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

Abstract

BackgroundAlthough logotherapy has been shown to relieve other psychological symptoms of patients with cancer, no studies have specifically investigated the effect of logotherapy on anxiety about death and existential loneliness in these patients.ObjectiveThe aim of this study was to determine the effect of group logotherapy on anxiety about death and existential loneliness in patients with advanced cancer.MethodsSixty-three patients who were in the advanced stage of cancer were recruited from 2 hospital oncology services and were randomly assigned to either experimental (n = 31) or control group (n = 32). The intervention group received 10 weekly 2-hour group logotherapy. Templer’s Death Anxiety Scale and ELQ were completed pre- and posttreatment.ResultsA 2 × 2 mixed analysis of variance was used to determine the effect of the treatment on each of the dependent variables. The analyses revealed that patients in the logotherapy group reported a significant decrease in anxiety about death and existential loneliness after (vs before) the treatment. No significant decreases were observed in the waitlist control group.ConclusionsThese results have implications for treating death anxiety and feelings of existential loneliness among patients with advanced cancer. They suggest that group logotherapy is highly effective in reducing these existential concerns. Limitations and avenues for future research are discussed.Implications for PracticeThe study emphasizes that group logotherapy can be considered in oncology care programs by healthcare professionals and in educational curriculums and is suggested for use among caregivers and patients with advanced 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.…”

Design and effectiveness of an online group logotherapy intervention on the mental health of Iranian international students in European countries during the COVID-19 pandemic

“…The existential dimensions addressed by logotherapy resonate with individuals dealing with life-threatening illnesses and challenges, offering a sense of purpose and meaning. Thus, logotherapy has effectively addressed anxiety and depression across various existential scenarios such as mothers of children with cancer and individuals with advanced cancer ( 33 , 37 , 84 ); managing distress, demoralization, and hopelessness in cancer patients ( 44 , 85 ); reducing existential loneliness and anxiety about death ( 85 ), enhancing hope of life ( 36 ), and improving self-esteem and happiness among teenagers ( 34 ). In other specific populations, such as diabetic patients with depression, logotherapy has effectively reduced death anxiety, increased hope, and improved medication compliance ( 41 ).…”

Current practices in managing end-of-life existential suffering

“…While individual logotherapy has been shown to be relatively effective in managing death anxiety and existential loneliness, group logotherapy fosters a shared meaning of common hardship and allows each member of the group to feel less alone and more connected to the world around them. Heidary et al 4▪ tested group logotherapy which was comprised of 10 weekly sessions, and each therapeutic session lasted about 2 h. See Table 1 to review Heidary and colleagues findings on the effectiveness of group logotherapy in patients with terminal cancer.…”

“…Common existential concerns dying persons can experience are heightened death anxiety, feelings of social, and existential loneliness, and a sense of meaninglessness. Moreover, given the foreshortened time, dying persons are vulnerable to feeling hopeless and may therefore lack the motivation to pursue resources that foster meaning in life and promote coping skills that could help remediate ES 4▪. The remediation of dying persons’ ES can present challenges to EOL care clinicians but has received increasing clinical attention over the past few decades.…”