The effectiveness of meaning-making interventions on clients living with advanced cancer

Abstract

Overview: When an individual is faced with unavoidable suffering and the finitude of life, as in advanced cancer, they may question the meaning of their existence and the value of their terminal illness (Breitbart, Gibson, Poppito and Berg, 2004). This project will address the effectiveness of interventions that might help clients with advanced cancer find meaning in their suffering, illness and life. Research question: Are meaning-making interventions effective on clients living with advanced cancer? PICO: P- Clients (adults and adolescents) with advanced cancer I- Meaning-making interventions C- The use of other interventions and the absence of meaning-making interventions 0- Clients participating in meaning-making programmes may demonstrate higher scores of meaning and purpose in life (which may lead to improved spiritual and existential well being). Inclusion and exclusion criteria: The inclusion criteria are studies written in the English language, which utilise meaning-making interventions with clients (adults and adolescents) with advanced cancer including those making use of palliative care services, and conducted by expert personnel. The exclusion criteria are studies which: do not involve trials or an intervention; use meaning-making interventions with populations without advanced cancer; are conducted with cognitively impaired populations; written in languages other than English; evaluate psychometric tools; address life goals or patient attitudes. Outcomes of the search: The search for literature was conducted extensively through databases, books, theses, journals and articles. Expert personnel were also contacted. After the overall search, nine studies which addressed the research question were chosen. Methods of appraisal: The literature retrieved was appraised using the TREND tool for quasi-experimental designs and the CASP tool for the other research designs. Results: Meaning-centred group psychotherapy, individual meaning-centred psychotherapy, the meaning-making intervention, logotherapy and managing cancer and living meaningfully proved to be effective in providing meaning for clients living with advanced cancer. Dignity therapy, an intervention utilising meaning to generate dignity, was found to be helpful. Spiritually-focused psychotherapy, an intervention addressing the existential concepts of meaning, control, identity and relationships, served to stabilise depression levels in the treatment group. Conclusion: Some meaning-making interventions are effective in helping clients with advanced cancer find meaning in their illness and suffering Implications and recommendations: Local research is needed to validate meaning making interventions. Concepts of spirituality and existentialism must be incorporated in education and practice. Proper assessment tools must be developed to appropriately address spiritual and existential needs.