The Effect of Group Logotherapy on Spirituality and Death Anxiety of Patients with Cancer: An Open-Label Randomized Clinical Trial

Abstract

Background: Cancer is one of the most important health problems, which cause anxiety. Owing to physical and psychological problems it may lead to thinking about impending death. Logotherapy is the most powerful method to treat problems that exist in nature. Objectives: This study aimed to determine the effect of group logotherapy on spirituality and death anxiety in patients with cancer. Methods: This randomized clinical trial study was done on patients with cancer referred to Imam Khomeini Hospital in Sari in 2017. Sixty-four eligible patients were selected from the oncology clinic using convenience sampling method. Patients were randomly allocated to the control and intervention groups (n = 32). Group logotherapy was done for the intervention group for five weeks. Data was gathered through a questionnaire, including demographic, Templer Death Anxiety Scale (DAS), and Spirituality Questionnaire (SQ) one week before and one week after the intervention. Data were analyzed in SPSS V. 16 software using independent t-test, Wilcoxon, and Mann-Whitney U test. The significant level was considered 0.05. Results: There were no significant differences in death anxiety and spirituality scores between the two groups at baseline, indicating that the two groups were matched in terms of death anxiety and spirituality. Before the logotherapy, the mean score of death anxiety in both groups was high (more than 8). After the logotherapy, the mean and SD of death anxiety score in the intervention and control groups were 7.14 ± 4.12 and 9.76 ± 2.64, respectively, there were statistically significant differences in death anxiety scores between the groups (P < 0.05). There were statistically significant differences between the mean of spirituality score in the intervention group before and after the logotherapy (P < 0.05), but it was not significant in the control group, indicating that group logotherapy was effective in increasing the spirituality score. Conclusions: Based on the findings, group logotherapy can increase the spirituality score of the patients. Moreover, the logotherapy may result in decreasing death anxiety, and spirituality-oriented meetings may be beneficial for patients.

Effect of Group Logotherapy on Anxiety About Death and Existential Loneliness in Patients With Advanced Cancer

“…These effects are substantial, and the general finding is consistent with the other research that has established the effectiveness of logotherapy for treating death anxiety. 29,30 The results also supported the hypothesis that group logotherapy reduces feelings of existential loneliness in patients with advanced cancer. To our knowledge, this study represents the first to demonstrate the effectiveness of group logotherapy in threating existential loneliness.…”

“…Logotherapy can help patients accept their unchangeable destiny and improve their spiritual well-being for the rest of their lives. Spiritual well-being may decrease the anxiety of patients on the verge of death 29,30 . Moreover, few studies have addressed the effectiveness of logotherapy on existential loneliness in patients with cancer.…”

Effects of different psychosocial interventions on death anxiety in patients: a network meta-analysis of randomized controlled trials

“…Our analysis encompassed 15 RCTs in total, involving a cohort of 926 patients. The interventions in experimental group comprised the following: spiritual care (1 study) ( Amini et al, 2020 ), group logotherapy (2 studies) ( Emafti et al, 2019 ; Heidary et al, 2023 ), acceptance and commitment therapy (3 studies) ( Farahi and Khalatbari, 2019 ; Sahebanmaleki et al, 2021 ; Fadhil et al, 2022 ), cognitive-behavioral therapy (2 studies) ( Moradi et al, 2022 ; Saki et al, 2022 ), logotherapy (2 studies) ( Akbari et al, 2021 ; Bahar et al, 2021 ), rational-emotive hospice care therapy (1 study) ( Onyechi et al, 2016 ), spirituality therapy training (1 study) ( Ameri et al, 2021 ), positive psychology group therapy (1 study) ( Saeedi et al, 2016 ), mindfulness based cognitive therapy (1 study) ( Nabipour et al, 2018 ), and white noise and Benson’s relaxation technique (1 study) ( Ahmadi et al, 2022 ). Thirteen studies utilized TDAS as an outcome indicator.…”

“…This research seeks to explore and compare these interventions, providing evidence-based insights into their effectiveness in reducing death anxiety among patients. Several therapeutic approaches, such as spiritual care, group logotherapy, acceptance and commitment therapy, cognitive-behavioral therapy, and rational-emotive hospice care therapy have been empirically proven to effectively alleviate the experience of DA in patients ( Onyechi et al, 2016 ; Saeedi et al, 2016 ; Nabipour et al, 2018 ; Emafti et al, 2019 ; Farahi and Khalatbari, 2019 ; Amini et al, 2020 ; Akbari et al, 2021 ; Ameri et al, 2021 ; Bahar et al, 2021 ; Sahebanmaleki et al, 2021 ; Ahmadi et al, 2022 ; Fadhil et al, 2022 ; Moradi et al, 2022 ; Saki et al, 2022 ; Heidary et al, 2023 ). This meta-analysis exclusively includes randomized controlled trials (RCTs) to ensure the highest level of evidence and minimize bias.…”

The effect of group logotherapy on spirituality and preoperative anxiety in patients seeking open heart surgery referring to Tehran Heart Center in 2020

“…studied the effect of group logotherapy on spirituality and death anxiety in cancer patients and showed that the mean score of death anxiety in both groups was high (more than 8) because the two groups were similar in terms of death anxiety and spirituality before logotherapy, but after logotherapy, there was a significant difference in death anxiety scores between the groups ( P < 0.05). [ 44 ] There was also a statistically significant difference between the mean score of spirituality in the intervention group before and after logotherapy ( P < 0.05), but in the control group, it was not significant, indicating that group logotherapy is effective in increasing the score of spirituality and reducing death anxiety.…”