Understanding meaning in life interventions in patients with advanced disease: A systematic review and realist synthesis

Abstract

This review provides an explanatory model of the contextual factors and mechanisms that may be involved in promoting meaning in life. These approaches could provide useful tools for relieving existential suffering at the end of life.

Depression and Spiritual Distress in Adult Palliative Patients: A Cross-Sectional Study

“…Swinton states that "depression is a profound spiritual illness that digs into the heart of a person´s spirit and forces them to face experiences of meaninglessness and hopelessness" (Swinton 2001, p. 167). It seems that previous qualitative and quantitative research suggests meaning in life is a core aspect of the human person (Frankl 1992) and a lack of this dimension might be related to depression (Swinton 2001;Guerrero-Torrelles et al 2017), addiction (White et al 2006;Krentzman et al 2015) and spiritual distress (Caldeira et al 2015;Villagomeza 2005). However, the present study does not explain the nature and direction of the causal relationship between depression and a lack of meaning in life.…”

“…In European patients with advanced cancer, interpersonal relationships were reported as the area that provides more meaning in life to these patients (Tomás-Sábado et al 2015). Among patients with advanced diseases, having a sense of meaning in life is a buffer against depression and the wish to hasten death (Guerrero-Torrelles et al 2017). In the general population, interventions increasing gratitude and meaning in life facilitate the remission of depression (Disabato et al 2016).…”

The association of demoralization with mental disorders and suicidal ideation in patients with cancer

“…In contrast, we argue that demoralization ought not be viewed simply as a weaker form of a mood or anxiety disorder. 41,42 They can help patients to deal with disease-related losses and fears and focus on what matters most in the future. 40 Such individuals who do not fulfill criteria for a full-blown psychiatric disorder may nevertheless benefit from a therapeutic intervention.…”

“…15,19 Existential and meaningfocused therapeutic interventions can specifically address the loss of purpose and motivation to go on. 41,42 They can help patients to deal with disease-related losses and fears and focus on what matters most in the future. 43 Our results showed that demoralization was more common when a mood disorder, an anxiety disorder, or suicidal ideation were present.…”

What brings meaning to life in a highly secular society? A study on sources of meaning among Danes

“…Furthermore, meaning in life is often construed in a uni-dimensional way, that is, it only measures the degree of perceived meaning and purpose in life, but not the factors that contribute to this perception (Brands€ atter, Baumann, Borasio & Fegg, 2012). Having multidimensional measures of personal sources of meaning, may be especially relevant for health personnel operating with individuals in crisis due to sudden life change such as bereavement (Neimeyer, 2011), chronic or life-threatening illness (Guerrero-Torrelles, Monforte-Royo, Rodr ıguez-Prat, Porta-Sales, & Balaguer, 2017;Lin, Bauer-Wu, 2003;Vos, 2016), or traumatic events (Silver & Updegraff, 2013), who might have lost access to their primary source of meaning in life. Therefore, there is a need for multidimensional instruments that are able to address both dimensions, for example, experienced meaning in life as well as the sources that contribute to its experience.…”