Effects of psychosocial interventions on meaning and purpose in adults with cancer: A systematic review and meta‐analysis

Abstract

Meaning and purpose in life are associated with the mental and physical health of patients with cancer and survivors and also constitute highly valued outcomes in themselves. Because meaning and purpose are often threatened by a cancer diagnosis and treatment, interventions have been developed to promote meaning and purpose. The present meta‐analysis of randomized controlled trials (RCTs) evaluated effects of psychosocial interventions on meaning/purpose in adults with cancer and tested potential moderators of intervention effects. Six literature databases were systematically searched to identify RCTs of psychosocial interventions in which meaning or purpose was an outcome. Using Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines, rater pairs extracted and evaluated data for quality. Findings were synthesized across studies with standard meta‐analytic methods, including meta‐regression with robust variance estimation and risk‐of‐bias sensitivity analysis. Twenty‐nine RCTs were identified, and they encompassed 82 treatment effects among 2305 patients/survivors. Psychosocial interventions were associated with significant improvements in meaning/purpose (g = 0.37; 95% CI, 0.22‐0.52; P < .0001). Interventions designed to enhance meaning/purpose (g = 0.42; 95% CI, 0.24‐0.60) demonstrated significantly higher effect sizes than those targeting other primary outcomes (g = 0.18; 95% CI, 0.09‐0.27; P = .009). Few other intervention, clinical, or demographic characteristics tested were significant moderators. In conclusion, the results suggest that psychosocial interventions are associated with small to medium effects in enhancing meaning/purpose among patients with cancer, and the benefits are comparable to those of interventions designed to reduce depression, pain, and fatigue in patients with cancer. Methodological concerns include small samples and ambiguity regarding allocation concealment. Future research should focus on explicitly meaning‐centered interventions and identify optimal treatment or survivorship phases for implementation.

Purpose in Life and Motoric Cognitive Risk Syndrome: Replicable Evidence from Two National Samples

“…Purpose in life may be a useful target of intervention for healthier cognitive aging. In particular, there is replicable evidence that purpose can be increased through intervention 31 . However, these interventions were not designed to promote healthier cognitive aging.…”

A systematic review and meta‐analysis of effects of psychosocial interventions on spiritual well‐being in adults with cancer

“…See Park et al for detailed description of overall meta-analysis methods used. 15 Below, we briefly describe key methodological details specific to this study. The raw data (including effect size estimates, variance estimates and moderator variables) and code for replicating all reported analyses are available in the Supporting Information S1 accompanying this article.…”

“…16,17 Detailed search strategies for each database are available in the Supporting Information S1 accompanying this article. 15…”

“…See Park et al for detailed description. 15 Five doctoral-level investigators comprised the review team. Covidence, a Cochrane technology platform, was used to manage study reviews and coding.…”

Psychological assistance for end-of-life patients under palliative care in the hospital environment: an integrative review

“…8 Therefore, clinical investments are based on the interventions performed by psychologists as they can greatly influence treatment adherence and decisionmaking, favoring the mental and physical well-being of patients under PC. 9 It is important to emphasize that clinical psychologists' duties can go beyond the assistance provided in the hospital environment. Psychological assistance can be provided in the communities or inside residences in accordance with the objectives of palliative care.…”