The existential plight of cancer: meaning making as a concrete approach to the intangible search for meaning (original) (raw)
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Measuring meaning in life following cancer
Quality of life …, 2006
Meaning in life is a multi-faceted construct that has been conceptualized in diverse ways. It refers broadly to the value and purpose of life, important life goals, and for some, spirituality. We developed a measure of meaning in life derived from this conceptualization and designed to be a synthesis of relevant theoretical and empirical traditions. Two samples, all cancer patients, provided data for scale development and psychometric study. From exploratory and confirmatory factor analyses the Meaning in Life Scale (MiLS) emerged, and includes four aspects: Harmony and Peace, Life Perspective, Purpose and Goals, Confusion and Lessened Meaning, and Benefits of Spirituality. Supporting data for reliability (internal consistency, test–retest) and construct validity (convergent, discriminant, individual differences) are provided. The MiLS offers a theoretically based and psychometrically sound assessment of meaning in life suitable for use with cancer patients.
Meaning in life of patients with cancer
Objective: The aim of this study was to evaluate meaning in life and its predictors in Turkish patients with cancer. Methods: A convenience sample of 182 patients with cancer at a Turkish university hospital completed a structured questionnaire including demographic characteristics, disease/ treatment characteristics, symptom level, and the meaning in life scale for patients with cancer in 2007. The researcher visited the oncology clinic five work days in every week and conducted interviews with the patients. In analysis of the data, correlation, t-tests, Kruskal-Wallis variance and regression analysis were used. Results: In this study, the mean score of the total meaning in life showed that the patients tended to be undecided concerning meaning in life. Education level, age, and diagnosis duration of the independent variables were effective predictors of meaning in life. Together the independent variables explained 24.3% of the variance of the purpose subscale, 26.2% of the variance of the coherence subscale, 14% of the variance of the choice/responsibleness subscale, and 44.1% of the total variance of the goal seeking subscale. Overall the independent variables explained 19.8% of the total variance of the total meaning in life. Significance of results: The results in this study should increase the awareness of cancer care professionals about a range of the meaning in life and may help them to target particular patient groups for detail support interventions.
Supportive Care in Cancer, 2011
Goal of work While significance of the concept of meaning in understanding adaptation to cancer is widely accepted, it has been little studied, especially in longitudinal data. This study aims to clarify the role of global meaning and meaning-related life attitudes (death acceptance and goal seeking) in predicting different aspects of psychological and existential distress by reference to a specified research model. Patients and methods At baseline (T1), a sample of 270 cancer patients was recruited. Data from 178 patients could be obtained after 3 months at T2. Patients completed the Life-Attitude-Profile—Revised assessing global meaning and meaning-related life attitudes, the Hospital Anxiety and Depression Scale, and the Demoralization Scale. Hierarchical regression analyses were carried out in two steps. Sociodemographic and physical factors were controlled. Results Global meaning emerged as a significant negative predictor of depression (β = −0.27) (p ≤ 0.001) and demoralization (β = −0.27) (p ≤ 0.001). Death acceptance was a predictor of anxiety only (β = −0.21) (p ≤ 0.003), whereas goal seeking was a positive predictor of depression (β = 0.29) (p ≤ 0.001), anxiety (β = 0.36) (p ≤ 0.001), and demoralization (β = 0.35) (p ≤ 0.001). Discussion Findings confirm a global sense of meaning as an important protecting factor regarding the development of distress symptoms. Results suggest that different dimensions of meaning contribute to different dimensions of psychological well-being, as they refer to different existential problems. The need for and relevance of meaning-focused interventions in cancer patients is strengthened.
Meaning in adjustment to cancer: A model of care
Palliative & Supportive Care, 2008
Objectives: In the clinical setting of cancer, meaning may well have a central role in the life changes the illness experience brings about. As health care professionals working with people with life-threatening illness, we are exposed to one of the major turning points in life and the ways people confront this transition. Meaning can assist coping by offering a framework, perspective, and counterbalance to the challenge of illness. However, the absence of meaning can be a precursor to profound despair.
Strategies used in coping with a cancer diagnosis predict meaning in life for survivors
Health Psychology, 2006
The search for meaning in life is part of the human experience. A negative life event may threaten perceptions about meaning in life, such as the benevolence of the world and one's sense of harmony and peace. The authors examined the longitudinal relationship between women's coping with a diagnosis of breast cancer and their self-reported meaning in life 2 years later. Multiple regression analyses revealed that positive strategies for coping predicted significant variance in the sense of meaning in life-feelings of inner peace, satisfaction with one's current life and the future, and spirituality and faith-and the absence of such strategies predicted reports of loss of meaning and confusion (ps < .01). The importance and process of finding meaning in the context of a life stressor are discussed. Keywords coping; meaning in life; survivor; breast cancer Human beings are motivated to find meaning in their lives (Frankl, 1959/1963). At no time is this more evident than in the aftermath of a traumatic event. Events that pose physical harm or death can shatter one's schemas of a just, purposeful world and an invulnerable self (Janoff-Bulman, 1989). A cancer diagnosis is one such event (e.g., Alter et al., 1996; Cordova et al., 1995). The diagnosis brings acute emotional distress (Andersen, Anderson, & deProsse, 1989; Epping-Jordan et al., 1999; Maunsell, Brisson, & Deschenes, 1992), and individuals struggle with questions about why the disease struck them, its significance for their future, and the changes that may follow. If patients can somehow answer these questions or address these issues, improved adjustment may follow. Several cross-sectional studies show that patients who report more meaning in their life in the wake of their cancer diagnosis also report less distress (
Meaning Making in Cancer Survivors: A Focus Group Study
PLoS ONE, 2013
Background: Confrontation with a life-threatening disease like cancer can evoke existential distress, which can trigger a search for meaning in people after having survived this disease. Methods: In an effort to gain more insight in the meaning making process, we conducted four focus groups with 23 cancer survivors on this topic. Participants responded to questions about experienced meaning making, perceived changes in meaning making after cancer and the perceived need for help in this area. Results: Most frequently mentioned meaning making themes were relationships and experiences. We found that, in general, cancer survivors experienced enhanced meaning after cancer through relationships, experiences, resilience, goal-orientation and leaving a legacy. Some participants, however, also said to have (also) experienced a loss of meaning in their lives through experiences, social roles, relationships and uncertainties about the future. Conclusions: The results indicated that there is a group of cancer survivors that has succeeded in meaning making efforts, and experienced sometimes even more meaning in life than before diagnosis, while there is also a considerable group of survivors that struggled with meaning making and has an unmet need for help with that. The results of this study contribute to develop a meaning centered intervention for cancer survivors.
Whys and Wherefores: Adult Patient Perspectives of the Meaning of Cancer
Theory and empirical evidence suggest that the search for meaning is a significant part of the cancer experience. Yet differences exist in how the construct "search for meaning" is conceptualized. In this article, the meaning of cancer is discussed using four approaches: (1) casual explanations, (2) selective incidence, (3) responsibility, and (4) significance. Research describing these approaches to the process of searching for meaning among persons with cancer is reviewed. Several studies have investigated cancer patients' casual explanations: the most frequently cited causes include God's will, heredity, chance, life-style and personal factors, and environment. Whereas no studies have focused explicitly on the phenomenon of selective incidence (eg, asking "why me?"), a few investigations have begun to explore cancer patients' attributions of responsibility. These investigations have identified projections of responsibility/blame for cancer such as chance, God, others, or the environment. Research describing the significance, which is usually positive, that persons with cancer ascribe to their illness is also reviewed. Such meanings for cancer identified include reprioritization of goals, changed lifestyles and values, increased appreciation for nature and others, and spiritual development. Responses to the need for meaning vary; indeed, some persons with cancer do not perceive that they "search for meaning." The nursing implications of these various responses to meaning making are presented.