The Effect of Forgiveness-based Motivational Interviewing

January 23, 2026 updated by: Ömer USLU

The Effect of Forgiveness-based Motivational Interviewing on Death Anxiety, Life Satisfaction, and Forgiveness Disposition in Patients With COPD: A Randomized Controlled Trial

This study aimed to examine the effect of forgiveness-based motivational interviewing on death anxiety, life satisfaction, and forgiveness disposition in patients with COPD. A randomized controlled experimental design with pretest, posttest, and one-month follow-up measurements was employed. The study sample consisted of 30 patients (experimental group: 15; control group: 15). The experimental group received forgiveness-based motivational interviewing, whereas no intervention was provided to the control group. Data were collected using a personal information form, the Death Anxiety Scale, the Life Satisfaction Scale, and the Forgiveness Scale. The findings revealed that, in the posttest and follow-up measurements, the experimental group had significantly lower mean scores on the Death Anxiety Scale compared to the control group (p<0.05). Furthermore, the experimental group demonstrated significantly higher mean scores on the Life Satisfaction Scale and the Forgiveness Scale in the posttest and follow-up measurements than the control group (p<0.05). This study concluded that forgiveness-based motivational interviewing effectively reduces death anxiety while enhancing life satisfaction and forgiveness disposition in patients with COPD. Therefore, implementing motivational interviewing for patients is recommended.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Chronic obstructive pulmonary disease (COPD) is a global chronic respiratory disease that arises from a combination of genetic and environmental factors, predominantly due to smoking and air pollution.As the disease progresses, symptoms such as dyspnoea, cough, and sputum production emerge, leading to several complications, including fatigue, insomnia, social withdrawal, and anxiety. The persistent presence of these symptoms can result in intense death anxiety among COPD patients. Studies on COPD patients in the literature suggest that the prolonged duration of the disease, continuous medication use, and the burden of disease-related symptoms negatively impact their quality of life, ultimately reducing their life satisfaction. This decline in life satisfaction can, in turn, give rise to a diminished sense of hope for the future and an escalation in death anxiety. Moreover, COPD patients frequently encounter emotional distress during treatment and care, undergo a critical reassessment of their past lives, and grapple with feelings of guilt and regret. The management of these emotions can be arduous. In this context, the concept of forgiveness emerges as a potential mitigating factor for the adverse emotional effects of the disease. Forgiveness is not about denying the pain and consequences of a distressing experience but rather an effort to replace feelings of anger, resentment, and bitterness with compassion, empathy, and kindness. To date, no studies have specifically examined forgiveness training for COPD patients; however, previous research indicates that motivational interviewing has positive effects on various patient populations. Motivation can be defined as an internal state influenced by external factors. Motivational interviewing is a client-centred and encouraging approach that helps individuals explore and resolve ambivalence to facilitate behaviour change. Motivational interviewing not only supports behavioural and lifestyle changes in patients but also enhances their adherence to treatment. Beyond the necessity of treating physical symptoms in individuals with chronic diseases like COPD, the need for psychological support underscores the importance of consultation-liaison psychiatry. Consultation-liaison psychiatry (CLP) nurses do not merely provide care services; they also assume advisory and educational roles by conducting individual or group psychoeducation sessions. CLP nurses should support patients in expressing emotions such as anger, guilt, sadness, and regret, strengthen their coping mechanisms, mobilise effective support systems, and increase awareness of the impact of these emotions on their lives. In consideration of the role of CLP nurses, it can be posited that forgiveness-based motivational interviewing for COPD patients may prove efficacious in reducing death anxiety, increasing life satisfaction, and enhancing forgiveness tendencies, while concomitantly addressing their need for care, education, and counselling.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
30

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey (Türkiye)
    • Bergama
      • Izmir, Bergama, Turkey (Türkiye), 35700
        • Bergama Necla Mithat Öztüre State Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • They must be 18 years of age or older,
  • Possess sufficient mental capacity and communication skills to follow the study guidelines, be literate,
  • Have a diagnosis of COPD,
  • Have been hospitalized in the pulmonary diseases unit between June and September 2024.

Exclusion Criteria:

  • Determined having communication barriers due to disease symptoms,
  • Experiencing dyspnea at a level that prevents cooperation
  • Having a chronic psychiatric disorder that would interfere with participation in the study.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: forgiveness-based motivational interviewing
Participants will receive an 6-session forgiveness-based motivational interviewing
Other: Control
no intervention was performed in the control group
Other: forgiveness-based motivational interviewing
The forgiveness-based motivational interviewing was administered face-to-face, with each session lasting 40-60 minutes, scheduled twice a week over a three-week period (a total of six sessions).
No Intervention: Control
Throughout the study, the forgiveness-based motivational interviewing was applied only to the experimental group, and no intervention was performed in the control group

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Death Anxiety Scale
Time Frame: Baseline (pretest), 3 weeks (posttest) and one month after the posttest
The scale is a unidimensional, dichotomous Likert-type instrument consisting of 15 items that assess an individual's anxiety related to their own death and the risk of dying. Each item is answered as "yes" or "no," where a "yes" response for the first nine items and a "no" response for the remaining six items receive one point. The total score ranges from 0 to 15, with higher scores indicating greater death anxiety.
Baseline (pretest), 3 weeks (posttest) and one month after the posttest

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Forgiveness scale
Time Frame: Baseline (pretest), 3 weeks (posttest) and one month after the posttest
Forgiveness Scale, developed by Ersanlı and Batık, designed to measure individuals' levels of self-forgiveness and forgiveness of others. The scale is scored from "strongly disagree" to "strongly agree," with higher scores indicating higher levels of forgiveness.
Baseline (pretest), 3 weeks (posttest) and one month after the posttest

Other Outcome Measures

Other Outcome Measures

For clinical trials, a planned measurement described in the protocol that is used to determine the effect of an intervention/treatment on participants. For observational studies, a measurement or observation that is used to describe patterns of diseases or traits, or associations with exposures, risk factors, or treatment. Types of outcome measures include primary outcome measure and secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Life satisfaction scale
Time Frame: Baseline (pretest), 3 weeks (posttest) and one month after the posttest
The scale consists of a single dimension with five items, rated on a five-point Likert scale ranging from 1 ("Strongly Disagree") to 5 ("Strongly Agree"). The total score ranges from 5 to 25, with higher scores indicating higher life satisfaction.
Baseline (pretest), 3 weeks (posttest) and one month after the posttest

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Ömer USLU

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Merve Şahin, PhD, RN, Bergama Necla Mithat Öztüre State Hospital

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
June 1, 2024

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
September 27, 2024

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
September 30, 2024

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
January 17, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
January 23, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
January 26, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
January 26, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
January 23, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
January 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • MERVE-RCT-2025-COPD

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data (IPD) from this study will not be shared due to ethical and institutional restrictions. The dataset includes sensitive health information from postpartum women, and the informed consent process did not include permission for public data sharing. Therefore, in accordance with privacy regulations and ethical committee requirements, IPD will not be made available to other researchers

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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