The Effectiveness of Logotherapy on the Sense of Energy and Spiritual Self-Esteem of the Elderly Living in Nursing Homes

The changes that occur in old age may lead to a significant decrease in physical ability and can make them feel empty and burdensome. Therefore, this study was conducted to investigate the effectiveness of logotherapy on the sense of energy and spiritual self-esteem among older people. In terms of purpose, this research was practical, and in terms of its nature, it was a quasi-experimental study with a pretest-posttest-follow-up design with a control group. The statistical population of the current research included all older people over 65 living in Qazvin, Iran in 2023, Among whom, a sample of 40 people was selected using convenience sampling method and according to inclusion and exclusion criteria and randomly assigned into two experimental and control groups (20 people in each group). The data collection tools included Atwater and Carmeli's Energy Feeling and Farhosh et al.’s Spiritual Self-Esteem questionnaires. Moreover, Frankel’s logotherapy protocol was utilized in the format of eight 90-minutes group sessions. The data were analyzed using univariate analysis of covariance (ANCOVA) in SPSS-27 software. The findings revealed that logotherapy significantly increased the sense of energy and spiritual self-esteem in older people. Based on the results of the current study, it can be concluded that strengthening spiritual empowerment via meaning therapy may enhance the sense of energy and spiritual self-esteem in older adults.
EXTENDED ABSTRACT
 Introduction
lder age represents a critical stage in human psychological development, marked by specific physiological, cognitive, and social changes. Evidence suggests that older individuals vary in experience of sense of energy, with such variances largely dependent on motivational influences and individual characteristics. Exclusion from family can engender feelings of emptiness and despair among older adults, leading them to become disengaged from life and experience a sense of energy depletion and fatigue. Additionally, spiritual self-esteem profoundly influences the cognitive processes, emotions, aspirations, and values of older individuals. Those with high self-esteem are more likely to withstand challenges, whereas decreased self-esteem increases the likelihood of surrender or underutilization of their capabilities. Nowadays, logotherapy appears to play a significant role in the mental health and quality of life of older population. In recent years, logotherapy has been effective in enhancing energy levels, sense of purpose, quality of life, increasing hopefulness, and reducing feelings of loneliness among older adults. Therefore, considering the existing gaps in the research literature in this realm, the present study aimed to investigate the effectiveness of logotherapy on the sense of energy and spiritual self-esteem among older residents of nursing homes.
Method
The present study employed a quasi-experimental design with pretest-posttest-follow-up with a control group. The population consisted of all older individuals aged 65 years and above in Qazvin, Iran, among whom 40 participants (20 in the experimental group and 20 in the control group) were selected as the study sample using convenience sampling and according to inclusion and exclusion criteria. Inclusion criteria comprised (1) age between 65 to 70 years, (2) willingness to participate in the study, (3) residency in elderly care centers, and (4) literacy in reading and writing. Exclusion criteria included (1) acute psychiatric illness, (2) refusal to complete questionnaires, and (3) absence for more than one session. Participants initially completed the Atwater and Carmeli's (2009) Energy Feeling and Farhoush et al.’s (2019) Spiritual Self-Esteem questionnaires as pretests. The intervention protocol was based on the principles and techniques of Frankl’s logotherapy (1978), administered to the experimental group over eight 90-minute sessions, with a standard 15-minute break during each session, while the control group received no intervention. Two days after the end of intervention, both groups were assessed for energy levels and spiritual self-esteem (posttest). Two months after the posttest assessment, a follow-up was conducted. The data obtained from pre-test, post-test, and follow-up were entered into SPSS-27 and analyzed using univariate covariance analysis (ANCOVA).
 Results
The results indicated that the distribution of scores for all variables are normal, and the assumption of variance homogeneity was confirmed using Levene’s test, while the assumption of covariance homogeneity was confirmed using regression coefficients. The results of ANCOVA for the energy feeling and spiritual self-esteem scores among older participants are presented in Table 1.
According to table 1, the F statistic for the variables of energy feeling and spiritual self-esteem in the post-test are 19.890 and 34.701, respectively, and in the follow-up stage, they are 21.651 and 35.504, respectively, that all of these statistics are significant at the 0.01 level, indicating that there is a significant difference between the two groups in terms of both variables. Based on the means of these variables, this suggests that the mean scores of the experimental group in the post-test and follow-up stages for both variables are significantly higher than the mean scores of the same group in the pre-test stage. This implies that logotherapy significantly increased the levels of energy feeling and spiritual self-esteem among the older participants in both the post-test and follow-up stages.
Conclusion
Logotherapy helps the older adults to discover values, meaning, and purpose in their lives, enabling them to cope with challenges and transitions more effectively. Through enhancing social relationships, searching for meaning, finding life purpose, and accepting changes, this approach helps older adults attain energy felling and psychological-emotional growth. Additionally, logotherapy can motivate individuals to engage more enthusiastically in daily living and can provide an opportunity for establishing and strengthening social connections among older adults. Furthermore, logotherapy aids older people in recognizing their role and existential depth in the world. This process, facilitated by finding meaning, connecting with others, and serving larger communities, can strengthen the spiritual self-esteem of older adults and assist them in discovering significant meaning and purpose in life experiences. Even in the face of challenges and aging-related changes,
through accepting and experiencing meaning in life, the elderly can feel a deep and meaningful connection with others, society, and the spiritual dimension of life, which ultimately aids in strengthening their spiritual self-esteem and can guide them towards deeper spiritual engagement in life.
Ethical Consideration
Ethical Code
To comply with ethical standards in the research, the current study, extracted from the master’s thesis, was pre-registered at Payame Noor University, Bushehr Branch.
Financial Support
 This study had no financial support
Authors’ Contributions
H.A: Conceptualization, methodology, software, validation, project administration; H.M: Resources, writing- original draft, writingreview & editing; S.A: Data curation, formal analysis.
Conflict of Interest
The author had no conflicts of interest.
Acknowledgments
The researchers would like to express their gratitude to the authorities of the elderly care centers in Qazvin and the older men and women for their cooperation.
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