Limitations of logotherapy in enhancing self-efficacy among Iranian women with stage III breast cancer: Emphasizing the need for continuous, contextualized psychosocial interventions
Morteza Mansourian, Farahrouz Z. Amogain, Hadi Darvishigilan, Seyyed Mohammad Hassan Alavi Sereshki, Fatemehsadat AlaviBACKGROUND:
Breast cancer remains the leading cancer among women globally and a significant cause of female mortality. Many women with breast cancer experience reduced self-efficacy, often linked to spirituality, personal values, and a disrupted sense of purpose. This qualitative content analysis aimed to explore the perceived long-term effects of a structured logotherapy intervention on self-efficacy in Iranian women with breast cancer, drawing on Frankl’s existential theory of meaning, freedom, and responsibility.
MATERIALS AND METHODS:
This qualitative study was conducted in Iran over a nine-month period (April–December 2024) at Hazrat Rasoul Akram Hospital, Tehran. Data were gathered through semi-structured, in-depth interviews with 17 Iranian women diagnosed with stage III breast cancer, conducted three months after completion of a four-session logotherapy intervention. Sessions lasted 60–90 minutes and addressed core logotherapy themes such as meaning-making, self-transcendence, and value-oriented living. To enhance data triangulation, eight healthcare providers (including four nurses, two gynecologists, and two psychologists) were also interviewed. Purposive sampling was used until theoretical saturation was achieved. Data were analyzed using the conventional content analysis approach, involving open coding, category formulation, and theme extraction. To ensure trustworthiness, Lincoln and Guba’s criteria were applied: credibility (via member checking and peer debriefing), dependability (audit trail), confirmability (reflexive journaling), and transferability (through thick description). MAXQDA software supported data organization and coding.
RESULTS:
Ten interconnected themes influencing women’s self-efficacy were identified: social support, effective healthcare communication, coping mechanisms, sense of control, self-management capabilities, body image and self-perception, participation in cancer rehabilitation, spiritual and emotional health, access to reliable information, and personal resilience. Although logotherapy contributed to enhancing existential meaning and partially improved self-efficacy, the findings emphasize that such improvements are not sustained without continuous, multidimensional psychosocial interventions beyond meaning-centered therapy.
CONCLUSION:
The study indicates that long-term self-efficacy enhancement in women with breast cancer depends on multi-dimensional, sustained interventions that extend beyond meaning-centered therapy. Understanding patients’ lived experiences offers valuable perspectives for developing more effective psycho-oncological support strategies and culturally sensitive clinical guidelines.