes.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eRecent bereavement.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eWithdrawal from the study at any point.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eEthical Considerations\u003c/h2\u003e \u003cp\u003eTo ensure confidentiality, participants\u0026rsquo; identifying information was excluded from the analysis and presentation of findings. Signed consent forms were stored separately from interview transcripts and audio files. This study was approved by the Ethics Committee of Isfahan University of Medical Sciences under approval number 395911, date 2018. All procedures followed ethical standards in accordance with the Declaration of Helsinki.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eData Collection\u003c/h2\u003e \u003cdiv id=\"Sec15\" class=\"Section3\"\u003e \u003ch2\u003eInterview Process\u003c/h2\u003e \u003cp\u003eData collection was carried out between February 2021 and June 2022 using a semi-structured interview protocol specifically developed by the research team. The interview guide was informed by a review of relevant literature and expert consultations in the field of aging and mental health (\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e). A translated English version of the guide has been provided as a supplementary file.\u003c/p\u003e \u003cp\u003eInterviews were conducted in Persian to eliminate language barriers and followed a flexible format that began with general, open-ended questions (e.g., \u0026ldquo;Tell me about your typical day/week\u0026rdquo;) and gradually moved toward more specific topics (e.g., \u0026ldquo;What do you do after your children leave home?\u0026rdquo;).\u003c/p\u003e \u003cp\u003eA total of 40 interviews were held at participant-selected locations such as homes, gardens, and mosques. The average duration was 85 minutes (range: 30\u0026ndash;140 minutes). All sessions were audio-recorded with participant consent, transcribed verbatim, and securely managed. Audio files were permanently deleted prior to October 1, 2022, to ensure confidentiality\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eData Analysis\u003c/h2\u003e \u003cp\u003eThematic analysis (TA) was employed to identify concepts, categories, and themes within the data (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e). Analysis followed an iterative coding process, involving three levels: codes, categories, and themes.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003eStages of Thematic Analysis\u003c/h2\u003e \u003cdiv id=\"Sec18\" class=\"Section3\"\u003e \u003ch2\u003eStage I: Familiarization with Data\u003c/h2\u003e \u003cp\u003e\u003cul\u003e\u003cli\u003e\u003cp\u003e Researchers transcribed interviews in Persian, ensuring fidelity to participants\u0026rsquo; narratives.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eData was read and re-read to identify initial ideas and meaning patterns.\u003c/p\u003e\u003c/li\u003e\u003c/ul\u003e\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003eStage II: Generating Codes\u003c/h2\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eOpen coding was conducted through line-by-line reading.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eKey phrases and words were identified and extracted using New Comment.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eInitial codes were categorized based on similarities and differences.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eAmbiguous responses were clarified through follow-up questions.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec20\" class=\"Section2\"\u003e \u003ch2\u003eStage III: Searching for Themes\u003c/h2\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eCodes were grouped into initial themes.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eThe research team collaboratively developed, tested, and reviewed candidate themes.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eData was revisited to ensure consistency between themes and coded extracts.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec21\" class=\"Section2\"\u003e \u003ch2\u003eStage IV: Reviewing Themes\u003c/h2\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eThemes were further refined by cross-referencing supporting data extracts.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eThe research team ensured coherence across the dataset.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec22\" class=\"Section2\"\u003e \u003ch2\u003eStage V: Defining and Naming Themes\u003c/h2\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eThemes and subthemes were clearly defined.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eThe analysis remained iterative, moving between theoretical concepts and empirical data to explore emerging patterns.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eSaturated themes were identified through memo writing and team discussions.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cdiv id=\"Sec23\" class=\"Section3\"\u003e \u003ch2\u003eStage VI: Producing the Report\u003c/h2\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eThe final report integrated narratives, data extracts, and arguments to illustrate relationships between themes.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003eFindings were triangulated using multiple verification techniques (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec24\" class=\"Section2\"\u003e \u003ch2\u003eEnsuring Rigor\u003c/h2\u003e \u003cp\u003eTo ensure reliability and validity, the study employed the following methods:\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eProlonged engagement\u003c/b\u003e: Sufficient time was allocated for data collection and analysis.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eTriangulation\u003c/b\u003e: Multiple data sources and perspectives were examined.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003ePeer debriefing\u003c/b\u003e: Two Ph.D. students in social work with qualitative research expertise independently coded the data.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eIntercoder agreement\u003c/b\u003e: Codes were compared and refined through discussion.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eMember checking\u003c/b\u003e: Summaries of findings were shared with participants to confirm accuracy and representation of their experiences\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eThis qualitative research sought to explore the personal coping mechanisms of empty nesters within a particular cultural setting. We performed semi-structured interviews with 40 empty nesters (both male and female) aged between 60 and 97 years, with a mean age of 75.56 years. The participants\u0026apos; socio-demographic status (Table 1) varied, offering a wide range of viewpoints on dealing with ENS.\u003c/p\u003e\n\u003cp\u003eTable 1. Socio-Demographic Characteristics of Participants (N=40)\u003c/p\u003e\n\u003ctable border=\"1\" cellpadding=\"0\" align=\"\"\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 152px;\"\u003e\n \u003cp\u003eCharacteristic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003eCategory\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003eNumber (N)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 119px;\"\u003e\n \u003cp\u003ePercentage (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width: 152px;\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003eYoung old (60-74)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 119px;\"\u003e\n \u003cp\u003e27.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003eOld (75-89)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 119px;\"\u003e\n \u003cp\u003e40.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003eOld old (over 90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 119px;\"\u003e\n \u003cp\u003e32.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width: 152px;\"\u003e\n \u003cp\u003eMarital Status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 119px;\"\u003e\n \u003cp\u003e50.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003eWidowed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 119px;\"\u003e\n \u003cp\u003e37.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003eDivorced\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 119px;\"\u003e\n \u003cp\u003e12.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eThematic Categories\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBased on the experiences shared by the empty nesters, two themes emerged: \u003cem\u003e\u003cstrong\u003eStruggle to Rediscover Life\u003c/strong\u003e\u003c/em\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eand\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cem\u003e\u003cstrong\u003eEcho of the Stagnation\u003c/strong\u003e\u003c/em\u003e. These themes encapsulate positive and negative coping strategies used by the participants in responding to changes that ENS has brought into their lives (Table 2).\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003eStruggle to rediscover life.\u003c/strong\u003e\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThis theme reflects how participants adapted to the significant changes brought about by their children\u0026apos;s departure. This is a reciprocal process where participants reconstructed, reframed, and redefined goals and freedom while facing the challenges of ENS. They used positive coping methods, such as self-control and ease, at the psychological level. They combined these strategies with independent, participatory, and interactive approaches. Many of them aspired to enhance or advance their lives by seizing new opportunities, a perspective rarely acknowledged in the literature.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2:\u003c/strong\u003e Themes and Sub-Themes of Coping Strategies among Empty Nesters\u003c/p\u003e\n\u003ctable border=\"1\" cellpadding=\"0\"\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 27.1493%;\"\u003e\n \u003cp\u003eMain Theme\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25.3394%;\"\u003e\n \u003cp\u003eTheme\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47.5113%;\"\u003e\n \u003cp\u003eSub-Theme\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"22\" style=\"width: 27.1493%;\"\u003e\n \u003cp\u003eStruggle to rediscover life\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width: 25.3394%;\"\u003e\n \u003cp\u003eInner Alchemy Practices\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47.5113%;\"\u003e\n \u003cp\u003ePerseverance through hardship\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 47.5113%;\"\u003e\n \u003cp\u003eProgress through strength\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 47.5113%;\"\u003e\n \u003cp\u003eWorrying in silence\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 47.5113%;\"\u003e\n \u003cp\u003eMental avoidance\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"5\" style=\"width: 25.3394%;\"\u003e\n \u003cp\u003eCreating meaningful perspective strategies\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47.5113%;\"\u003e\n \u003cp\u003ePositive thinking and self-encouragement\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 47.5113%;\"\u003e\n \u003cp\u003eHope for the future\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 47.5113%;\"\u003e\n \u003cp\u003eHumor\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 47.5113%;\"\u003e\n \u003cp\u003eFocus and mindfulness\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 47.5113%;\"\u003e\n \u003cp\u003eReliance on spirituality and transcendence (belief in divine destiny, gratitude, engaging in religious rituals, altruism, acceptance of death, and reframing solitude as purposeful)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width: 25.3394%;\"\u003e\n \u003cp\u003eFlexiMorph Strategies\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47.5113%;\"\u003e\n \u003cp\u003eMaintaining a positive self-concept\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 47.5113%;\"\u003e\n \u003cp\u003eAdapting to change\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 47.5113%;\"\u003e\n \u003cp\u003eBehavior modification\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" style=\"width: 25.3394%;\"\u003e\n \u003cp\u003eNested (Education) Strategies\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47.5113%;\"\u003e\n \u003cp\u003eEfforts to be useful\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 47.5113%;\"\u003e\n \u003cp\u003eGoing beyond stereotypes\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 47.5113%;\"\u003e\n \u003cp\u003eActive time management\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 47.5113%;\"\u003e\n \u003cp\u003eEngaging in teaching-learning activities (Innovative initiatives, reinforcing previous skills Musical engagement and learning modern \u0026nbsp;technologies)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 25.3394%;\"\u003e\n \u003cp\u003eAutonomy Preservation Strategies\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47.5113%;\"\u003e\n \u003cp\u003eMaintaining an independent identity\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 47.5113%;\"\u003e\n \u003cp\u003eFunctional independence\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 25.3394%;\"\u003e\n \u003cp\u003eProactive Engagement\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47.5113%;\"\u003e\n \u003cp\u003eVoluntary and informal activities (social cooperation, practical support to family)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 47.5113%;\"\u003e\n \u003cp\u003eContinuation of Professional Roles (monetary engagement, informal vocational counseling, and\u003c/p\u003e\n \u003cp\u003eInstitutional participation)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 25.3394%;\"\u003e\n \u003cp\u003eInteraction-Oriented Strategies\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47.5113%;\"\u003e\n \u003cp\u003eMaintaining family networks\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 47.5113%;\"\u003e\n \u003cp\u003eSocial bonding\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"12\" style=\"width: 27.1493%;\"\u003e\n \u003cp\u003eEcho of the Stagnation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"7\" style=\"width: 25.3394%;\"\u003e\n \u003cp\u003eAmplifying Turmoil\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47.5113%;\"\u003e\n \u003cp\u003eRumination and exaggerating problems\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 47.5113%;\"\u003e\n \u003cp\u003eRegretfully comparing oneself with others\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 47.5113%;\"\u003e\n \u003cp\u003eResiding in nursing homes\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 47.5113%;\"\u003e\n \u003cp\u003e\u0026nbsp;Engagement in obsessive behaviors\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 47.5113%;\"\u003e\n \u003cp\u003eDenial of children\u0026apos;s moving out\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 47.5113%;\"\u003e\n \u003cp\u003e\u0026nbsp;Emotional ventilation\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 47.5113%;\"\u003e\n \u003cp\u003e\u0026nbsp;Restarting smoking and substance abuse\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"5\" style=\"width: 25.3394%;\"\u003e\n \u003cp\u003eGetting Deadlock\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47.5113%;\"\u003e\n \u003cp\u003e\u0026nbsp;Behavioral disengagement\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 47.5113%;\"\u003e\n \u003cp\u003e\u0026nbsp;Isolation and seclusion\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 47.5113%;\"\u003e\n \u003cp\u003e\u0026nbsp;Self-blame\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 47.5113%;\"\u003e\n \u003cp\u003e\u0026nbsp;Dependency on neighbors\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 47.5113%;\"\u003e\n \u003cp\u003e\u0026nbsp;Suicidal rumination\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cu\u003eInner Alchemy Practices\u003cspan dir=\"RTL\"\u003e)\u0026nbsp;\u003c/span\u003eWill for Enduring the Difficult in Life\u003cspan dir=\"RTL\"\u003e(:\u003c/span\u003e\u003c/u\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eResearch participants demonstrated inner strength by enduring life\u0026apos;s challenges, turning pains into growth, and utilizing perseverance, silence, and mental avoidance to progress through hardships.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePerseverance through hardship:\u003c/strong\u003e Participants recognized that perseverance was essential for continuing to live meaningfully, even without the presence of their children.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026quot;Standing on your feet is just that\u0026mdash;enduring your limitations and loneliness. Coping with loneliness and the kids leaving means enduring, persisting, and surviving.\u0026nbsp;\u003c/em\u003e\u003cem\u003eIf you dwell on the issue, it becomes twice as difficult. That way, you can\u0026apos;t endure.\u0026quot; (65y)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eProgress through Strengths and Hardships:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eLearning from past difficult experiences contributed significantly to participants\u0026apos; resilience in the face of empty nest challenges. This resilience helped them maintain independence and even improved their mental health.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026quot;Look, I know that when someone wants something and strives to achieve it, they can endure hardships better. When you fight and strive, you achieve things.\u0026nbsp;\u003c/em\u003e\u003cem\u003e\u0026quot; (72 y)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eWorrying in silence\u003c/strong\u003e\u003cstrong\u003e.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eParticipants, despite feeling anxious about their children leaving home, they tried to appear composed and calm in various situations.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026quot;I didn\u0026apos;t want my wife and children to know about my concern, as they would also become worried.\u0026quot;\u003c/em\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003cem\u003e(74 y)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMental avoidance:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSome participants used the strategy of not dwelling on current and past losses, weaknesses, and difficulties following their children\u0026apos;s departure to cope with ENS.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026quot;If I continue to worry about what might happen now that my son has gone abroad, I\u0026apos;ll lose my mind.\u0026quot; I\u0026apos;ll get nervous and upset. Nothing will change. I try not to think about it. If you dwell on something excessively, it will eventually surface. (63 y)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cu\u003eCreating Meaningful Perspectives:\u003c/u\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eParticipants used coping strategies like positive thinking, hope, and self-encouragement to find new meaning in life after leaving children, fostering a renewed sense of purpose.\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003ePositive Thinking and Self-Encouragement:\u003c/strong\u003e\u003cbr\u003eParticipants emphasized the significance of focusing on positive aspects of life and practicing positive thinking to combat life\u0026apos;s hardships, comparing them to a dark tunnel.\u003cem\u003e\u0026quot;Hardships in life are like a dark tunnel. Now that I\u0026apos;ve passed through it, this mindset has greatly helped me endure problems better.\u0026quot;(60y)\u003c/em\u003e\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eHope for the Future:\u003c/strong\u003e\u003cbr\u003eA participant struggling with arthritis compared despair to sinking into darkness, saying, \u003cem\u003e\u0026quot;If I lose hope now, I won\u0026apos;t be able to move. I refuse to be depressed and desperate. When someone at home feels hopeless, it impacts everyone. (83y)\u003c/em\u003e\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eHumor:\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;Some participants adapted to loneliness by infusing humor and joy into their lives. Engaging in friendly gatherings, sharing jokes, and creating lighthearted moments brought them happiness.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003e\u003cem\u003e\u0026quot;Why should I be upset? Now I\u0026apos;m relieved. I have no small children or job to worry about. I enjoy outings with friends, and we have fun. We even gather at each other\u0026apos;s houses, making life easier for ourselves.\u0026quot;(71y)\u003c/em\u003e\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eFocus and Mindfulness:\u003c/strong\u003e\u003cbr\u003eThis strategy involved directing thoughts toward specific goals, which helped reduce anxiety and kept participants mentally active.\u003cem\u003e\u0026quot;Often, chaotic thoughts overwhelm me, bringing worry and turmoil, like the fear of being sick alone. But when I wake up, I focus on positive things to keep myself busy.\u0026quot;(83y)\u003c/em\u003e\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eReliance on spirituality and transcendence:\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;Spiritual beliefs and practices were significant sources of strength and resilience during late-life challenges, helping participants find meaning, maintain hope, and manage life\u0026apos;s complexities..\u003c/li\u003e\n\u003c/ul\u003e\n\u003cul type=\"disc\"\u003e\n \u003cli\u003e\u003cstrong\u003eBelief in divine destiny:\u003cbr\u003e\u003c/strong\u003eFaith provided hope and strength, enabling participants to respond more adaptively to loneliness.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003e\u0026nbsp;\u0026quot;\u003cem\u003eRelying on God helped me cope with loneliness. Despite receiving a lymphoma diagnosis, I placed my trust in God, perceiving these challenges as his test\u003c/em\u003e\u0026rdquo;.(80y)\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eGratitude:\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;Practicing gratitude helped participants shift focus from past losses, allowing them to evaluate their lives positively.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003e\u003cem\u003e\u0026quot;Every night, I look up at the sky and thank God for everything\u0026mdash;what He has given, taken, and withheld. I believe loneliness is my destiny, and I accept it as wisdom.\u0026quot;\u003c/em\u003e \u003cem\u003e\u0026rdquo;.(85y)\u003c/em\u003e\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eEngaging in religious rituals:\u003c/strong\u003e\u003cbr\u003eIndividual and communal spiritual practices helped alleviate emotional and psychological stress while fostering community engagement., \u003cem\u003e\u0026quot;I start my day relying on God, sending blessings, and reading the Quran whenever I miss my children.\u0026quot;\u003c/em\u003e \u003cem\u003e\u0026rdquo;.(65y)\u003c/em\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003eTranscendence:\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;Transcendence reflected a shift in self-perception, incorporating concepts like altruism, acceptance of death, and reframing solitude as purposeful\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eAltruism:\u003c/strong\u003e\u003cbr\u003eAltruism, despite financial constraints, has been found to enhance participants\u0026apos; aging experience, providing a sense of peace and readiness for the afterlife. \u003cem\u003e\u0026quot;Helping others is like helping myself. These beneficial deeds will remain for my afterlife. I always ask God for the strength to help others.\u0026quot;\u003c/em\u003e \u003cem\u003e\u0026rdquo;.(76y)\u003c/em\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cul type=\"disc\"\u003e\n \u003cli\u003e\u003cstrong\u003eReframing Solitude as Purposeful:\u003c/strong\u003e\u003cbr\u003eSome participants viewed solitude favorably, using it for reflection, reading, or listening to music. \u003cem\u003e\u0026quot;I now prefer being alone, reflecting on my life, reading books, or enjoying music.\u0026quot; (76y)\u003c/em\u003e\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eAcceptance of Death:\u003c/strong\u003e\u003cbr\u003eAcceptance of death, strengthened by a sense of closeness to God, was another coping mechanism. A participant who had lost his wife and child in an accident shared, \u003cem\u003e\u0026quot;Losing loved ones is hard, but I\u0026apos;ve come to terms with it. I gradually found myself again. After all, death is inevitable for everyone.\u0026quot; (79y)\u003c/em\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cu\u003eFlexiMorph Strategies\u003c/u\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eParticipants utilized FlexiMorph Strategies to adapt their behavior, self-concept, and routines to new situations, reshaping their lives and discovering new roles in the world.\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003eMaintaining a Positive Self-Concept:\u003c/strong\u003e\u003cbr\u003eFor many participants, a positive self-concept became a hallmark of wisdom, reflecting their ability to adapt and find meaning in adversity without succumbing to hopelessness. \u003cem\u003e\u0026quot;When you get on the bus, everyone respects you. Wherever I feel kindness, I understand and feel proud of myself.\u0026quot;(60y)\u003c/em\u003e\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eAdapting to Change:\u003c/strong\u003e\u003cbr\u003eParticipants demonstrated remarkable adaptability to life changes, especially after their children left, by adopting a realistic outlook and maintaining internal cohesion. A participant, who found herself alone after her children married, remarked, \u003cem\u003e\u0026quot;I try to handle my affairs. Life is like this\u0026mdash;children grow up, get married, and start their own lives. You can\u0026apos;t expect them to always be with us; they have problems. If I keep dwelling on why my children left and why I\u0026apos;m alone, I\u0026apos;ll be destroyed\u003c/em\u003e.\u0026quot; (80 y)\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eBehavior Modification:\u003c/strong\u003e\u003cbr\u003eIndividuals adapted or abstained from harmful activities after children\u0026apos;s departure, altering daily tasks or finding alternate means to maintain routines, such as changing a sewing profession due to eye strain.\u003cem\u003e\u0026quot;For years, I profited from stitching, but suddenly my eyes began to trouble me.\u0026quot; I recognized that I could not proceed due to the pressure on my eyes. After raising my children, I transitioned to a new role.\u0026rdquo; (61 y)\u003c/em\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003ch3\u003e\u003cu\u003e\u0026nbsp;\u003c/u\u003e\u003cstrong\u003e\u003cu\u003eNestEd (Education) Strategies\u003c/u\u003e\u003c/strong\u003e\u003c/h3\u003e\n\u003cp\u003eParticipants gained new life significance through educational frameworks, acquiring knowledge and skills to compensate for lost time with children, fostering personal and societal growth.\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003eEfforts to Be Useful:\u003cbr\u003e\u0026nbsp;\u003c/strong\u003eThe participants\u0026apos; approach to managing ENS emphasized productivity and relevance, emphasizing the importance of family and community involvement.\u0026quot;\u003cem\u003eI want to convey that even in retirement, I can still embrace life, be productive, and contribute to others. This is a facet of my obligation on this planet\u003c/em\u003e\u003cem\u003e.\u0026quot;\u003c/em\u003e (66 y)\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eGoing Beyond Stereotypes:\u003c/strong\u003e\u003cbr\u003eParticipants faced negative stereotypes and inappropriate attitudes towards older, lonely individuals, but chose to ignore them and pursue activities that provided pleasure and satisfaction.\u003cem\u003e\u0026quot;\u003c/em\u003e \u003cem\u003eWhen one is alone at home, others anticipate one\u0026apos;s decline. However, upon commencing painting classes, my neighbors remarked on my age. I was indifferent\u0026mdash;I found it captivating\u003cem\u003e.\u0026quot;\u003c/em\u003e\u003c/em\u003e (63 y)\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eActive Time Management:\u003c/strong\u003e\u003cbr\u003eParticipants actively managed their leisure time by visiting parks, playing games, caring for animals and plants, sewing, and traveling, enhancing their skills and enhancing their leisure time. \u003cem\u003e\u0026quot;I\u0026apos;m not much into TV, except for programs interpreting Rumi\u0026apos;s poems.\u0026nbsp;\u003c/em\u003e\u003cem\u003eNow that I am alone, I have raised my level and am listening attentively.\u0026quot;\u003c/em\u003e (83 y)\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eEngaging in Teaching-Learning Activities:\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;Participants utilized their life experiences for personal growth and empowerment through teaching, innovative initiatives, skill enhancement, music engagement, and modern technology learning.\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eTeaching Activities:\u003c/strong\u003e\u003cbr\u003eDespite experiencing loneliness, some participants found fulfillment in sharing their knowledge and skills with others, even in retirement. \u003cem\u003e\u0026quot;Since last year, I began a small sewing workshop with six machines. This has helped me overcome loneliness.\u0026nbsp;\u003c/em\u003e\u003cem\u003eI don\u0026apos;t think society should exclude retirees\u003cem\u003e.\u0026quot;\u003c/em\u003e\u003c/em\u003e (81 y)\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eInnovative Initiatives:\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;Participants engaged in creative activities, despite physical limitations, boosted their self-efficacy, displayed flexibility, and purposefulness, contributing to their overall well-being.\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eReinforcing Previous Skills:\u003c/strong\u003e\u003cbr\u003eFor some seniors, retirement provided an opportunity to rekindle skills and passions that had been dormant for years. \u003cem\u003e\u0026quot;While teaching physics was my career, I\u0026apos;ve always had a deep love for theater. Despite pursuing a different field, I remained involved with theater intermittently. I\u0026apos;ve returned to it now that I have no other obligations.\u0026quot;\u003c/em\u003e (79 y)\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eMusical Engagement:\u003c/strong\u003e\u003cbr\u003eMusic served as a powerful tool for finding solace and enjoyment in solitude. Participants who viewed music as a divine gift used it to elevate their spirits and combat loneliness. \u003cem\u003e\u0026quot;When I feel low, I retreat to my room, play an instrument, and forget my worries. Music is a divine gift that wards off loneliness.\u0026quot;\u003c/em\u003e (86 y)\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eLearning Modern Technology:\u003c/strong\u003e\u003cbr\u003eTechnological advancements such as cell phones, text messaging, and the Internet significantly improved communication between parents and their children, particularly for those living apart\u003cem\u003e\u0026quot;My children have lived abroad for several years. I stay in touch with them via online video calls, which makes me feel like they\u0026apos;re nearby. When I\u0026apos;m idle, I read economic news or research my medications.\u0026nbsp;\u003c/em\u003e\u003cem\u003eThis keeps me occupied, even when I\u0026apos;m alone\u003cem\u003e.\u0026quot;\u003c/em\u003e\u003c/em\u003e (89 y)\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cu\u003eAutonomy Preservation Strategies \u003cspan dir=\"RTL\"\u003e:\u003c/span\u003e\u003c/u\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eStrategies for preserving autonomy \u0026nbsp;emphasize self-sufficiency and the ongoing effort to maintain a feeling of autonomy as fundamental components in reclaiming life on their own terms.\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003eMaintaining an Independent Identity:\u003c/strong\u003e\u003cbr\u003eENS can be mitigated by maintaining an independent identity, which is tied to self-reliance and autonomy within society. One participant described this loss of autonomy using the metaphor of a \u0026quot;bird in a cage,\u0026quot; stating, \u003cem\u003e\u0026quot;My spouse complains every morning, treating me as if I know nothing. I lived independently my whole life, and now I have to wait for decisions on what to buy and wear. It feels like being in a cage where I have no power, like a bird waiting for someone to give it food and water. I long for the freedom and autonomy to do what I want.\u0026quot;\u003c/em\u003e (75 y)\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eFunctional Independence:\u003c/strong\u003e\u003cbr\u003eFunctional independence enhances daily activities, authority, self-care, and self-efficacy, while losing it can be distressing and negatively impact life satisfaction.\u003cem\u003e\u0026quot;I try to stand on my own feet. Even when I have guests, I prefer to do more chores myself. I sweep and cook. I strive to manage my tasks. I don\u0026apos;t want to burden anyone; I want to be self-sufficient.\u0026quot;\u003c/em\u003e \u003cem\u003e(81 y)\u003c/em\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u003cstrong\u003eProactive Engagement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDuring empty nest period, seniors tried to \u0026nbsp;re-engaged socially and professionally to restore a sense of belonging . they used participation-oriented strategies, spanned from informal volunteer activities to the maintenance of ongoing professional jobs\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eVoluntary and Informal Activities:\u003c/strong\u003e\u003cbr\u003eThese activities were crucial for social engagement in aging, including Social Cooperation and practical Support to family.\u003c/p\u003e\n\u003cul type=\"disc\"\u003e\n \u003cli\u003e\u003cstrong\u003eSocial Cooperation\u003c/strong\u003e\u003cstrong\u003e:\u003c/strong\u003e\u003cbr\u003eParticipants engaged in volunteer endeavors to assist strangers, including supporting those with disabilities and supplying essential resources such as food, clothes, and financial assistance. \u003cem\u003e\u0026quot;At the Khaghani Cultural and Literary Center, we helped a center for disabled individuals by offering financial and material assistance. To me, helping others means being active.\u0026quot;\u003c/em\u003e (88 y)\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003ePractical Support to Family:\u003c/strong\u003e\u003cbr\u003eCaring for grandkids and and aiding with familial duties enabled participants to experience fulfillment and uphold their parental obligations. \u003cem\u003e\u0026quot;Even though the children have moved out, I still handle their administrative tasks and look after their children. It keeps me connected to them.\u0026quot;\u003c/em\u003e (81 y)\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u003cstrong\u003eContinuation of Professional Roles:\u003c/strong\u003e\u003cbr\u003eParticipants found solace in continuing professional roles, which included monetary engagement, informal vocational counseling, and institutional participation, thereby avoiding feeling burdened.\u003c/p\u003e\n\u003cul type=\"disc\"\u003e\n \u003cli\u003e\u003cstrong\u003eMonetary Engagement:\u003c/strong\u003e\u003cbr\u003eEngaging in work, such as opening a small business, helped participants stay busy, ease boredom, and cope with loneliness. \u003cem\u003e\u0026quot;Having a job helps me feel useful and productive, much better than being unemployed.\u0026quot;\u003c/em\u003e (74 y)\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eInformal Vocational Counseling:\u003c/strong\u003e\u003cbr\u003eDrawing on their skills and experiences, some participants voluntarily took on new professional roles, enhancing their social participation and well-being. \u0026quot;\u003cem\u003eAfter retirement, I utilized my experience in cultural events to keep connected and retain my autonomy,\u0026quot; said one participant. (79y)\u0026nbsp;\u003c/em\u003e\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eInstitutional Participation\u003c/strong\u003e\u003cstrong\u003e:\u003c/strong\u003e\u003cbr\u003eParticipants\u0026apos; involvement ranged from simple membership in religious and social institutions to participation in political activities, contributing to a sense of belonging and active social engagement. \u003cem\u003e\u0026quot;I am involved in a couple of clubs, engaging without any particular obligations.\u0026quot;\u003c/em\u003e (80 y)\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cu\u003eInteraction oriented strategies\u003cspan dir=\"RTL\"\u003e:\u003c/span\u003e\u003c/u\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eInteraction-oriented techniques involved \u0026nbsp;intentional endeavors to cultivate relationships with family, friends , restore a feeling of belonging and emotional satisfaction and mitigate the isolation and loneliness generated by ENS.\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003eMaintaining Family Networks:\u003c/strong\u003e\u003cbr\u003eFamily connections were maintained to alleviate emptiness and grief after children\u0026apos;s departure, through frequent visits, communication, and collaborative activities, facilitating the transition to a new life stage.\u0026quot; \u003cem\u003efamilial connections were an organized aspect of her routine post-retirement, enabling her to manage the emotional intricacies of ENS more proficiently\u003c/em\u003e.\u003cspan dir=\"RTL\"\u003e\u0026quot;\u003c/span\u003e(71y)\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eSocial Bonding:\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;Interviewees emphasized the importance of fostering connections with friends and neighbors, as participating in social events restores normality and satisfaction, focusing on community and collective experience.\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u003cu\u003eEcho of the Stagnation:\u0026nbsp;\u003c/u\u003e\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe participants in the ENS state perceive it as emotionally paralyzing and psychologically declining, resembling a lonely winter filled with confusion and despair. The echo of cold isolation lingers, and harmful coping mechanisms deepen their sorrows, creating a self-reinforcing cycle of emotional upheaval and psychological passivity. This theme is crucial in understanding the participants\u0026apos; experiences\u003cspan dir=\"RTL\"\u003e.\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAmplifying Turmoil\u003cspan dir=\"RTL\"\u003e:\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAmplifying Turmoil refers to the increase in mental and emotional stress among the participants undergoing ENS. The sub-theme explains that,negative ways of coping instead of decreasing distress, \u0026nbsp; amplify it .\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003eRegretful Comparison of Self with Others:\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eA good number of empty nesters made unfavorable comparisons between themselves and others, like siblings or peers, thereby feeling inferior and increasing their mental distress. \u0026quot;\u003cem\u003eMy siblings are well-off, and sometimes I ask myself why I am not like them, why I am lower than them. Since the kids have gone, I notice their comfortable life while I am struggling\u003c/em\u003e.\u0026quot; (89 y)\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003eEngagement in Obsessive Behaviors:\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eSome participants developed obsessive behavior, such as excessive shopping and over-preparing food, to cope with anxiety and distress. This disrupted daily routines and increased the emotional load. \u0026quot;\u003cem\u003eI must wash everything several times. Now that my hands hurt and I have arthritis, I can\u0026apos;t be as active, and it bothers me a lot.\u0026quot;\u003c/em\u003e (73 y)\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003eRumination and Exaggerating Problems:\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eMost participants exaggerated their problems and focused on them until they consumed them. Rumination created a complicated and painfully emotional state,\u003cem\u003e\u0026quot;I felt abandoned when I lost my husband. He died and buried my motivation and joy.\u0026rdquo;\u003c/em\u003e (81 y)\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003eRestarting Smoking and Substance Abuse:\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eSome participants returned to smoking or substance abuse as a misguided way to cope with the emotional shock of their children\u0026apos;s moving out and ensuing loneliness. \u0026quot;\u003cem\u003eLoneliness hurts a lot. At times, I gather with my friends and indulge in drug use, which serves as a temporary escape from the pain of loneliness\u003c/em\u003e.\u0026quot; (77 y)\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003eDenial About Children Moving Out:\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eMany of these respondents grappled with the idea of leaving home with their children, expressing feelings of emptiness and a sense of closing a stage in their lives. \u0026quot;\u003cem\u003eI have found it difficult, or perhaps unwilling, to acknowledge that this child has transitioned into a new stage of life\u003c/em\u003e.\u003cem\u003e\u0026quot;\u0026nbsp;\u003c/em\u003e(69 y)\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003eResiding in Nursing Homes:\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eSome individuals, unable to care for themselves, either made the decision to enter nursing homes. One of the participants shared that this decision was typical, feeling both defeatist and filled with relief. \u0026quot;\u003cem\u003eAfter my husband died, I decided to enter the nursing home. Now, I have found my place and intend to remain here for the remainder of my life.\u0026quot;\u003c/em\u003e (88 y)\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003eEmotional Ventilation:\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003esome times, sharing \u0026nbsp; \u0026nbsp;of the emotional outburst very intense caused caught listeners off guard, \u0026nbsp;straining relationships with others. \u0026quot;\u003cem\u003eSometimes we get caught in emotional whirlwinds, and my relatives were irritated, overwhelmed by the forcefulness of my words\u003c/em\u003e.\u0026quot; (80 y)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eGetting Deadlock:\u003c/strong\u003e\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003eThe concept describes a state of nonaction experienced by individuals overwhelmed by life changes and setbacks, often characterized by maladaptive behaviors and thought processes that perpetuate feelings of helplessness and hopelessness, akin to a train at a standstill, unable to move forward.\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eBehavioral Disengagement:\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;Behavioral disengagement involves individuals intentionally withdrawing activities they once enjoyed, especially social interactions. This withdrawal is characterized by canceling plans, leaving early, and retreating into solitary activities. Although it serves as a coping mechanism, it can lead to further isolation and a deeper sense of loneliness.\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eSelf-Blame:\u003c/strong\u003e\u003cbr\u003eSelf-blame emerged as a particularly paralyzing aspect of this deadlock. Participants often internalized their perceived failures, leading to feelings of shame and self-devaluation. This self-directed negativity prevented them from engaging in new activities and trapped them in a cycle of guilt. \u003cem\u003e\u0026quot;I curse myself for the way things have turned out. I feel like a failure, and it\u0026apos;s all my fault that my children have left me.\u0026quot;\u003c/em\u003e (83 y)\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eIsolation and Seclusion:\u003c/strong\u003e\u003cbr\u003eLong periods of separation from their children, led many participants to choose isolation and seclusion. Despite opportunities to reconnect, such as invitations from family, they often preferred to remain alone and satisfied from their seclusion .\u003cem\u003e\u0026quot;My son invites me to join them, but I prefer to stay at home, feeling lonely. It seems easier to remain isolated.\u0026quot;\u003c/em\u003e (75 y)\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eDependency on Others:\u003c/strong\u003e\u003cbr\u003eParticipants experienced emotional dependency, which threatened their independence and created a sense of vulnerability due to their insatiable need to be close to certain people, unable to break these ties. This Dependency often left them feeling abandoned and unsure of their ability to survive on their own. \u003cem\u003e\u0026quot;I feel like they think it\u0026apos;s all over now, so they\u0026apos;re distancing themselves.\u0026quot;\u003c/em\u003e (90 y)\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eSuicidal Rumination:\u003c/strong\u003e\u003cbr\u003eFor some participants, the inability to maintain an independent living status led to intense anxiety and suicidal rumination. These participants, burdened by stressors and feelings of hopelessness, fixated on thoughts of ending their lives as a way to escape their suffering. \u003cem\u003e\u0026quot;Many times I\u0026apos;ve thought about dying and ending this life, but then I come to my senses and...\u0026quot;\u003c/em\u003e (74 y).\u003c/li\u003e\n\u003c/ul\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe present qualitative study investigated the lived experiences of Iranian empty nesters in the culturally diversified setting of Isfahan. The findings offer a comprehensive analysis of how these individuals navigate the emotional and psychological challenges that accompany ENS. The data analysis resulted in two major themes: the struggle for rediscovery and the echo of stagnation. These themes encapsulate the dual coping strategies employed by participants, as some sought new meaning in life, while others remained mired in patterns of emotional and psychological stagnation.\u003c/p\u003e \u003cp\u003eOn the theory of the empty nest perspective, it assumes that an empty nest is of significance as an event in the lives of older adult parents and a natural stage in the journey of parenting(\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e). This work, therefore, spotlights that the experiences of ENS span a broad spectrum because of cultural, gender, and individual differences. In fact, some argue that \"even in similar cultural contexts, this experience is highly gendered, with mothers experiencing more distress than fathers due to their deeper involvement in child-rearing and greater emotional connection.\" However, as the present research demonstrates, in Iran, the above gendered experiences closely relate to the pressure of cultural tradition, which puts women in a challenging position and complicates their identity work (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThis theme revealed a striking finding about inner alchemy practices, where participants demonstrated extraordinary inner strength by overcoming life's challenges and relying on resilience rooted in deep cultural and religious beliefs. This research aligns with the theory of the Season of Change, which posits that life transitions trigger both positive and negative coping strategies, by highlighting the culturally specific coping mechanisms used by Iranian empty-nesters. Participants from more traditional backgrounds often relied on religious practices such as \u003cem\u003eSabr\u003c/em\u003e (patience) and faith in divine wisdom, while those from more modern or urbanized environments were more likely to seek professional mental health support or engage in lifelong learning. This dichotomy aligns with existing literature that emphasizes the role of cultural and individual differences in shaping ENS experiences. This finding resonates with literature pointing to the role of spirituality in coping with life adversities (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe subgroup Creating Meaningful Perspectives underlines participants' proactive efforts toward the ENS problem. Consequently, they maintained hope and optimism by concentrating on positive thoughts, seeking self-encouragement, and drawing upon their spirituality. This finding agrees with other studies indicating the role of spirituality in emotional and psychic support during life transitions(\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). Most striking about this reliance on spirituality and transcendence is that it occurs within the Iranian context, where religious practices and beliefs are integral to daily life (\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e). Participants derived meaning and sense from this connection, enabling them to navigate the complexities of ENS with resilience.\u003c/p\u003e \u003cp\u003eFlexiMorph strategies is significant in Iranian culture, which links old age to status and autonomy loss (\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e). This theme of maintenance of independence is replicated in studies across different cultures, where the transition to an empty nest often requires a redefinition of self and a reaffirmation of personal autonomy(\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e). The theme of the NestEd paradigms also emerged as a critical strategy for rediscovering life after ENS. People viewed lifelong learning and education not as a mere passing of time, but rather as opportunities for personal growth and reinvention. This stress on efforts to be helpful and go beyond the stereotypes reflects a more considerable cultural change underway in Iran\u0026mdash;a perception of older adults as valuable members of society through which a lot can be contributed. This proactive engagement in education and skill development is indicative of active aging (\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e). This finding is consistent with other cultural contexts studies, where maintenance of purposefulness through continuing education and professional engagement made very substantial differences in the well-being of older adults. For example, studies of older adults in Korea and Thailand have equally emphasized that lifelong learning and community involvement could be essential remedies against the effects of ENS (\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e, \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn contrast, the theme of \u003cem\u003eEcho of Stagnation\u003c/em\u003e captures the experiences of participants who struggled to cope with ENS, leading to emotional and psychological stagnation. This theme is particularly poignant in the Iranian context, where the transition to an empty nest can be deeply isolating, especially for those who have dedicated their lives to their families. The subtheme of \u003cem\u003eAmplifying Turmoil\u003c/em\u003e highlights how maladaptive coping mechanisms, such as rumination and regretful comparisons with others, exacerbated participants' distress. These findings are consistent with studies that document similar patterns of negative coping in other cultural contexts, where unresolved grief and denial have been linked to deteriorating mental health outcomes (\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e). There is previous research that documents, as in this case, similar maladaptive coping patterns amongst older adults experiencing significant life changes(\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e). Abi-Habib and Luyten note that individuals who have the tendency to fall into such rumination act hostile and biased, unable to contain their anger, which often leads to disputes within interpersonal relationships (\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eSome participants experienced psychological stagnation, characterized by feelings of entrapment and inability to progress, as captured by the theme of Getting Deadlock. Behavioral disengagement, self-blame, and isolation exacerbated their helplessness, as they conformed to societal expectations that older adults should withdraw from society. This stagnation parallels the \"cul-de-sac\" phenomenon observed in other studies (\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e), where aging individuals, burdened by functional limitations, lose their sense of agency and meaning aspects(\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e). The \u003cem\u003esuicidal rumination\u003c/em\u003e subtheme is particularly alarming, reflecting profound psychological distress and underscoring the urgent need for mental health support in contexts like Iran, where discussing mental health remains taboo. Similar concerns are observed in other cultural contexts, including the Caribbean and Southeast Asia, often where the stigma surrounding mental health deters individuals from seeking help, exacerbating their struggles. This issue underscores the critical need for mental health interventions that respect cultural and social norms (\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e, \u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e).\u003c/p\u003e \u003cp\u003ePolicymakers should be aware of the need for programs that foster opportunities for older adults to remain socially engaged through lifelong learning, given the rapid social changes in Iran due to the rise of single-child families and migration. This would include community-organized educational programs, mental health campaigns, and support for older adult parents in dealing with the challenges of ENS. By promoting active aging in a society where older adults can connect and remain socially relevant in Iran, these interventions could contribute to mitigating the adverse effects of ENS.\u003c/p\u003e \u003cp\u003eThe arrival of Generation Z, with their emphasis on individualism and technological know-how, meant new challenges for older generations in general but especially in the context of ENS. As young Iranians more and more compromise adherence to traditional family structures for personal and career goals, the risk of social isolation for older parents has grown. The study labels this as a \"technological empty nest\", where the pervasiveness of technology creates a sense of alienation between parents and children, even when they are physically proximate.\u003c/p\u003e \u003cp\u003eIn this regard, policymakers would do well to design culturally sensitive strategies to bridge this intergenerational gap. Digital literacy programs are among the strategies that will ensure older adults stay in touch with their children and grandchildren in this digital era. We would design the strategies to maintain respect and uphold traditional family values, all while adapting to the evolving dynamics of modern Iranian society.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis research emphasizes the complex dynamics of dealing with ENS among Iranian parents, influenced by cultural norms, individual resilience, and the difficulties associated with aging. Some parents manage this shift with resilience and proactive engagement, others experience stagnation and despair. The generation of children who prioritize individualism and are highly proficient with technology adds new challenges to ENS for older parents in Iran. As family structures evolve and trends like single-child families and migration increase, feelings of loneliness and isolation among older adult parents have intensified. These findings emphasize the need for culturally sensitive interventions that promote positive coping strategies, lifelong learning, and mental health support. Policymakers should address the challenges posed by intergenerational differences and societal changes to ensure that the older adult in Iran remain connected and socially relevant. Developing the concept of healthy aging and planning for its realization in the society is also very important. Encouraging the older adult to psychosocial self-care and developing a social support network can also be among the suggestions of this study.\u003c/p\u003e \u003cp\u003e \u003cb\u003eLimitations\u003c/b\u003e \u003c/p\u003e \u003cp\u003eOne of the limitations of this study was the fatigue and impatience of the older adult. In this context, we tried to conduct the interviews in short time intervals, and whenever the older adult did not want to answer, the interview was stopped. Whenever the older adult persons were emotionally unable to respond, empathy was given to them.\u003c/p\u003e \u003cp\u003e \u003cb\u003eRecommendations for Future Research\u003c/b\u003e \u003c/p\u003e \u003cp\u003eFuture research should explore coping strategies among empty nesters in Iran, considering psychological, social, and cultural factors. Comparative analyses of urban and rural situations could reveal unique challenges and resources. Creating culturally specific therapies could improve overall well-being.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eENS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eEmpty Nest Syndrome\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eTA\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eThematic Analysis\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eAMT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAbbreviated Mental Test\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was approved by the Ethics Committee of Isfahan University of Medical Sciences (approval number: 395911, date: 2018). All participants provided written informed consent prior to participation, including permission for audio recording and anonymized data usage.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data supporting the findings of this study are available from the corresponding author upon reasonable request. To protect participant confidentiality, full transcripts are not publicly accessible.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFRD contributed to data collection, transcription, and initial analysis. MN led the study design, conducted the final analysis, and drafted the manuscript. SN assisted in the interpretation of findings and manuscript editing. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors would like to thank all participants for sharing their experiences, as well as the local health and social service centers that facilitated the interview process. Special thanks to Dr. Sodabeh Zaree for methodological consultation.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eHe W, Goodkind D, Kowal PR. An aging world: 2015. United States Census Bureau Washington, DC; 2016.\u003c/li\u003e\n\u003cli\u003eLau AL, Chi I, Cummins RA, Lee TM, Chou K-L, Chung LW. The SARS (Severe Acute Respiratory Syndrome) pandemic in Hong Kong: Effects on the subjective wellbeing of elderly and younger people. Aging and mental health. 2008;12(6):746-60.\u003c/li\u003e\n\u003cli\u003eYoung C. 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A long and resilient life: the role of coping strategies and variability in their use in lifespan among women. Anxiety, Stress, \u0026amp; Coping. 2024;37(4):473-86.\u003c/li\u003e\n\u003cli\u003eAbi-Habib R, Luyten P. The role of dependency and self-criticism in the relationship between anger and depression. Personality and Individual Differences. 2013;55(8):921-5.\u003c/li\u003e\n\u003cli\u003eYounesi SJ, Khanjani MS, Abdi K, Mardani-Hamooleh M, Sohrabnejad S. Captivity in the dead-end of life; the lived experiences of male drug users who have attempted suicide. Journal of Substance Use. 2024;29(2):270-6.\u003c/li\u003e\n\u003cli\u003eMitchell BA. Empty nest. Encyclopedia of gerontology and population aging: Springer; 2022. p. 1637-42.\u003c/li\u003e\n\u003cli\u003eAgimudie T. Caribbean mothers and the empty nest: A qualitative study: Capella University; 2021.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-psychology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"psyo","sideBox":"Learn more about [BMC Psychology](http://bmcpsychology.biomedcentral.com/)","snPcode":"","submissionUrl":"","title":"BMC Psychology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Empty Nest Syndrome, Coping Strategies, Iran, Aging, Cultural Context","lastPublishedDoi":"10.21203/rs.3.rs-6427726/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6427726/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eEmpty Nest Syndrome (ENS) presents significant emotional challenges for older adult, especially in cultures with strong family bonds like Iran. This qualitative study explores the coping strategies, both positive and negative, employed by empty nesters in Iran, offering insights into how aging individuals navigate the emotional consequences of their children leaving home.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eWe conducted semi-structured individual interviews with 40 empty nesters, a mix of men and women aged 60\u0026ndash;97 years, were selected through purposeful sampling. Data collection and analysis occurred concurrently. Thematic analysis revealed two main themes: \"Struggle to Rediscover Life\" and \"Echo of Stagnation,\" which reflect opposing coping strategies related to aging and family dynamics.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe themes highlight two distinct sets of strategies: one focused on active engagement, resilience, and personal growth, while the other reflects emotional stagnation and a sense of loss. Positive coping strategies included perseverance, hope, humor, spiritual reliance, and proactive social engagement. In contrast, negative strategies involved emotional rumination, social isolation, and harmful behaviors such as substance abuse.\u003c/p\u003e\u003ch2\u003eDiscussion\u003c/h2\u003e \u003cp\u003eThese results tell us a lot about how complicated Iranian empty nesters feel. They also show how important it is for healthcare and policies to be sensitive to different cultures in order to help older people deal with the mental effects of empty nest syndrome. Knowing both the good and bad ways that this group of people copes can help people come up with personalized interventions that improve their mental health.\u003c/p\u003e","manuscriptTitle":"The Echo of the Stagnation or Struggle to Rediscover Life: Stories of Positive and Negative Coping Strategies among Older Adult Empty Nesters in Iran","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-05-23 06:41:58","doi":"10.21203/rs.3.rs-6427726/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewersInvited","content":"","date":"2025-05-21T13:44:53+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-05-13T09:01:09+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-04-25T12:14:14+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-04-25T11:11:35+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Psychology","date":"2025-04-25T11:10:26+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-psychology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"psyo","sideBox":"Learn more about [BMC Psychology](http://bmcpsychology.biomedcentral.com/)","snPcode":"","submissionUrl":"","title":"BMC Psychology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"a64dfba0-0d59-4c99-9d59-9085e2bb1589","owner":[],"postedDate":"May 23rd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-05-23T06:41:58+00:00","versionOfRecord":[],"versionCreatedAt":"2025-05-23 06:41:58","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6427726","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6427726","identity":"rs-6427726","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}