The Effectiveness of Drama Therapy on Happiness and Life Expectancy of Older Women Living in Nursing Homes

The older adults are subject to loneliness and isolation, and due to physical and mental disabilities, their individual independence is threatened in many cases. The set of these conditions leads to a decrease in the quality of life and ultimately to a decrease in happiness and life expectancy in older adults. As a result, this study aimed to determine the effectiveness of drama therapy on increasing the happiness and life expectancy of older women. This was a quasi-experimental study with pretest-posttest design with a control group. The statistical population included all older women residing in nursing homes in Qom, Iran in 2023, among whom 30 people (65 to 80 years old) were selected using convenience sampling method and with regarded to the inclusion criteria, and randomly assigned into experimental and control groups. The experimental group received eight 90-minute sessions of drama therapy and the control group did not receive any training. The content of the sessions was derived from Moreno's perspective on drama therapy. Participants responsed the Oxford happiness questionnaire and Snyder’s life expectancy test. The data were analyzed using univariate analysis of covariance (ANCOVA) in SPSS-26 software. The results showed that drama therapy led to a significant increase in happiness and life expectancy in the experimental group (P<.01). Based on the results, it is recommended that counselors and psychologists of nursing homes take advantages of drama therapy along with other methods to improve happiness and life expectancy in older adults.
EXTENDED ABSTRACT
 Introduction
Happiness and life expectancy in older adults diminish due to the downward trend of biological processes and the increase in quantitative and qualitative stressors during old age. Despite the implementation of interventions such as drama therapy for targeting depression, death anxiety, social anxiety, social adjustment, and subjective well-being in older adults, the effectiveness of this therapeutic approach concerning both happiness and life expectancy has not been simultaneously investigated in Iran. This is while that the older population poses a fundamental challenge for future of Iran that society will inevitably confront. This study was conducted due to the efficacy of drama therapy as one of the effective methods to enhance happiness and life expectancy, and given the ever-increasing older population, alongside limited research on the impact of drama therapy on the happiness and life expectancy of older adults. Moreover, the results of this research could have practical implications for families with older members, counseling centers, psychological services, and older adults’ care facilities. Based on the results of present study and similar ones, authorities could consider enrolling older individuals in drama therapy workshops to enhance their psychological attributes. Therefore, this study aimed to investigate the effectiveness of drama therapy on increasing the happiness and life expectancy in older women.
Method
This study was a quasi-experimental research with pretest-posttest design with a control group. The statistical population consisted of all older women residing in the nursing homes in Qom, Iran in 2023, among which Fatemieh nursing home was selected using convenience sampling, in which thirty participants were selected according to the inclusion criteria and were randomly assigned into experimental and control groups, each of which had 15 members. Inclusion criteria comprised (1) age between 65 to 80 years, (2) being literate, (3) scoring lower on the Oxford happiness and Snyder’s life expectancy scales, and (4) willingness to participate, while exclusion criteria included (1) the consumption of psychiatric medications, (2) history of receiving drama therapy, and (3) absence for more than one session. Participants filled out the questionnaires. The content of sessions was extracted from Moreno’s perspective on drama therapy. The experimental group received eight 90-minute sessions of drama therapy once a week, while the control group did not receive any intervention. The therapeutic protocol was implemented by the researcher and a theater director using methods such as lectures, question and answer, group discussions, and practical skill exercises in group form in Fatemieh nursing homes. At the end of each session, based on the taught content, tasks were assigned to the older women, which were considered at the beginning of the subsequent session and feedback was given to them. The data obtained from the questionnaires were analyzed using analysis of covariance (ANCOVA) in SPSS-26 software.
Results
Prior to conducting ANCOVA, it was established that the distribution of scores of variables in the experimental and control groups was normal. The results also indicated the homogeneity of variances and regression coefficients. As the assumptions of the ANCOVA were met, ANCOVA was utilized to examine the effectiveness of drama therapy on happiness and life expectancy. The results indicated that in the pretest phase, the mean scores of happiness and life expectancy in two groups had no significant difference before the intervention. However, the mean scores of happiness and life expectancy of the experimental group indicated an increase after the intervention. The results of this analysis are presented in Table 1.
As demonstrated in Table 3, there was a significant difference between the experimental and control groups in terms of happiness. In other words, according to the mean score of happiness in the experimental group (51.53) compared to mean score of happiness in the control group (18.46), drama therapy led to a significant increase in happiness within the experimental group. Therefore, the first hypothesis was confirmed. Plus, there was a significant difference between the experimental and control groups in terms of life expectancy. In other words, considering the mean score of life expectancy in the experimental group (27.33) compared to the mean score of life expectancy in the control group (14.06), drama therapy resulted in a substantial increase in life expectancy in the experimental group. Hence, the second hypothesis was confirmed.
Conclusion
Drama therapy is a performance-centered approach that uses repeated theatrical exercises to facilitate the reconstruction of both positive and negative emotional situations which helps individuals to enhance their positive emotions and reduce their negative ones. Therefore, according to its theatrical play, creative techniques, and attractiveness, drama therapy can contribute to increasing happiness. The efficacy of art therapy in improving older adults’ life expectancy lies in fostering connections among individuals and between individuals and the therapist, enhancing intimacy, self-expression, disclosure, and emotional exploration within an art-based relationship. When these relationships develop within a group setting, it leads to the enhancement of the level of connection and interaction among individuals, the diminishment of negative emotions, and affects the shared objectives in areas of personal functioning, such as interacting with others, which, in turn, result in the increase of the effectiveness of therapy. Drama therapy provides a platform where older adults, who suffer from anxiety-related issues, can indirectly express their emotions and unpleasant experiences they might feel unable to articulate directly, through pantomime, role-playing, and personalization. Hence, drama therapy in comparison with verbal communication can be considered as a more suitable tool for establishing connections, all of which collectively may contribute to an increase of life expectancy.
Ethical Consideration
Ethical Code
This article is extracted from the second author’s master thesis with the code 484027 from ToloueMehr University, Qom.
Financial Support
 This study had no financial support.
Authors’ Contributions
H.G: Writing-Review & editing, project administration, and supervision; Z.M: Conceptualization, methodology, software, validation, formal analysis, visualization, data curation, writing-original draft
Conflict of Interest
 The authors had no conflicts of interest.
Acknowledgments
The researchers hereby express their gratitude and appreciation to the authorities of Fatemieh nursing home in Qom and the older women for their cooperation.
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