The Effectiveness of Spiritual Therapy on the Quality of Sleep, Resilience, and Death Anxiety of the Elderly

Elderly has already devoted a major share of the population composition to themselves. People with high resiliency make stressful events less threatening, and instead of suppressing them, it is more likely to seek help. Human health is associated with sleep quantity and quality. Insomnia is a common type of sleep disorder in the elderly. Spirituality can be defined as the spirit of life section or images such as breathing, wind, energy, and courage. Various training and treatment methods have been used to improve cognitive psychological components in the elderly. One of these methods is spirituality therapy. The diversity and variety of stresses that people face in old age have made it necessary to pay attention to the issue of mental health, especially resilience in old age. This study aimed to investigate the effectiveness of spiritual therapy on the quality of sleep, resilience, and anxiety about the death of the elderly.

The present research method was quasi–experimental with a pretest–posttest and a 2–month follow–up design with a control group. The statistical population of this study included all elderly people living in the nursing home in Shiraz City, Iran, in 2019. The sample of this study consists of 30 people from the mentioned community who were selected using the available sampling. Using the simple randomization method, they were assigned to two groups of spiritual therapy (n=15) and control group (n=15). The inclusion criteria were as follows: having at least 60 years of age; having a minimum cycle education; not receiving psychological treatments since the diagnosis of the disease; lacking an acute or chronic medical disease such as epilepsy, skeletal diseases, and heart and respiratory failure causing problems in blood sampling and enduring long sessions; not suffering from severe mental illnesses, such as psychotic disorders; and not currently taking psychoactive drugs or abusing substances. The absence of more than two sessions in therapy sessions and the occurrence of major stress due to unforeseen events were also considered as the exclusion criteria. The data were obtained using Connor–Davidson Resilience Scale (CD–RISC) (Connor & Davidson, 2003), the Collett–Lester Fear of Death Scale (CL–FODS) (Collett & Lester, 1969) and the Pittsburgh Sleep Quality Index (Buysse et al., 1989). In the descriptive statistics section, central and dispersion indicators such as mean and standard deviation were used, and in the inferential statistics section, repeated measures ANOVA, Bonferroni post hoc test, and the Chi–square test were used. The mentioned statistical analyses were done using SPSS version 22 software. The significance level of the tests was considered to be 0.05.

The results showed that the effect of the group on the variables of sleep quality (p=0.001), resilience (p=0.001), and death anxiety (p<0.001) was significant. In the experimental group, the scores of sleep quality variables, resilience, and death anxiety were significantly different compared to the pretest in the posttest and follow–up stages (p<0.05). However, no significant difference was observed in the scores of the mentioned variables between the posttest and follow–up stages, indicating the intervention's continued effectiveness in the follow–up stage. In the control group, there was no significant difference between the pretest, posttest, and follow–up stages and between the posttest and follow–up stages.

Based on the findings of this study, spiritual group therapy can be used to improve sleep quality, resilience, and death anxiety in elderly people. Therefore, spirituality therapy can be used as a therapeutic or educational method to improve the psychological status of elderly people.