Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-20T04:08:11.708Z Has data issue: false hasContentIssue false
  • English
  • Français

To what extent does meaning mediate adaptation to cancer? The relationship between physical suffering, meaning in life, and connection to others in adjustment to cancer

Published online by Cambridge University Press:  25 October 2007

Carrie Lethborg ,
Sanchia Aranda ,
Shelley Cox  and
David Kissane
Carrie Lethborg*
Affiliation:
Department of Oncology, St. Vincent's Hospital, Fitzroy, Victoria, Australia
Sanchia Aranda
Affiliation:
Peter MacCallum Cancer Centre and School of Nursing, University of Melbourne, Melbourne, Australia
Shelley Cox
Affiliation:
Independent researcher
David Kissane
Affiliation:
Department of Psychiatry & Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
*
Corresponding author: Carrie Lethborg, Oncology Department, St. Vincent's Hospital, Fitzroy, Victoria, Australia, 3104. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

This study builds on previous work that explored the lived experience of meaning in advanced cancer. The aims were to explore the associations of suffering (physical and existential distress) and coping (via social support) with psychological distress and global meaning using a battery of instruments among adults attending an Australian metropolitan cancer service (n = 100).

Methods:

The contribution of suffering and coping via social support to psychological distress and meaning were examined using a variety of statistical methods. Multiple regression analyses were conducted to further examine relative contributions to both psychological distress and global meaning.

Results:

Physical and existential distress were found to be positively associated with psychological distress whereas high social support and personal meaning are related to lower levels of psychological distress. Social support was the strongest correlate of global meaning whereas high levels of existential distress were related to lower levels of global meaning. On the basis of this study, it is concluded that the factors related to suffering clearly promote psychological distress, and the reverse is true for global meaning for those living with cancer.

Significance of results:

This study speaks to the clinical complexity of the dynamic experience of suffering and meaning in cancer. We need to better understand the impact of physical suffering and meaning in the lives of this population and to actively work toward the enhancement of social support and connection with others for this group. Optimal palliative and family-centered care blended with therapies that promote a sense of meaning of life lived appear crucial to ameliorate suffering.

Keywords

MeaningAdjustment to cancerSufferingPalliative careSocial support
Type
Research Article
Information
Palliative & Supportive Care , Volume 5 , Issue 4 , December 2007 , pp. 377 - 388
Copyright
Copyright © Cambridge University Press 2007

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

Antonovsky, A. (1987). Unravelling the Mystery of Health: How People Manage Stress and Stay Well. San Fransisco: Jossey-Bass.Google Scholar
Ballard, A., Green, T., McCaa, A., et al. (1997). A comparison of the level of hope in patients with newly diagnosed and recurrent cancer. Oncology Nursing Forum, 24, 899–904.Google ScholarPubMed
Brady, M.J., Peterman, A.H., Fitchett, G., et al. (1999). The expanded version of the Functional Assessment of Chronic Illness Therapy—Spiritual Well-Being Scale (FACIT-Sp-Ex): Initial report of psychometric properties. Annals of Behavioral Medicine, 21, 129.Google Scholar
Breitbart, W., Gibson, C., Poppito, S.R., et al. (2004). Psychotherapeutic interventions at the end of life: A focus on meaning and spirituality. Canadian Journal of Psychiatry, 49, 366–372.CrossRefGoogle ScholarPubMed
Broadhead, W.E., Gehlbach, S.H., de Gruy, F.V., et al. (1988). The Duke-UNC Functional Social Support Questionnaire. Measurement of social support in family medicine patients. Medical Care, 26, 709–723.CrossRefGoogle ScholarPubMed
Carlson, L.E., Angen, M., Cullum, J., et al. (2004). High levels of untreated distress and fatigue in cancer patients. British Journal of Cancer, 90, 2297–2304.CrossRefGoogle ScholarPubMed
Carver, C.S. (1997). You want to measure coping but your protocol's too long: Consider the brief COPE. International Journal of Behavioral Medicine, 4, 92–100.CrossRefGoogle ScholarPubMed
Carver, C.S., Scheier, M.F., & Weintraub, J.K. (1989). Assessing coping strategies: A theoretically based approach. Journal of Personality and Social Psychology, 56, 267–283.CrossRefGoogle ScholarPubMed
Cella, D.F., Tulsky, D.S., Gray, G., et al. (1993). The Functional Assessment of Cancer Therapy (FACT) scale: Development and validation of the general measure. Journal of Clinical Oncology, 11, 570–579.CrossRefGoogle ScholarPubMed
Chang, V.T., Hwang, S.S., Feuerman, M., et al. (2000). The memorial symptom assessment scale short form. Cancer, 89, 1162–1171.3.0.CO;2-Y>CrossRefGoogle ScholarPubMed
Clarke, D. (2003). Faith and Hope. Australasian Psychiatry, 11, 164–168.CrossRefGoogle Scholar
Cobb, S. (1976). Social support as a moderator of life stress. Psychosomatic Medicine, 38, 300–314.CrossRefGoogle ScholarPubMed
Coyle, N. (2006). The hard work of living in the face of death. Journal of Pain and Symptom Management, 32, 266–274.CrossRefGoogle ScholarPubMed
Derogatis, L. (2000). Brief Symptom Inventory 18. Minneapolis: National Computer Systems, Inc.Google Scholar
Derogatis, L. & Melisaratos, N. (1983). The brief symptom inventory. Psychological Medicine, 13, 595–605.CrossRefGoogle ScholarPubMed
Dufault, K. & Martocchio, B.C. (1985). Hope: Its spheres and dimensions. Nursing Clinics of North America, 20, 379–391.CrossRefGoogle ScholarPubMed
Engel, G. (1977). The need for a new medical model: A challenge for biomedicine. Science, 196, 129–136.CrossRefGoogle Scholar
Folkman, S. (1997). Positive psychological states and coping with severe stress. Social Science & Medicine, 45, 1207–1221.CrossRefGoogle ScholarPubMed
Frankl, V.E. (1963). Man's Search for Meaning: An Introduction to Logotherapy. New York: Washington Square Press.Google Scholar
Friedman, L.C., Kalidas, M., Elledge, R., et al. (2006). Optimism, social support and psychosocial functioning among women with breast cancer. Psychooncology, 15, 595–603.CrossRefGoogle ScholarPubMed
Kissane, D.W., Wein, S., Love, A., et al. (2004). The Demoralization Scale: A preliminary report of its development and validation. Journal of Palliative Care, 20, 269–276.CrossRefGoogle Scholar
Lethborg, C., Aranda, S., Bloch, S., et al. (2006). The role of meaning in advanced cancer—Integrating the constructs of assumptive world, sense of coherence and meaning-based coping. Journal of Psychosocial Oncology, 24, 27–42.CrossRefGoogle ScholarPubMed
Mahon, S.M. & Casperson, D. (1997). Exploring the psychosocial meaning of recurrent cancer: A descriptive study. Cancer Nursing, 20, 178–186.CrossRefGoogle ScholarPubMed
Marris, P. (1974). Loss and Change. New York: Pantheon Books.Google Scholar
Maslow, A. (1954). Motivation and Personality. New York: Harper.Google Scholar
Nunnally, J.C. (1978). Psychometric Theory, 2nd ed. New York: McGraw-Hill.Google Scholar
Portenoy, R.K., Thaler, H.T., Kornblith, A.B., et al. (1994). The Memorial Symptom Assessment Scale: An instrument for the evaluation of symptom prevalence, characteristics and distress. European Journal of Cancer, 30A, 1326–1336.CrossRefGoogle ScholarPubMed
Reker, G.T. (2001). Life Attitude Profile—Revised, Manual. Peterborough, ON: Student Psychologists Press.Google Scholar
Reker, G.T. & Peacock, E.J. (1981). The Life Attitude Profile (LAP): A multidimensional instrument for assessing attitudes toward life. Canadian Journal of Behavioral Science, 13, 264–273.CrossRefGoogle Scholar
Roud, P.C. (1986). Psychosocial variables associated with the exceptional survival of patients with advanced malignant disease. International Journal of Psychiatry in Medicine, 16, 113–122.CrossRefGoogle ScholarPubMed
Schroevers, M., Ranchor, A.V., & Sanderman, R. (2006). Adjustment to cancer in the 8 years following diagnosis: A longitudinal study comparing cancer survivors with healthy individuals. Social Science in Medicine, 63, 598–610.CrossRefGoogle ScholarPubMed
Suchman, A. & Matthews, D. (1988). What makes the patient–doctor relationship therapeutic? Exploring the connexional dimension of medical care. Annals of Internal Medicine, 108, 125–130.CrossRefGoogle ScholarPubMed
Tedeschi, R.G. & Calhoun, L.G. (1996). The posttraumatic growth inventory: Measuring the positive legacy of trauma. Journal of Traumatic Stress, 9, 455–471.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
Vosvick, M., Koopman, C., Gore-Felton, C., et al. (2003). Relationship of functional quality of life to strategies for coping with the stress of living with HIV/AIDS. Psychosomatics, 44, 51–58.CrossRefGoogle ScholarPubMed
White, C.A. (2004). Meaning and its measurement in psychosocial oncology. Psycho-Oncology, 13, 468–481.CrossRefGoogle ScholarPubMed
Younger, J. (1995). The alienation of the sufferer. Advances in Nursing Science, 17, 53–72.CrossRefGoogle ScholarPubMed
Zabora, J., BrintzenhofeSzoc, K., Jacobsen, P., et al. (2001). A new psychosocial screening instrument for use with cancer patients. Psychosomatics, 42, 241–246.CrossRefGoogle ScholarPubMed
Zabora, J.R., Smith-Wilson, R., Fetting, J.H., et al. (1990). An efficient method for psychosocial screening of cancer patients. Psychosomatics, 31, 192–196.CrossRefGoogle ScholarPubMed