Effect of logotherapy counseling program on chronic sorrow, dignityand meaning in life of palliative care patients

This study was conducted to evaluate the effect of logotherapy counseling program on feelings of grief and dignity and finding meaning in life of palliative care patients. The sample of this randomized-controlled study, conducted between September 2021-June 2023, was consisted of 58 individuals hospitalized due to advanced cancer, in the medical oncology and gynecology clinics of a university hospital. Participants were assigned to either intervention (n=29) or control (n=29) group by simple randomization via a randomizationspecific computer program. Data were collected with demographic information form, Palliative Performance Scale, Patient Dignity Inventory (PDI), Prolonged Grief Disorder Scale-Patient Form (PGD-PF) and Meaning in Life (MIL) Questionnaire . Data collection forms were applied on admission, at the 4th and 8th weeks. Intervention group received logotherapy, lasting about of 45 minutes, 2 days a week for 4 weeks.. The control group received no intervention. Data were analyzed by independent sample t test, analysis of variance, Pearson correlation analysis, repeated measure analysis of variance, paired sample t test, Cohen d effect size and multiple linear regression analysis. According to the results of the study, paired group analysis at follow-up evaluation, a significant change was found in favor of the intervention group in mean scores of symptom distress sub-dimension of PDI (p=0.01), the PGD-PF (p=0.01) and the presence of meaning sub-dimension of the MIL (p=0.03). The time-dependent variation between the groups revealed that PDI (p=0.01), PGD-PF (p=0.01) and presence of meaning sub-dimension of MIL (p=0.02) showed significant changes over time between groups. Within-group analysis showed a significant difference in the intervention group in terms of PDI (p=0.01), PGD-PF (p=0.01) and presence (p=0.01) of and search for (p=0.02) meaning sub-dimensions of MIL. The mean score of presence of-meaning sub-dimension of MIL was increased in the intervention group while mean scores of other dependent variables were decreased. In the control group, a significant difference was found in mean scores of PDI (p=0.01), PDG-PF (p=0.02) and presence of (p=0.04) and search for (p=0.04) meaning sub-dimensions of MIL. The mean scores MIL sub-dimensions decreased in control group while mean scores of other dependent variables increased. The multiple linear regression analysis revealed that, although a low level, the changes in mean scores of PDI and PDG-PF were determined by gender, disease stage and actively receiving cancer treatment while presence of meaning sub-dimension of MIL was determined by stage of the disease, education level and actively receiving cancer treatment. The experiential values of individuals were to spend time with family, to watch nature or do yard work, and to pray; creative values were to meet the needs of the family and to take care of the household; and attitudinal values were to act upon own beliefs, to be altruistic and be patient. As a result, the program was found to be effective on decreasing sorrow and dignity related distress of palliative care patients, while increasing finding meaning in life.