The Effectiveness of Spiritual Intelligence Training on Mental Health in Older Men with COVID-19

Abstract
COVID-19, an emerging disease with a global reach and high mortality rates in vulnerable populations, has caused not only physical symptoms but also led to numerous psychological disorders in older adults. This study aimed to assess the impact of spiritual intelligence training on the mental health of older men affected by COVID-19. In terms of purpose, this research was practical, and in terms of its nature, it was a quasi-experimental study with a pretest-posttest design with a control group. The statistical population of the current research included all older men diagnosed with COVID-19 in Khorramabad city, among whom, a sample of 30 people was selected using convenience sampling method and according to inclusion and exclusion criteria. Participants were randomly assigned to two experimental and control groups (15 people in each group). King's spiritual intelligence training protocol was utilized in the format of ten 90-minute group sessions. The questionnaire used in this research was the Goldberg & Hiller general health questionnaire. Data were analyzed using univariate covariance analysis (ANCOVA) in SPSS-22. The results indicated a significant improvement in mental health and its sub-scales in the experimental group compared to the control group (P<0.005), with controlling for the effect of the pre-test. These findings suggest that spiritual intelligence training can be used to improve mental health and its dimensions in older men with COVID-19.
EXTENDED ABSTRACT
Introduction
The phenomenon of aging is a multifaceted issue faced by the modern world, with its most significant aspect being its social implications. COVID-19, recognized as a public health crisis, has posed challenges to psychological resilience, with its spread being the most extensive since the acute respiratory syndrome outbreak. During the COVID-19 pandemic, an increase in psychological problems has been reported. Older individuals, due to their compromised immune systems and underlying health conditions, are at a higher risk of complications from COVID-19. There is substantial evidence linking spirituality with both physical and mental health. Spiritual intelligence encompasses a form of adaptation and problem-solving behaviors, facilitating the highest levels of growth in various cognitive, moral, emotional, and interpersonal domains. Various studies have shown correlations between mental health, spirituality, life purpose, and life satisfaction. Enhancing the spiritual intelligence of older adults leads to mental tranquility, adaptability, improved coping mechanisms, increased capacity and abilities, and overall quality of life. Therefore, this study aims to examine the effectiveness of spiritual intelligence training on the mental health of older men with COVID-19. The hypothesis of the study was that spiritual intelligence training improves the mental health of older men with COVID-19.
Method
This applied research employs a quasi-experimental design with a pre-test and post-test control group design. The statistical population consisted of older men aged 60 to 70 years with COVID-19 in Khorramabad city, among whom 70 individuals consented to participate in the study, among whom 30 individuals were selected using convenience sampling along with inclusion and exclusion criteria, and randomly assigned in equal numbers to the experimental group (15 individuals) and the control group (15 individuals). The inclusion criteria were: (1) minimum age of 60 years, (2) at least a high school diploma, (3) a positive COVID-19 test with 7 to 10 days elapsed since the test result, (4) willingness and interest in participating in the study, and (5) scoring at least one standard deviation above the mean on the General Health Questionnaire. Exclusion criteria included: (1) absence from more than three sessions, (2) physician’s recommendation for hospitalization. The mean age of the control group was 62.3 years, and the mean age of the experimental group was 61.7 years. Among them, 41.9% were retired from private jobs, 26.2% were educators, 19.7% were employees, and 12.1% were military personnel. Additionally, 54.5% had a high school diploma, 38.2% had a bachelor’s degree, and 7.3% had a master’s degree. The King’s Spiritual Intelligence Training Protocol was used for spiritual intelligence training. The intervention consisted of 10 weekly 90-minute sessions for the experimental group. After training being completed and a ten-day interval, the post-test phase was conducted. To adhere to ethical principles, this training was also conducted for the control group after the study. The data were analyzed using univariate covariance analysis (ANCOVA) with SPSS-22. 
Results
To ensure the assumptions of covariance analysis were met, Levene’s test for homogeneity of variances was used. The calculated Levene’s test for mental health was not statistically significant, confirming the assumption of homogeneity of variances. Additionally, the critical assumption of covariance analysis, the homogeneity of regression slopes, was tested by examining the interaction effect of the independent variable and pre-test on the dependent variable in the post-test. The results indicated that the F value was not significant at the 0.05 level for mental health. Furthermore, the Shapiro-Wilk test was used to check the normal distribution of the dependent variables. The results showed a normal distribution as the obtained Z value was not significant at the 0.05 level, confirming the assumptions of covariance analysis. Table 1 shows that calculated F value, with a significance level of p<0.05, shows a significant difference between the mental health of older adults in the pre-test and post-test of the experimental and control groups. Therefore, spiritual intelligence training significantly increased the level of mental health.
 
Conclusion
The hypothesis of this study, which posited that spiritual intelligence training impacts the mental health of older men with COVID-19, was confirmed. The results of examining the hypothesis of the study indicated that the post-test scores of participants in the experimental group increased significantly compared to that of participants in the control group. Therefore, it can be concluded that spiritual intelligence training enhances the mental health of older individuals with COVID-19. This finding suggests that spiritual intelligence training enhances individuals’ insight into having meaning and purpose in life, highlighting the importance of belief systems. Spiritual and religious beliefs enable individuals to find meaning in adversities, psychological pressures, and inevitable losses that occur throughout the life cycle, and to remain hopeful and optimistic about an afterlife where such difficulties do not exist. This is why the sense of the supernatural may provide psychological support, thereby improving mental health. Additionally, one of the significant impacts of spiritual intelligence training is health promotion, as strong spiritual tendencies and a positive outlook contribute to better health.
 
Ethical Consideration
Ethical Code
This study has the ethics code IR.SCU.REC.1402.036.
 
Financial Support
 This study had no financial support
 
Authors’ Contributions
Z.A: Conceptualization, Methodology, Writing – Original Draft, Writing – Review & Editing, Project Administration, Supervision, Visualization; A.T: Software, Validation, Formal Analysis, Data Curation
 
Conflict of Interest
The author had no conflicts of interest.
 
Acknowledgments
The authors extend special thanks to all the older participants in this study. The authors also thank the Vice Chancellor for Research at Shahid Chamran University of Ahvaz for their moral support in conducting this research.
 

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