Hostname: page-component-78c5997874-4rdpn Total loading time: 0 Render date: 2024-11-17T12:23:05.378Z Has data issue: false hasContentIssue false
  • English
  • Français

Clarifying “meaning” in the context of cancer research: A systematic literature review

Published online by Cambridge University Press:  12 May 2005

VIRGINIA LEE ,
S. ROBIN COHEN ,
LINDA EDGAR ,
ANDREA M. LAIZNER  and
ANITA J. GAGNON
VIRGINIA LEE
Affiliation:
School of Nursing, McGill University, Montreal, Quebec, Canada McGill University Health Centre, Montreal, Quebec, Canada Montreal General Hospital, Montreal, Quebec, Canada
S. ROBIN COHEN
Affiliation:
School of Nursing, McGill University, Montreal, Quebec, Canada Department of Oncology, McGill University, Montreal, Quebec, Canada Department of Medicine, McGill University, Montreal, Quebec, Canada Lady Davis Institute, Sir Mortimer B. Davis-Jewish General Hospital, Montreal, Quebec, Canada
LINDA EDGAR
Affiliation:
School of Nursing, McGill University, Montreal, Quebec, Canada Department of Oncology, McGill University, Montreal, Quebec, Canada Department of Epidemiology, and Hope and Cope, Sir Mortimer B. Davis-Jewish General Hospital
ANDREA M. LAIZNER
Affiliation:
School of Nursing, McGill University, Montreal, Quebec, Canada McGill University Health Centre, Montreal, Quebec, Canada Royal Victoria Hospital, Montreal, Quebec, Canada
ANITA J. GAGNON
Affiliation:
School of Nursing, McGill University, Montreal, Quebec, Canada McGill University Health Centre, Montreal, Quebec, Canada Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives: This article synthesizes the published literature related to the construct of meaning in the adult cancer population.

Methods: The databases CancerLit, CINAHL, Medline, PsychINFO, and the Journal of Psychosocial Oncology and PsychoOncology were searched to identify all studies related to meaning. The methodological aspects of all studies are described and the conceptual aspects are summarized only from those studies that met criteria for methodological rigor and validity of findings. The definitions for global meaning, appraised meaning, search for meaning, and meaning as outcome as proposed by Park and Folkman were used to interpret the findings.

Results: Of 44 studies identified, 26 met the criteria for methodological rigor. There is strong empirical and qualitative evidence of a relationship between meaning as an outcome of and psychosocial adjustment to cancer.

Significance of results: The qualitative findings are considered useful for the development of psychosocial interventions aimed at helping cancer patients cope with and even derive positive benefit from their experience. However, variations in the conceptual and operational definitions, frequent reliance on homogeneous and convenience sampling, and the lack of experimental designs are considered to be methodological limitations that need to be addressed to advance the study of meaning in the context of cancer.

Keywords

MeaningCancerSystematic literature reviewResearch
Type
Research Article
Information
Palliative & Supportive Care , Volume 2 , Issue 3 , September 2004 , pp. 291 - 303
Copyright
© 2004 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES (References marked with an asterisk indicate studies included in the systematic review.)

*Albaugh, J.A. (2003). Spirituality and life-threatening illness: A phenomenological study. Oncology Nursing Forum, 30, 593–598.Google Scholar
Antonovsky, A. (1987). Unraveling the Mystery of Health. San Francisco: Jossey-Bass.
*Baider, L. & De Nour, A.K. (1986). The meaning of a disease: An exploratory study of Moslem Arab women after a mastectomy. Journal of Psychosocial Oncology, 4, 1–13.Google Scholar
*Barkwell, D.P. (1991). Ascribed meaning: A critical factor in coping and pain attenuation in patients with cancer-related pain. Journal of Palliative Care, 7, 5–14.Google Scholar
*Bolmsjo, I. (2000). Existential issues in palliative care: Interviews with cancer patients. Journal of Palliative Care, 16, 20–24.Google Scholar
*Bowes, D.E., Tamlyn, D., & Butler, L.J. (2002). Women living with ovarian cancer: Dealing with an early death. Health Care for Women International, 23, 135–148.Google Scholar
Breitbart, W. (2001). Spirituality and meaning in supportive care: Spirituality and meaning-centered group psychotherapy interventions in advanced cancer [Electronic version]. Supportive Care in Cancer, 1–15.Google Scholar
Carnevale, F.A. (2002). Authentic qualitative research and the quest for methodological rigour. Canadian Journal of Nursing Research, 34, 121–128.Google Scholar
*Carter, B.J. (1993). Long-term survivors of breast cancer. Cancer Nursing, 16, 354–361.Google Scholar
*Chin-A-Loy, S.S. & Fernsler, J.I. (1998). Self-transcendence in older men attending a prostate cancer support group. Cancer Nursing, 21, 358–363.Google Scholar
Cole, B. & Pargament, K. (1999). Re-creating your life: A spiritual/psychotherapeutic intervention for people diagnosed with cancer. Psycho-Oncology, 8, 395–407.Google Scholar
*Coward, D.D. (1990). The lived experience of self-transcendence in women with advanced breast cancer. Nursing Science Quarterly, 3, 162–169.Google Scholar
*Coward, D.D. (1991). Self-transcendence and emotional well-being in women with advanced breast cancer. Oncology Nursing Forum, 18, 857–863.Google Scholar
Crumbaugh, J.C. & Maholick, L.T. (1981). Manual of Instructions for the Purpose in Life Test. Saratoga, CA: Viktor Frankl Institute of Logotherapy.
Davis, C.G., Nolen-Hoeksema, S., & Larson, J. (1998). Making sense of loss and benefiting from the experience: Two construals of meaning. Journal of Personality & Social Psychology, 75, 561–574.Google Scholar
*Degner, L.F., Hack, T., O'Neil, J., & Kristanson, L.J. (2003). A new approach to eliciting meaning in the context of breast cancer. Cancer Nursing, 26, 169–178.Google Scholar
*Dirksen, S.R. (1995). Search for meaning in long-term cancer survivors. Journal of Advanced Nursing, 21, 628–633.Google Scholar
Edlund, B. & Sneed, N.V. (1989). Emotional responses to the diagnosis of cancer: Age-related comparisons. Oncology Nursing Forum, 16, 691–697.Google Scholar
*Ferrell, B.R., Smith, S.L., Juarez, & G., et al. (2003). Meaning of illness and spirituality in ovarian cancer survivors. Oncology Nursing Forum, 30, 249–257.Google Scholar
*Fife, B.L. (1994). The conceptualization of meaning in illness. Social Science & Medicine, 38, 309–316.Google Scholar
Folkman, S. & Greer, S. (2000). Promoting psychological well-being in the face of serious illness: When theory, research and practice inform each other. Psycho-Oncology, 9, 11–19.Google Scholar
Folkman, S. & Moskowitz, J.T. (2000). Positive affect and the other side of coping. American Psychologist, 55, 647–654.Google Scholar
Frankl, V. (1959). Man's Search for Meaning. Boston: Washington Square Press.
Greenstein, M. (2000). The house that's on fire: Meaning-centered psychotherapy pilot group for cancer patients. American Journal of Psychotherapy, 54, 501–511.Google Scholar
Greenstein, M. & Breitbart, W. (2000). Cancer and the experience of meaning: A group psychotherapy program for people with cancer. American Journal of Psychotherapy, 54, 486–500.Google Scholar
Guba, E.G. & Lincoln, Y.S. (1981). Effective Evaluation. Washington, DC: Jossey-Bass.
*Halstead, M.T. & Hull, M. (2001). Struggling with paradoxes: The process of spiritual development in women with cancer. Oncology Nursing Forum, 28, 1534–1543.Google Scholar
Ibrahim, F.A. & Kahn, H. (1987). Assessment of world views. Psychological Reports, 60, 163–176.Google Scholar
Ishiyama, F.I. (1990). Meaningful life therapy: Use of Morita therapy principles in treating patients with cancer and intractable diseases. International Bulletin of Morita Therapy, 3(2), 77–84.Google Scholar
Janoff-Bulman, R. (1992). Shattered Assumptions: Towards a New Psychology of Trauma. New York: The Free Press.
Kearney, M.H. (2001). Levels and applications of qualitative research evidence. Research in Nursing and Health, 24, 145–153.Google Scholar
*Lam, W.W.T. & Fielding, R. (2003). The evolving experience of illness for Chinese women with breast cancer: A qualitative study. Psycho-Oncology, 12, 127–140.Google Scholar
*Landmark, B.T., Strandmark, M., & Wahl, A.K. (2001). Living with newly diagnosed breast cancer—The meaning of existential issues. Cancer Nursing, 24, 220–226.Google Scholar
*Lechner, S.C., Zakowski, S.G., Antoni, M.H., Greenhawt, M., Block, K., & Block, P. (2003). Do sociodemographic and disease-related variables influence benefit-finding in cancer patients? Psycho-Oncology, 12, 491–499.Google Scholar
Lerner, M.J. (1970). The desire for justice and reactions to victims: Social psychological studies of some antecedent and consequences. In Altruism and Helping Behaviors, J. Macaulay, L. Berkowitz (eds.), pp. 205–229. New York: Academic Press.
*Lewis, F.M. (1989). Attributions of control, experienced meaning, and psychosocial well-being in patients with advanced cancer. Journal of Psychosocial Oncology, 7, 105–119.Google Scholar
Linn, M.W., Linn, B.S., & Harris, R. (1982). Effects of counseling for late stage cancer patients. Cancer, 49, 1048–1055.Google Scholar
Lipowski, Z. (1970). Physical illness, the individual and the coping processes. Psychiatry in Medicine, 1, 91–102.Google Scholar
*Luker, K.A., Beaver, K., Leinster, & S.J., et al. (1996). Meaning of illness for women with breast cancer. Journal of Advanced Nursing, 23, 1194–1201.Google Scholar
*Mahon, S.M. & Casperson, D.M. (1997). Exploring the psychosocial meaning of recurrent cancer: A descriptive study. Cancer Nursing, 20, 278–186.Google Scholar
*Matthews, H.F., Lannin, D.R., & Mitchell, J.P. (1994). Coming to terms with advanced breast cancer: Black women's narratives from Eastern North Carolina. Social Science & Medicine, 38, 789–800.Google Scholar
McMillan, S.C. & Weitzner, M.A. (2003). Methodological issues in collecting data from debilitated patients with cancer near the end of life. Oncology Nursing Forum, 30, 123–129.Google Scholar
*Moadel, A., Morgan, C., Fatone, & A., et al. (1999). Seeking meaning and hope: Self-reported spiritual and existential needs among an ethnically diverse cancer population. Psycho-Oncology, 8, 378–385.Google Scholar
*Mullen, P.M., Smith, R.M., & Hill, E.W. (1993). Sense of coherence as a mediator of stress for cancer patients and spouses. Journal of Psychosocial Oncology, 11, 23–46.Google Scholar
Murray, M. & McMillan, C.L. (1993). Gender differences in perceptions of cancer. Journal of Cancer Education, 8, 52–62.Google Scholar
*Nelson, J.P. (1996). Struggling to gain meaning: Living with the uncertainty of breast cancer. Advances in Nursing Science, 18, 59–76.Google Scholar
*O'Connor, A.P., Wicker, C.A., & Germino, B.B. (1990). Understanding the cancer patient's search for meaning. Cancer Nursing, 13, 167–175.Google Scholar
*Olsson, U., Bergbom, I., & Bosaeus, I. (2002). Patients' experiences of the recovery period 3 months after gastrointestinal cancer surgery. European Journal of Cancer Care, 11, 51–60.Google Scholar
Park, C. & Folkman, S. (1997). Meaning in the context of stress and coping. Review of General Psychology, 1, 115–144.Google Scholar
Peacock, E.J. & Wong, P.T.P. (1990). The Stress Appraisal Measure (SAM): A multidimensional approach to cognitive appraisal. Stress Medicine, 6, 227–236.Google Scholar
*Pelusi, J. (1997). The lived experience of surviving breast cancer. Oncology Nursing Forum, 24, 1343–1353.Google Scholar
*Post-White, J., Ceronsky, C., Kreitzer, & M.J., et al. (1996). Hope, spirituality, sense of coherence, and quality of life in patients with cancer. Oncology Nursing Forum, 23, 1571–1579.Google Scholar
*Ramfelt, E., Langius, A., Bjorvell, & H., et al. (2000). Treatment decision-making and its relation to the sense of coherence and the meaning of the disease in a group of patients with colorectal cancer. European Journal of Cancer Care, 9, 158–165.Google Scholar
*Ramfelt, E., Severinsson, E., & Lutzen, K. (2002). Attempting to find meaning in illness to achieve emotional coherence. Cancer Nursing, 25, 141–149.Google Scholar
Reed, P. (1991). Self-transcendence and mental health in oldest-old adults. Nursing Research, 40, 5–11.Google Scholar
Reker, G.T. (1992). The Life Attitude Profile–Revised (LAP-R): Procedures Manual: Research Edition. Peterborough, Ontario, Canada: Student Psychologists' Press.
Richer, M.C. & Ezer, H. (2000). Understanding beliefs and meanings in the experience of cancer: A concept analysis. Journal of Advanced Nursing, 32, 1108–1115.Google Scholar
*Richer, M.C. & Ezer, H. (2002). Living in it, living with it, and moving on: Dimensions of meaning during chemotherapy. Oncology Nursing Forum, 29, 113–119.Google Scholar
Salmon, P., Manzi, F., & Valori, R.M. (1996). Measuring the meaning of life for patients with incurable cancer: The Life Evaluation Questionnaire (LEQ). European Journal of Cancer, 32A, 755–760.Google Scholar
*Schnoll, R.A., Knowles, J.C., & Harlow, L. (2002). Correlates of adjustment among cancer survivors. Journal of Psychosocial Oncology, 20, 37–59.Google Scholar
Siegel, K., Gluhoski, V., & Gorey, E. (1999). Age-related distress among young women with breast cancer. Journal of Psychosocial Oncology, 17, 1–20.Google Scholar
*Smith, E.D., Stefanek, M.E., Joseph, & M.V., et al. (1993). Spiritual awareness, personal perspective on death, and psychosocial distress among cancer patients: An initial investigation. Journal of Psychosocial Oncology, 11, 89–103.Google Scholar
*Steeves, R.H. (1992). Patients who have undergone bone marrow transplantation: Their quest for meaning. Oncology Nursing Forum, 19, 899–905.Google Scholar
Sullivan, G.C. (1993). Towards clarification of convergent concepts: Sense of coherence, will to meaning, locus of control, learned helplessness and hardiness. Journal of Advanced Nursing, 18, 1772–1778.Google Scholar
*Taylor, E.J. (1993). Factors associated with meaning in life among people with recurrent cancer. Oncology Nursing Forum, 20, 1399–1407.Google Scholar
Taylor, E.J. (1995). Whys and wherefores: Adult patient perspectives of the meaning of cancer. Seminars in Oncology Nursing, 11, 32–40.Google Scholar
*Taylor, E.J. (2000). Transformation of tragedy among women surviving breast cancer. Oncology Nursing Forum, 27, 781–788.Google Scholar
Tedeschi, R.G. & Calhoun, L.G. (1996). The post-traumatic growth inventory: Measuring the positive legacy of trauma. Journal of Traumatic Stress, 9, 455–471.Google Scholar
*Thibodeau, J. & MacRae, J. (1997). Breast cancer survival: A phenomenological inquiry. Advances in Nursing Science, 19, 65–74.Google Scholar
*Thomas, J. & Retsas, A. (1999). Transacting self-preservation: A grounded theory of the spiritual dimensions of people with terminal cancer. International Journal of Nursing Studies, 36, 191–201.Google Scholar
*Thompson, S.C. & Janigian, A. (1988). Life schemes: A framework for understanding the search for meaning. Journal of Social and Clinical Psychology, 7, 260–280.Google Scholar
*Thompson, S.C. & Pitts, J. (1993). Factors relating to a person's ability to find meaning after a diagnosis of cancer. Journal of Psychosocial Oncology, 11, 1–21.Google Scholar
Thompson, S.C., Sobolew-Shubin, A., Graham, & M., et al. (1989). Psychological adjustment following a stroke. Social Science & Medicine, 28, 239–247.Google Scholar
*Tomich, P.L. & Helgeson, V.S. (2002). Five years later: A cross-sectional comparison of breast cancer survivors with healthy women. Psycho-Oncology, 11, 154–169.Google Scholar
*Utley, R. (1999). The evolving meaning of cancer for long-term survivors of breast cancer. Oncology Nursing Forum, 26, 1519–1523.Google Scholar
*Vickberg, S.M., Bovberg, D.H., Duhamel, & K.N., et al. (2000). Intrusive thoughts and psychological distress among breast cancer survivors: Global meaning as a possible protective factor. Behavioral Medicine, 25, 152–160.Google Scholar
*Vickberg, S.M., Duhamel, K.N., Smith, & M.Y., et al. (2001). Global meaning and psychological adjustment among survivors of bone marrow transplant. Psycho-Oncology, 10, 29–39.Google Scholar