Meaning in life is an important resource for coping with cancer-related distress. Little is known about which areas of life contribute to meaning in life of patients with cancer and their relatives, and how these change over time. In this prospective observational study, patients with solid tumours and their relatives were surveyed two (T1) and twelve months (T2) after diagnosis using the validated Schedule for Meaning in Life Evaluation (SMiLE) and other validated questionnaires. Published data from a representative sample of the German population was used as comparative data. Participants reported meaningful life areas and rated their satisfaction and importance; corresponding indices were calculated. The indices, frequency, satisfaction and importance of life areas were compared between patients, relatives and a representative sample. Multiple linear regression analyses explored sociodemographic, medical and psychological factors influencing global meaning. At T1 433 patients (55% men, mean age 62 years) and 193 relatives (69% women, mean age 58 years) participated; at T2, 445 patients and 91 relatives. Global meaning, satisfaction and weighting indices were lower in patients and relatives than in the representative sample (p = 0.003). The most frequently mentioned areas were 'Family' (patients: 82%; relatives: 88%), 'Leisure time' (patients: 57%; relatives: 61%) and 'Social relations' (patients: 55%; relatives: 59%). Compared to the representative sample, patients more often reported 'Leisure time', 'Social relations' and 'Home/Garden' (p = 0.01), while 'Occupation/Work' was less frequent (p = 0.01). No changes were observed between T1 and T2. Depression was significantly associated with lower global meaning. Meaning in life is significantly reduced in patients with cancer and their relatives during early survivorship, despite largely similar meaningful life areas in both groups. Our findings underscore the need for psycho-oncological care that systematically assesses individual sources of meaning in life and targets both patients and relatives through meaning-centred interventions.
Wolf et al. (Thu,) studied this question.