The Effect of Logotherapy Based on Rumi’s Thoughts on Anxiety, Depression, and Distress in Frontline Nurses During the COVID-19 Pandemic

Abstract

Background: With the spread of infectious diseases, especially coronavirus disease 2019 (COVID-19), healthcare workers are vulnerable to mental health problems. Culture-based interventions in such critical situations are highly effective for the individuals in that cultural context. Objectives: The current study aimed to investigate the effect of Logotherapy Based on Rumi’s Thoughts (LBRT) on depression, anxiety, and distress in frontline nurses during the COVID-19 pandemic. Methods: The present study employed a quasi-experimental controlled pre-test-post-test design with a 2-month follow-up. This interventional study was conducted on frontline nurses during the COVID-19 pandemic 2020. Imam Khomeini and Fatemeh Zahra hospitals were selected as the research samples, as they were the main educational and medical centers of Mazandaran University of Medical Sciences, Mazandaran, Iran, and provincial referral centers. A total of 32 eligible individuals were selected for experimental (n = 16) and control (n = 16) groups through the convenience sampling method. The data were collected using the Impact of Event Scale-Revised and the Hospital Anxiety and Depression Scale. Logotherapy Based on Rumi’s Thoughts included eight sessions of 90 minutes. The control group did not receive any intervention during the study. The data were analyzed using repeated-measures one-way analysis of variance (ANOVA). Results: The results revealed a statistically significant difference between the two groups. The intervention group exhibited lower levels of depression and anxiety among the frontline nurses at the post-test and 2-month follow-up than the control group (P < 0.001). However, there was no significant difference between the two groups in terms of distress at the post-test and 2-month follow-up (P > 0.001). Conclusions: The findings showed that LBRT improved anxiety and depression among frontline nurses during the COVID-19 pandemic. However, this intervention did not significantly affect frontline nurses’ distress during the COVID-19 crisis. Further studies should examine the effectiveness of culture-based interventions in critical situations.

A Scoping Review on the Use of Rumi’s Allegories and Metaphors in Psychotherapy

“…According to our review, the first article that psychologically investigated Rumi's thoughts was published in 1999 (25). Furthermore, we found that the number of studies has been growing increasingly in recent years, with 10 of 24 studies published in 2020 and 2021 (26)(27)(28)(29)(30)(31)(32)(33)(34)(35). Also, in recent years, the articles have studied more diverse topics and have been more experimental.…”

“…Since most of the studies were conducted in Iran, only 21% of the studies were written in the English language (21,25,27,32,36). Among the reviewed studies, Rumi's metaphors and allegories have been employed more in cognitive approach (31,32,(36)(37)(38)(39)(40), mindfulness-based approach (21,26,28,29,33,41,42), and existential-humanistic approach (29%, 29%, and 25%, respectively) (25,35,(43)(44)(45)(46). Also, 3 studies have developed interventional packages based on Rumi's thoughts (30,34,41).…”

“…An experimental study assessed the effectiveness of mindfulness therapy using Rumi's metaphors (29). Alipour and Norouzi elucidated the concept of mindfulness using the allegory of "The naked man and the bee," among other metaphors by Rumi (26). Mirdal highlighted the parallels between mindfulness-based therapies and Rumi's thoughts, emphasizing acceptance of the present moment, the ''beginner's mind,'' decentration, meditation practices such as breathing and walking, and the integration of body and mind through music and dance, reflecting the concept of ''flow'' and letting go (21).…”

“…Similarly, Alipour and Norouzi developed a logotherapy approach based on Rumi's thoughts, addressing concepts such as the source of meaning, selfregulation, acceptance, assimilation of suffering, mindfulness through dhikr and meditation, death anxiety and meaning-making, patience and tolerance in suffering, and gratitude. Empirical evidence indicated that this logotherapy approach improved well-being reduced death anxiety and depression, enhanced social health and autobiographical memory among the elderly (26), and alleviated anxiety and depression in frontline nurses during the COVID-19 pandemic (53). Additionally, Farazi et al implemented a model that integrated communication skills training with techniques derived from Rumi's allegory of the Parrot and Merchant (30).…”