IEJNSR. Vol.

3 (2), 2023

International Egyptian Journal of Nursing Sciences and Research

(IEJNSR)

Original Article

Effectiveness of Logotherapy Training on Self-Esteem,

Communication Skills and Impact of Event Among Older Adults
Faten Hasan Alam (1), Esmat Elsayed Ibrahim (2), Sabah H. El-Amrosy (3)
(1)Assistant Professor of Psychiatric & Mental Health Nursing, Faculty of Nursing, Menoufia University, Egypt. Currently, Associate
professor in Ibn Sina National College for Medical Studies, Saudi Arabia
(2) Lecturer of Geriatric Nursing, Faculty of Nursing, Menofia University, Egypt
(3)Assistant Professor of Psychiatric & Mental Health Nursing, Faculty of Nursing, Menoufia University, Egypt. Currently, Assistant
Professor in the Department of Nursing, Faculty of Applied Medical Sciences, Al Baha University, Saudi Arabia

Corresponding author: Sabah H. El-Amrosy. E-mail: [email protected]

ABSTRACT
Background: The population aged 60 years and older is growing both in number and proportion. One treatment
option for elderly patients with sleep issues and poor communication skills is logotherapy. this training assesses the
effects of altering the meaning of life and attitudes of older persons through training in areas like self-esteem,
communication skills, and the elements of mental helplessness when facing specific events. The study aimed to
evaluate the effectiveness of logotherapy training in self-esteem, communication skills, and the impact of events
among older adults. The setting of the study: The study was conducted in El-Sadat nursing home, Berket El-Saba
nursing home, and Elderly Club, Shebeen El-Kom, Menoufia, Governate, Egypt. Subjects: A Convenience sample
of 50 senior males and females. Research Design: A quasi-experimental design was used to achieve the aim of the
study. Data collection: Four tools were used; Tool (1): Socio-demographic and clinical characteristics structured
interview questionnaire. Tool (2): The Cooper smith Self-Esteem Inventory Tool (3) Human communication skills
scale Tool (4) Weiss and Marmar’s Impact of Event Scale-Revised. Results: The findings of the study revealed
that the mean age of the studied older adults was 67.98±6.02 and, more than half of them (52%) were females.
There was a decrease in the mean score of the total impact of the event scale in the posttest (41.92) than the pretest
(62.74). There was an increase in the mean score of self-esteem in the post-test (22.24) than pre-test (16.48). In
addition, the mean score of the total communication scale was increased in the post-test (195. 6) than in the pretest
(160.98) with a statistically significant difference. Conclusion: Applying logotherapy training among older adults
proved to be effective in improving self-esteem, and communication skills, and decreasing the impact of events
among older adults.

Keywords: Logotherapy, Self-Esteem, Communication skills, Impact of Event, and Older Adults

486
 IEJNSR. Vol. 3 (2), 2023

Introduction According to León Navarrete et al. (2017),

depressed individuals are more prone than
The proportion of adults 60 and older is
non-depressed individuals to have thoughts of
increasing, as is their number. In 2019, there
personal misery, unfavorable expectations,
were 1 billion persons 60 and older
low self-esteem, and helplessness. People with
worldwide. There will be 1.4 billion people on
high levels of anxiety employ dysfunctional
earth by 2030 and 2.1 billion by 2050. This
coping mechanisms to control their emotions
increase is occurring at an astounding rate and
because they are unable to think clearly and
will continue to accelerate in the upcoming
critically assess the situation due to their
decades, particularly in developing countries
misunderstandings and misinterpretations of
(WHO,2022). Like many other countries,
the circumstances.
Egypt is enduring a demographic shift toward
an aging society as global population aging Self-esteem is defined as the subjective

accelerates in both developed and developing assessment of one's worth. It comprises having

countries. The percentage of the population a positive outlook on oneself and a sense of

that was 60 or older in 2016 was 8.9%; self-acceptance. As a result of both great and

however, it is anticipated that this percentage negative life experiences, a person grows in

would rise to 10.9% in 2026 and to 12% by confidence. Self-esteem rises most during a

2030 (Shaheen et al., 2017). person's formative years and adulthood, peaks
at age 60 to 70, and then steadily fall as they
Because of the aging of the population, it is
age. This could be brought on by decreased
crucial to pay attention to their mental health
physical and mental capacity, a decline in
where the enormous volume and diversity of
social status, financial difficulty, and the
stresses that older adults experience every day,
passing of loved ones. (Ryszewska-
such as losing their jobs and social status,
Łab ̨edzka, D,2022). Older adults have
close relatives, or their health, as well as
trouble interpreting new cues that point out
changes in how they interact with others
their errors and compel them to revise their
(White & Casey, 2017). Older people assert
opinions. A person's unwillingness to assess
that they are miserable or disgusted and unable
new knowledge decreases their flexibility,
to enjoy life. Furthermore, they blame
which in turn affects their ability to respond
themselves for their shortcomings and have a
appropriately to tensions, leading to issues in
deep sense of worthlessness (León Navarrete
their social interactions. (Soroush., et al
et al., 2017).
2021).

487
 IEJNSR. Vol. 3 (2), 2023

Austrian physician and psychiatrist Viktor mental health, self-esteem, happiness, and
Frankl created logotherapy in the 1930s based interpersonal relationships in different age
on "logos," the Greek word for meaning, fields.
Frankl created the term logotherapy and
Significance of the study
claimed that humans' search for meaning is
one of their main drives. The foundation of Elderly people represent a population group
Frankl's thesis is the idea that people are that needs a particular and comprehensive
driven by a "desire for meaning."(Mortell, strategy that supports their well-being and
2020). Logotherapy is assumed that a health. Contextual variables, including the
technique whose use can assist the individual emergence of diseases, might have a negative
in discovering meaning in his or her life since impact on key areas of their life.
a meaningful life entails having a positive (LeónNavarrete et al., 2017). The goal of
attitude toward life no matter what we logotherapy is to highlight the range of
encounter, whether suffering or death. While individual control and freedom while assisting
the precise circumstances of one's life cannot the person in discovering a life purpose that is
be changed, one can learn to alter the strategy in line with their existence. The importance of
used to deal with these experiences to have a accepting responsibility is extensively
better reaction and experience. Logotherapy emphasized in logotherapy. Individuals are
helps the individual realize this. Logotherapy encouraged through logotherapy to view the
may be beneficial for persons going through world differently and work to rediscover their
existential sadness and not being able to ideals (Golshan et al., 2020).
discover "a cause to live." (Adhiya-Shah,
The primary tenets of logotherapy are
2017).
consistent with the teachings of the Quran,
Group logotherapy helps people by using which list the meaningfulness and
techniques such as showing concern and purposefulness of life in many verses. For
empathy, sharing knowledge, giving them example, in verse 115 of Sura Al-Muminoon,
tools to help them change their views about it is said: “Then did you think that we created
how to solve difficulties, and assisting them in you uselessly and that to Us you would not be
regaining their perspective on their returned?” (Farsinezhad & Dezhabad,
interpersonal relationships (White & 2009). Other factors which Frankl emphasized
Casey,2017). in addition to Jahanpour, are understanding suffering and accepting
(2014) mentioned that logotherapy has an them in life (Frankl, 2006). Allah says in
important role in psychotherapy and is used in verse 4, Sura Al-Balad: “We have certainly

488
 IEJNSR. Vol. 3 (2), 2023

created man into hardship”. Researchers and Materials and methods

translators of the Quran believe that this verse
Aim of the Study:
indicates that the universe is accompanied by
hardship, and according to Quran, hardships To evaluate the effectiveness of logotherapy

construct men (Shia News, 2013). training on self-esteem, communication skills,

and the impact of the event among older
Older persons are particularly susceptible to
adults.
acquiring Post-Traumatic Stress Disorder
(PTSD). due to the physical, emotional, and Research hypotheses:
social changes brought on by aging as well as
 Older adults who participate in
issues like having to deal with the deaths of
logotherapy training will have higher
colleagues. Thus The majority of countries
self-esteem and communication skills
have recently begun employing logotherapy to
post-intervention.
enhance the physical, mental, and social well-
 Older adults who participate in the
being of older adults. Logotherapy is a method
logotherapy training will have a lower
that helps the individual find meaning in her
score on the Impact of Events post-
life. (Schulenberg et al., 2018). Current
intervention.
events can have an impact on an individual’s
mental health. It is thus probable that
Research questions
discussions around current events may arise
for mental health nurses in their interactions 1. What is the level of self-esteem among
with patients. Logotherapy is introduced as a studied groups of older adults?
tool that mental health nurses, assist patients 2. What is the level of communication
who are adversely affected by current events skills among the studied groups of
(Mortell, 2020). there are very few studies on older adults?
the effects of Logotherapy on increasing self- 3. What is the impact of event level
esteem, improving social skills, and increasing among the studied groups of older
the ability of individuals to deal with adults?
environmental stresses. Hence, this study aims 4. Is there a correlation between the
to evaluate the effects of group logotherapy impact of an event, self-esteem, and
training on self-esteem, and communication communication skills?
skills, and the impact of the event among older
adults.

489
 IEJNSR. Vol. 3 (2), 2023

Design Instrument 1: A research questionnaire

prepared by the researcher based on a review
A quasi-experimental design with a pre-and
of relevant literature. It is comprised of socio-
post-test was used to carry out the study's
demographic characteristics such as age, sex,
objectives.
marital status, level of education, physical
Setting
illness, familial problems, compliance with
The study was implemented in El-Sadat
medications, source of social support, and the
nursing home, Berket El-Saba nursing home,
onset of the illness.
and Elderly Club, Shebeen El-Kom. Menoufia,
Governate, Egypt Instrument 2: The Cooper smith Self-
Esteem Inventory (CSEI) (Arabic version)
Sample

A Convenience sample of all elderly persons It was approved by Soroush et al., (2021). It
who had the following inclusion and exclusion was a valid and reliable Arabic scale to assess
criteria was selected self-esteem. It consisted of 25 items, eight
positive and seventeen negatives (25-24-23-
 Inclusion criteria: Age 60 years or 22-21-18-17-16-15-13-12-10-7-6-3-2) in the
older, unstable or poor self-esteem form of a two-point Likert scale ranging from
(self-esteem score >8 on the Cooper 0 (not applicable) to 1 (applicable). The total
Smith Self-Esteem Inventory), not score was assumed by summing across all
currently participating in other studies, scale items after reverse coding negatively.
literate, and no cognitive impairment, The researchers divided the total by 25 and
authors consented to participate in the multiplied by 100 to get the final self-esteem
intervention. score.
 Unwillingness to continue study
participation or repeated absences from Scores Parameter
the program and cognitive impairment  20-40 low self-esteem
were the exclusion criteria. The total  40-60 Moderate self-esteem
 60-80 High self-esteem
sample size was 50 older adults.
Instrument 3: Human Communication
Study instruments Skills Scale
The following study instruments were used to
It was approved by Ali (2018). It was a valid
gather data:
and reliable Arabic scale to measure
communication. This scale includes 46 items

490
 IEJNSR. Vol. 3 (2), 2023

that explore the following skills: Dialogue into Arabic utilizing translation procedures. A
skills (14 items); body language (12 items); jury of five nursing professionals, comprising
listening skills (ten items); and speaking skills psychiatry, community health, and
(ten items). a five-point Likert-type scale, administration experts, received the tools. The
ranging from one (rarely) to five (always). It surveys were evaluated for their accuracy,
contained seventeen negative items, as clarity, completeness, and applicability. The
follows: Dialogue skills (2-8-12); body instruments were proven to be valid in their
language (12); listening skills (2-3-4-6-7-9- eyes, and any necessary revisions were made.
10); and speaking skills (2-4-5-8-9) The Cronbach's α for the self-esteem scale was
0,81, the communication scale was 0.81 and
Instrument 4: The Impact of Event Scale-
the impact of the event was 0.93 in this study.
Revised (IESR)
A pilot study
It was created by Weiss D., & Marmar, C.
(1997). It was translated into Arabic by To ascertain the tool's clarity, appropriateness,
Alaedein et al., (2021) and is extremely useful and the amount of time needed to complete the
for assessing the effects of routine life stress, questionnaire, a pilot study was conducted
acute stress, and everyday traumas. This using 10% of older persons. Some of the
questionnaire consists of 22 questions and questions were altered and clarified in light of
aims to assess the components of emotional the findings of the pilot research. The current
helplessness in the face of specific life events research total sample did not include the pilot
(avoidance, intrusion, hyperarousal). sample to verify that the replies were
Responses are based on a Likert scale and are consistent.
rated on a scale of 0 to 4, never, sometimes,
often, and very highly. This scale includes his Ethical considerations
three subscales: Avoidance (8 questions),
The ethical and research committee of the
intrusive thoughts (7 questions), and
Nursing Faculty at Menoufia University
hyperarousal (7 questions). In general, higher
provided its ethical approval. Each senior was
total scores on this scale indicate higher levels
given thorough information about the study's
of emotional helplessness and vice versa.
objectives before providing their informed
Instruments' validity and reliability consent. The older adults were informed of the
study's ethical considerations, including the
To maintain the authenticity of the original
confidentiality of their identities and
validity, the questionnaire was back-translated
responses, and they were given the assurance

491
 IEJNSR. Vol. 3 (2), 2023

that no one interferes in one's personal or This phase includes:

family affairs; they were given the option of
Determining the objectives and contents of the
participating in the study on the condition that
logotherapy training which include:
they did so.

 Concept of logotherapy.
Field of work:
 Benefit of logotherapy.
The study was performed from the beginning  logotherapy with others
of April to the end of August 2022.  Strategies and exercises for
Participants voluntarily participated. logotherapy training.
Phase 3: Implementation:
Phase one: Assessment (pre-testing)— This
phase was intended to establish a connection Implementation of the intervention took place
between researchers and older adults and to in sessions using different teaching methods
explain the purpose of the study and the and guides developed during the planning
intervention plan. phase. The intervention lasted 5 weeks to
provide sessions to assess the effects of
The older adults were classified, each
logotherapy training on older adults. The
comprised of ten elderly adults to obtain a
general objective of this training was to
baseline assessment (pre-test).
evaluate the effect of logotherapy training on

The intervention was carried out for each self-esteem, communication skills, and the

group twice a week on various days impact of events among older adults.

throughout five weeks, each session lasting

Sessions are scheduled as follows:
approximately 45 to 90 minutes depending on
the older adult's ability to understand and Session 1: This session's goal was to motivate
speak. older adults to actively engage in logotherapy.
This is done by getting to know the older
Phase 2: Planning phase:
adults, explaining the study's objective and

This phase aims to develop logotherapy nature, as well as the group's regulations

training. It was designed in the Arabic regarding confidentiality.

language based on relevant recent literature

Discuss with the members about their skills,
reviews.
encouraging the group to come up with
solutions to enhance their skills, and get a

492
 IEJNSR. Vol. 3 (2), 2023

clear grasp of the interpersonal differences How much can you relate to other people?
within the group or the environment.
How much do you believe you owe your
Session 2: Enhancing the members' sense of family, your country, and strangers? When did
responsibility by reviewing the prior session's you last lend a hand to someone? How do you
homework, talking about the members' feel after lending a hand or showing someone
situations that are upsetting them and affecting kindness? Sort the important qualities or deeds
their mental health; describing freedom, you haven't done but are concerned about in
autonomy, and responsibility, and how these priority order. How perceptive are you to other
concepts relate to one another, people's issues?

Who has the most influence over you? What Session 5: "The Art of Paradoxical Aim"
have you done to date to make yourself
older adults' behavioral and mental issues
happy? Who is the person you've used as an
using replacement (in effect, the thoughts or
example?
muscles get involved in this new action and
Session 3: forming a mental picture behavior, making the repetition of the prior
habit impossible).
Who do you think is in charge of one of the
success or failure scenarios in your Make a note of your difficulties and any
imagination? How do you feel about that unfavorable behaviors or thoughts you have.
person? List the behaviors or acts you have What steps have you taken to address these
engaged in while being constrained by the problems so far?
standards and guidelines established by others,
How prosperous were you? Using a technique
and then talk about the outcomes.
to increase your capacity to regulate bodily
Reducing the stress caused by a disruption in functions and reactions that you previously
one's self- and body-image, and teaching life- believed you couldn't
expectancy techniques
Session 6: Modifying attitudes and
Session 4: Expanding the older adults' field logotherapy through dispositional, creative,
of perception and experiential values, reviewing the
homework from the previous class; expressing
discussing topics that may have an impact on
your problem; try to approach it from various
older adults' thoughts and feelings
aspects. Can you find an acceptable

493
 IEJNSR. Vol. 3 (2), 2023

explanation for your issue? Can you reach a communication can make older people feel
higher level of peace by changing your inadequate, disempowered, and helpless.
attitude toward the issue? In reality,
Session 10: This session is designed to
throughout this session, incorrect beliefs that
provide a summary of skills to date, gain
are frequently linked to anxiety, a bad mood,
insight into the older person's experience, and
and severe depression will be challenged, such
provide feedback on the logotherapy session.
as unpleasant fate, negative fate, terrible
At the end of the session, the researchers
omens, and guilt.
congratulated the elderly who participated in
Session 7: Retrieval Techniques (Teaching the logotherapy session.
Logo Sensitivity) and Review of Homework
Phase 4: Evaluation phase: The training was
from the last Session Encourage and support
evaluated by immediately reapplying the study
older adults to act on their true desires and
instruments (2, 3, and 4) as a post-test.
values. describes his journey. How do you
view your own religious beliefs? Do others
Statistical analysis:
share your beliefs? Practice hugging (eye
contact, friendly speech, and touching). All data were collected, tabulated, and
statistically evaluated using SPSS 22.0 for
Session 8: (self-esteem strategies) Establish
Windows. Quantitative data are expressed as
social contacts, encourage a sense of
Mean±SD. Qualitative data were expressed as
independence, and look for a senior group;
frequency (number) and relative frequency
review the homework from the previous
(percentage). Proportions of variables were
sessions, then provide feedback; It's preferable
compared using the chi-square test, Fisher's
to encourage an aging loved one to
exact test, and paired t-test as appropriate. A
concentrate on what they can manage and do
P-value < 0.05 was considered statistically
for themselves rather than lamenting
significant (S).
inevitable losses, even if they do need some
assistance or modifications. Results

Session 9: (Improving Communication) Table (1): This table demonstrated that the
Review the homework from the last session, mean age of the studied sample is 67.98±6.02.
talking about active listening, communication Regarding sex; 52% of the studied sample
methods, friendliness, sharing feedback, were females. Nearly two third of the studied
empathy, and respect. Explain that poor sample (64 %) were married. The majority of
the sample (94 %) have a good relationship

494
 IEJNSR. Vol. 3 (2), 2023

with their families. concerning chronic Moreover, there is an increase in the mean
diseases;58% of the studied sample have score of Listening skills in the post-test
diabetes and 22 %of them have hypertension. (43.86± 3.94) than pre-test (35.76± 5.51).
Furthermore, there is an increase in the mean
Figure (1): Revealed that there is a decrease
score of Speaking skills in the post-test
in the mean score of the total impact of event
(43.80±4.35) than the pretest (36.74±5.18). In
scale in the posttest (41.92) than the pretest
addition, there is an observed increase in the
(62.74). There is an increase in the mean score
mean score of the Total score of the
of self-esteem in the post-test (22.24) than pre-
communication scale in the post-test
test (16.48). In addition, the mean score of the
(195.60±18.52) than the pre-test
total communication scale was increased in the
(160.98±22.45) with a statistically significant
post-test (195. 6) than in the pretest (160.98)
difference between the pre and post-test.
with a statistically significant difference.
Table (4): Illustrated that, following the
Table (2): Illustrated that there is a decrease in
intervention, there was a statistically
the mean score of Intrusion in the posttest
significant positive correlation between overall
(16.78± 7.31) than the pretest (24.66± 6.41).
self-esteem and communication skills. In other
Also, there is a decrease in the mean score of
words, when overall communication skills
Avoidance in the posttest (13.36± 5.53) than
improved, self-esteem also will improve, even
the pretest (20.14± 6.46). Moreover, there is a
though there was a statistically significant
decrease in the mean score of Hyperarousal
negative correlation between overall
in the posttest (11.78± 5.35) than the pretest
communication skills and total event scale
(17.94± 5.18). In addition, there is an
post-intervention. i.e., total event scale
observed decrease in the mean score of the
symptoms are reduced when overall
total score of the impact of event scale in the
communication skills are enhanced.
post-test (41.92±17.29) than pre-test
(62.74±16.10) with a statistically significant Table (5): Showed that there was a
difference between pre and post-test. statistically significant negative correlation
between age, communication skills, and
Table (3): Showed that there is an increase in
overall self-esteem and post-intervention. even
the mean score of Dialog in the post-test
though there was no significant correlation
(57.62± 6.97) than pre-test (46.76± 7.73).
between age and the total event scale post-
Likewise, there is an increase in the mean
intervention.
score of Body language in the post-test
(50.32± 6.43) than pre-test (41.66± 8.56).

495
 IEJNSR. Vol. 3 (2), 2023

Table (6) portrayed that there is only a only a significant relationship between
significant relationship between self-esteem, communication skills, event scale, occupation,
occupation, and marital status. concerning and chronic disease.
communication skills and event scale there is

Table 1: Distribution of Sociodemographic data among the studied sample (N= 50).

Demographic data No. %

Age: Mean±SD
67.98±6.02

Sex:
Male 24 48
Female 26 52

Marital status:
Married 32 64
Divorced 5 10
Widowed 13 26

Relationship with family:

Good 47 94
Bad 3 6

Chronic diseases:
Diabetes 29 58
Hypertension 11 22
Heart disease 5 10
Comorbidities 5 10

Occupation:
Worked 9 18
Not worked 27 54
On promotion 14 28

Total 50 100

496
 IEJNSR. Vol. 3 (2), 2023

250

195.6
200

160.98
150

100

62.74

50 41.92

0 16.48 22.24
pre post

impact of event selfesteem communication

Figure (1): Mean scores of the total impact of event scale, self-esteem scale, and communication scale
among studied sample pre and post-test (n=50)

Table 2: Mean score of domains of the impact of event scale among studied sample pre and post-
logotherapy (N=50)

Domains of the impact of event scale pre post t p

M± SD M± SD

Intrusion 24.66± 6.41 16.78± 7.31 10.837 0.001

Avoidance 20.14± 6.46 13.36± 5.53 8.842 0.001

Hyperarousal 17.94± 5.18 11.78± 5.35 12.358 0.001

The total score of the impact of the event scale 62.74±16.10 41.92±17.29 11.352 0.001

497
 IEJNSR. Vol. 3 (2), 2023

Table 3: Mean score of domains of communication scale among studied sample pre and post-logo
therapy (N= 50)

Domains of communication scale pre Post t P

M± SD M± SD

Dialog 46.76± 7.73 57.62± 6.97 10.991 0.001

Body language 41.66± 8.56 50.32± 6.43 11.130 0.001

Listening skills 35.76± 5.51 43.86± 3.94 14.171 0.001

Speaking skills 36.74±5.18 43.80±4.35 14.678 0.001

The total score of the communication scale 160.98±22.45 195.60±18.52 15.133 0.001

Table (4) Pearson correlation between total communication skills, self-esteem, and total event scale

Studied variables Total communication skills

R P value

Total self-esteem .477** .000

Total event scale -.385** .006

**. Correlation is significant at the 0.01 level (2-tailed).

498
 IEJNSR. Vol. 3 (2), 2023

Table (5) Correlation between age, total communication skills, self-esteem, and total event scale

Studied variables Age

R P value

Total self-esteem -0.331* .0019

Total event scale 0.221 0.124

Total communication skills -0.508** 0.000

**. Correlation is significant at the 0.01 level (2-tailed).

Table (6) Relation between total communication skills, self-esteem, and total event scale and sociodemographic data

Sociodemographic data Total event post Self-esteem post Total communication

Total post

Mean±SD Mean±SD Mean±SD

sex Male 37.41±17.31 22.66±1.71 198.25±20.00

Female 46.07±16.52 21.84±1.73 193.15±17.08

Test of sig. T-test -1.809 1.681 .971

P value 0.077 0.099 0.336

Marital status Married 37.53±15.72 22.31±1.82 198.46±19.20

Divorced 54.60±12.09 22.00±1.22 197.60±12.75

Widow 47.84±19.44 22.15±1.86 187.76±17.45

Test of sig. F test 3.449 .086 1.613

P value .040 .917 .210

chronic disease Yes 42.26±18.40 22.66±1.52 197.78±18.88

No 40.12±10.30 20.00±1.06 184.12±11.67

Test of sig. F test .101 . 22.198 3.866

P value .752 .000 .055

Occupation Worked 33.22±11.43 23.55±1.66 209.33±16.91

Not worked 38.00±17.18 22.11±1.73 199.37±16.45

On promotion 55.07±13.66 21.64±1.49 179.50±11.73

Test of sig. F test 7.415 3.796 12.074

P value .002 .030 .000

499
 IEJNSR. Vol. 3 (2), 2023

was in line with what studies by Soroush et al.

Discussion (2021) on "the Effects of Group Logotherapy
Training on Self-Esteem, Communication Skills,
The current societal transformation is being
and the Impact of Event Scale-Revised (IES-R) in
influenced by the population's trend toward aging.
Older Adults" discovered the participants in his
The forecast estimates that the proportion of
study ranged in age from 60 to 80 years, with 8
individuals over 60 will increase from around 11%
women (53.33%) and 7 men (46.66%). 66.66 %
to 22 between 2000 and 2050 and that the total
were married and 73.33 % had strong relationships
number of people 60 and older would increase
with their families. Furthermore, was reported in a
from 605 million to 2 billion during that time.
study by Ravari et al., (2021) on "the Comparison
(Asadollahi, et al., 2017). Dr. Victor Frankl
of the Effects of Cognitive Therapy and
developed the existential therapy modality known
Logotherapy on Iranian Elderly People’s General
as logotherapy. Because it explores the spiritual
Health". the age of the control was 68.63±5.48
aspect of human existence and places a strong
years. Since a meaningful life entails having a
emphasis on the meaning and purpose of life, this
positive attitude toward life no matter what we
treatment is seen as being both deeper and more
face, including suffering or death, logotherapy is a
comprehensive than other psychological therapies.
technique that is used to help people find meaning
(Angelina and Rosalito, 2013) Logotherapy is a
in their lives. This understanding helps people
technique that can assist a person in finding
realize that while they cannot change some events
meaning in their life. To live a meaningful life, one
in their lives, they can learn to change how they
must respond positively to everything that comes
deal with these events and have a better reaction
their way. The majority of nations now practice
and response when facing those events. For people
logotherapy to raise the social, psychological, and
experiencing existential sorrow and failing to
physical well-being of older adults. (Soroush., et
discover "a cause to live," logotherapy is available
al 2021) Therefore, in this study, we examined the
(Adhiya-Shah, 2017).
effect of Logotherapy training on self-esteem,
communication skills, and the impact of events The current study's findings supported the

among elderly adults aforementioned claim, showing a decline in the

mean scores of the total impact of event scale, the
The current study's findings portrayed that the
Intrusion, Avoidance, and Hyperarousal
mean age of the studied sample is 67.98±6.02.
dimensions of the total impact of event scale in the
Nearly two-thirds of the sample under study were
posttest (41.92, 7.31, 6.41, and 5.53) compared to
married, and nearly half of the sample under study
the pretest (62.74, 16.78, 24.66, and 11.78,
were female. Most people in the sample had a
respectively). This may be a result of the impact of
good relationship with their families. This result
logotherapy, which functions by demonstrating

500
 IEJNSR. Vol. 3 (2), 2023

concern and empathy, disseminating knowledge, PTSD " by Southwick et al., (2006) produced the
supplying resources for the diffusion of beliefs in same results and found that logotherapy is
problem-solving, and assisting the person in considered to be an adjunctive therapy, enhancing
regaining their perspective on their interpersonal rather than replacing other treatment approaches.
environment. Along with the three paths to finding
According to the current study, the mean self-
one's life's purpose—creative, empirical, and
esteem score increased from the pre-test (16.48) to
orientation—creative values that have been
the post-test (22.24). This might be because of the
realized through activity are typically reliant on
effect of logotherapy training on self-esteem
some sort of action; they are produced by a
among elderly adults. This was in line with
tangible thing or an idea or by helping others, to be
research done by Soroush et al., (2021) titled "The
able to provide one's life's purpose.
Effects of Group Logotherapy Training on Self-
Additionally, this is also consistent with (Soroush Esteem, Communication Skills, and the Impact of
et al., 2021), who suggested that logotherapy may Event Scale-Revised (IES-R) in Older Adults".
be able to support older persons in having found that the self-esteem scores of the older
acceptable reactions when confronted with adults attending the group logotherapy sessions
unfavorable life circumstances. It will avoid a lot were substantially higher than the self-esteem
of issues brought on by tensions after tense life scores of the older adults not attending the
events including the death of a spouse, handicaps, logotherapy sessions (P < 0.005). when comparing
and loneliness. In another hand, this is in the same the mean scores of the posttest. Moreover, a
line with Angelina and Rosalito, (2013) title of research project by Mahmoudi et al., (2015).
the research "The Effectiveness of Logotherapy indicated that the learner's self-concept was
Program in Alleviating the Sense of improved through participatory learning, which
Meaninglessness of Paralyzed In-patients" results also increased the learner's social acceptance. On
show that with the aid of the Logotherapy the other hand, a study by Zahra et al., (2014)
program, it is possible to find meaning, even when titled "The study of group logo-therapy
faced with a fate that cannot be changed. effectiveness on self-esteem, happiness, and social
Furthermore, these findings supported a study by sufficiency in Tehranian girl teenagers" revealed
Safariolyaei et al., (2015) titled "The effect of after controlling for pre-test effects that the
logotherapy on sleep symptoms of PTSD in experimental group experienced a significant
emotionally abused men ", which revealed that log change in self-esteem in the post-test (F=44; df =1,
therapy treatment was successful in helping these 39; p<0.001). The self-esteem of the control group
men find purpose in their life and manage sleep has not significantly changed.
issues. However, this study" logotherapy as an
Additionally, the results of the current study are
adjunctive treatment for chronic combat-related
consistent with those of studies conducted by Kim,

501
 IEJNSR. Vol. 3 (2), 2023

who examined "the effects of logotherapy on attitude, these skills involved a series of actions for
making life purposeful, reducing stress, and improving the older adults' capacity for
increasing self-esteem”. (Kim, 1995); Koulaee et communication.
al. also measured "the impact of logotherapy on
The current finding demonstrated that there was a
coping with social exclusion among older adults"
statistically significant positive correlation
(Koulaee et al., 2018); and the study carried out
between overall self-esteem and communication
by Yazdanbakhsh, who focused on feeling lonely
skills. Self-esteem will rise when overall
among older adults men (Yazdanbakhsh et al.,
communication skills improved. This finding is
2016). According to Duffy et al., the association
consistent with research by Akshara et al., (2021),
between social conflict and negative social
who studied research on "self-esteem and
difficulties was moderated by self-esteem (Duffy
communication skills among young adults". They
et al., 2006). Furthermore, the findings of the
discovered a substantial connection between young
present study can be considered in line with the
adults' communication skills and self-esteem.
results of studies by scholars including (Dadkhah
Using approaches like feedback and modeling, the
et al., 2012; Ebrahimi et al 2014;
American Psychological Association (APA)
Golmohammadian,2016).
defines communication competence as an
The current study portrayed there is an increase in intervention that teaches people to communicate
the mean score of communication skills in the themselves emphatically and clearly in a group,
post-test (22.24) than in the pre-test (16.48). This family, or work setting. Eylem et al., (2016), who
might be because of the effect of logotherapy investigated "a Comparison of Self-Esteem and
training on communication skills among elderly Communication Skills at the 1st and Senior Year
adults. This was consistent with studies conducted Nursing Students"., also corroborated this finding.
by Soroush et al., (2021). "The Effects of Group demonstrated that there is a clear positive
Logotherapy Training on Self-Esteem, correlation between the students’ perceptions of
Communication Skills, and the Impact of Event communication skills and self-esteem.
Scale-Revised (IES-R) in Older Adults". The
The present result illustrated that there was a
findings suggest that group logotherapy training
statistically significant negative correlation
may be able to significantly improve older persons'
between overall communication skills and event
interpersonal communication abilities. These skills
scale, i.e., that when overall communication skills
exhibit a lower level of reduction over time, which
are increased, the symptoms of the event scale will
may indicate the older adults' capacity to
diminish. This finding is consistent with Fredman
comprehend and apply the logotherapy skills that
et al., (2016), who found that PTSD symptoms,
were taught to them. In contrast to self-esteem,
especially signs of effortful avoidance, that
whose persistence depended on changes in
become apparent as soon as one month after

502
 IEJNSR. Vol. 3 (2), 2023

trauma can raise the risk for later communication According to his findings, there was no significant
difficulties. in his study titled "Longitudinal difference between the perceptions of self-esteem
Associations Between PTSD Symptoms and of the class teachers and teachers' communication
Dyadic Conflict Communication Following a skills scores by gender, occupational seniority,
Severe Motor Vehicle Accident". Additionally, education status, and age.
this was consistent with a study by Markowitz et
Conclusion
al., (2009) entitled "Interpersonal Factors in
Understanding and Treating Posttraumatic Stress According to the study's findings, logotherapy
Disorder". Who provides a method to explain why training had a highly statistically significant
strengthening relationships may lessen PTSD positive impact on older persons' self-esteem,
symptoms by drawing attention to the potential communication skills, and ability to respond
significance of attachment and interpersonal appropriately to stressful life events.
relationships.

According to the findings of the current study, sex Recommendation

and income and total Self-Esteem and
 In light of current research, the results
Communication Skill are not significantly related.
recommend performing logotherapy on
Akshara et al., (2021) that there is no significant
older adults in a variety of settings to
difference between self-esteem and
improve their self-esteem, communication
communication skills among young adults across
skills, and their ability to respond
their gender. In addition, this result is in
appropriately to stressful life events.
accordance with Eylem et al., (2016) who found
The mean scores of nursing Students' Self-Esteem  A future direction of research is to conduct

and Communication Skill Evaluation Scale were such intervention studies in a variety of

compared with the gender and income status of settings for larger groups of older people.

their parents The result of the statistical analyses

Acknowledgments
showed that there was no difference. Concerning
the relationship between total Self-Esteem and The authors of this study would like to thank all
Communication Skills and age, and occupation. older adults who participated in this study.
The current study's findings showed a significant
relation. This study is contradicted by Derici Conflict of Interest
Cevap & Mentiş (2018). who investigated "
The authors of this study have declared no
Investigation of the relationship between self-
conflicts of interest.
esteem and communication skills of primary
school teachers in terms of various variables ".

503
 IEJNSR. Vol. 3 (2), 2023

References Eylem Pasli Gurdogan, Esin Çetinkaya Uslusoy.

Seda Kurt, Kübra Yasak.(2016). Comparison of the
Self Esteem and Communication Skills at the 1st and
Adhiya-Shah K. (2017). Book Review: The Will to Senior Year Nursing Students. International Journal of
Meaning: Foundations and Applications of Caring Sciences. 9 (2),496.
Logotherapy. Front. Psychol. 8:2106. doi:
10.3389/fpsyg.2017.02106 Farsinezhad, A. R., & Dezhabad, H. (2009). The goal
of creation of the universe and man according to the
Quran. Journal of Religious Thought, 9(30), 103-134.
Akshara K A, Jisiyamol jiju, Sannet Thomas.
(2021). Study on self-esteem and communication skills Frankl, V. E. (2006). Man’s Search for Meaning.
among young adults. International journal for Beacon Press, 184.
innovative research in a multidisciplinary field.
7(1),171-175. Golmohammadian, M., Nazari, H., & Parvaneh, A.
(2016). Effectiveness of group logo therapy on death
Alaedein, J., Abood, M., Al Shraifin, A., Ali, A. A., anxiety and social adjustment of older adult men.
& Al-Shobaki. (2021). Psychological Impact and Journal of Aging Psychology, 2(3), 167–175.
Mental Health Status during the COVID-19 Pandemic
Among Jordanian University Students, The Jordanian Golshan,A., Hajebi M .Z, & Gharamaleki N. S.
Journal of Educational Sciences, 17(3). (2020).The Effect of Logo therapy Group Training on
Changes of Depression, Self-Esteem and Intimacy
Ali, E. (2018). The Impact of Demographic Factors on Attitudes in Physically Disabled Women. Iranian
Human Communication Skills among Arab Adults. An- Journal of Health Psychology. 2(2).101-112.
Najah University Journal for Research-B
(Humanities), 33(5), 773–818. Jahanpour, Z., Sadeghi, S. A., Hosseini, F. S., &
Tekiyee, A. (2014). The study of group logo-therapy
Angelina M. Julom, Rosalito de Guzman. (2013). effectiveness on self-esteem, happiness and social
The Effectiveness of Logotherapy Program in sufficiency in Tehranian girl teenagers. Journal of
Alleviating the Sense of Meaninglessness of Paralyzed Medical Sciences.7 (3).
In-patients. International Journal of Psychology &
Psychological Therapy, 13, 3, 357-371 John C. Markowitz, Barbara Milrod., Kathryn
Bleiberg and Randall D. Marshall. (2009).
Asadollahi A, Bahadori F, Arastoo AA. (2017). Interpersonal Factors in Understanding and Treating
Effectiveness of group logo therapy on life expectancy Posttraumatic Stress Disorder. J Psychiatr Pract.; 15(2):
& loneliness of minority aged community in Southwest 133–140. DOI: 10.1097/01.pra.0000348366.34419.28
Iran. MOJ Gerontol Ger. 2(3):237‒239. DOI:
10.15406/mojgg.2017.02.00049 Kim, Y. (1995). The effects of group counseling based
on logotherapy on the level of purpose in life, self-
Dadkhah, A., Asghari, N., & Aliakbari, M. (2012). esteem, and the decreasing of the stress of unmarried
Effects of “group logo therapy” on reducing the degree females in their twenties. Unpublished master’s thesis,
of depression Older women. Journal of Disability Dong-A University, Busan.
Studies, 2(1), 1–8.
Koulaee, A. J., Khenarinezhad, F., Abutalebi, M., &
Derici Cevap, S., & Mentiş Taş, A. (2018). Bagheri-Nesami, M. (2018). The effect of logotherapy
Investigation of the relationship between self-esteem on depression in cancer patients: A systematic review
and communication skills of primary school teachers in study. World Cancer Research Journal, 5(3), 1–6.
terms of various variables. Research on Education and
Psychology (REP), 2(1), 47-68. León-Navarrete, M., Flores-Villavicencio, M.,
Mendoza-Ruvalcaba, N., Colunga-Rodríguez, C.,
Ebrahimi, N., Bahari, F., & Zare-Bahramabadi, M. Salazar-Garza, M., Sarabia-López, L., & Albán-
(2014). The effectiveness of group logo therapy on the Pérez, G. (2017). Coping Strategies and Quality of Life
hope among leukemic patients. Iranian Journal of in Elderly Population. Open Journal of Social Sciences,
Cancer Prevention, 7(1), 9–16. 5, 207-216. https://doi.org/10.4236/jss.2017.510017.

504
 IEJNSR. Vol. 3 (2), 2023

Mahmoudi, M., Ebrahimzadeh, I., MosaKazemi, Soroush, A., Ziapour, A., Abbas, J., Jahanbin, I.,
M., Farajollahi, M., & Mahmoudi, A. H. (2015). Andayeshgar, B., Moradi, F., Najafi, S., &
Analysis of the Relationship between Cooperative Cheraghpouran, E. (2021). Effects of Group
Learning and Student Persistence in Online Education. Logotherapy Training on Self-Esteem, Communication
Interdisciplinary Virtual Learning in Medical Sciences, Skills, and Impact of Event Scale-Revised (IES-R) in
6(1), 1–14. Older Adults. Ageing International
46(3):.DOI:10.1007/s12126-021-09458-
Mortell, S., (2020). Logotherapy to Mitigate the 2.https://doi.org/10.1007/s12126-021-09458-2
Harmful Psychological Effects of Current Events; A
Tool for Nurses. Journal of Psychosocial Nursing and
Mental Health Services. 58(4), 38-42.DOI: Southwick S, Gilmartin R, Mcdonough P, Morrissey
10.3928/02793695-20200127-01. P. (2006). Logotherapy as an adjunctive treatment for
chronic combat-related PTSD: A meaning-based
Ravari A, Mirzaei T, Hosieni F, Hassanshahi E. intervention. American Journal of Psychotherapy.
(2021). Comparison of The Effects of Cognitive 60(2), 161-174. PMID: 16892952
Therapy and Logotherapy on Iranian Elderly People’s
General Health. IJCBNM. 9(4):289-299. doi:
10.30476/ijcbnm.2021.88217.1497 Steffany J. Freedman, J. Gayle Beck, Philippe
Shnaider, Yunying Le, Nicole D. Pukay-Martin,
Kimberly Z. Pentel, and Candice M. Monson Naomi
Ryszewska-Łab ę dzka, D.; Tobis, S.; Kropi ́nska, S.;
M. Simon and Luana Marques. (2017). Longitudinal
Wieczorowska-Tobis, K.; Talarska, D. (2022). The
Associations Between PTSD Symptoms and Dyadic
Association of Self-Esteem with the Level of Conflict Communication Following a Severe Motor
Independent Functioning and the Primary Demographic Vehicle Accident.Behav Ther; 48(2): 235–246. DOI:
Factors in Persons over 60 Years of Age. Int. J. 10.1016/j.beth.2016.05.001.
Environ. Res. Public Health 2022, 19, 1996. https://
doi.org/10.3390/ijerph19041996
Vos, J., & Vitali, D. (2018). The effects of
Safariolyaei N, Dehkhoda F, Hamidi Y et. al. (2015). psychological meaning-centered therapies on quality of
The effect of logotherapy on sleep symptoms of PTSD life and psychological stress: A meta-analysis.
in emotionally abused men. Int J Health Sci Res. Palliative & Supportive Care, 16(5), 608–632.
5(3):291-296.
Weiss D., & Marmar, C. (1997). The impact of event
Schulenberg, S. E., Hutzell, R. R., Nassif, C., & scale—revised in Wilson, J., & Keane, T. (Eds.),
Rogina, J. M. (2018). Logotherapy for clinical Assessing psychological trauma and PTSD (pp.399-
practice. Psychotherapy (Chicago, Ill.), 45(4), 447–463. 411). New York: Guilford Press.
https://doi.org/10.1037/a0014331.
White, M., & Casey, L. (2017). Helping older adults
Shaheen H., Badr S., Saleh E. (2017). Comparative to help themselves: The role of mental health literacy in
study between elderly with medical problems living in family members. Aging & Mental Health, 21(11),
dwelling houses and with families in Banha City. 1129–1137.
Menoufia Med J; 30:44.
World Health Organization (WHO). (2022). Aging
Shia News. (2013). Why did God, the Merciful, create and Health. Key Facts. https://www.who.int/health-
man in suffering! https://www.shia-news.com/fa/ topics/ageing#tab=tab_1 . Accessed 5-11-2022
news/68220.
Yazdanbakhsh, N., Younesi, S. J., Aazimiyan, S., &
Soetrisno, S., Ardhianto, A., & Hadi, S. (2017). The Foroughan, M. (2016). Effects of group counseling
effect of logotherapy on the expressions of cortisol, based on logotherapy to decrease loneliness in older
HSP70, Beck Depression Inventory (BDI), and pain adult men. Iranian Journal of Ageing, 11(3), 392–399
scales in advanced cervical cancer patients. Health
Care for Women International, 38(2), 91–99.

505