Meaning and purpose in life, happiness, and life satisfaction in cancer: Systematic review with meta-analysis

Network analysis of the symptoms of posttraumatic stress disorder in patients undergoing chemotherapy for colorectal cancer

Objective

In this study, we examine the network structure of posttraumatic stress disorder (PTSD), including core symptoms and strong edges in patients undergoing chemotherapy for colorectal cancer in China, and lay the groundwork for targeted psychological interventions for these patients.

Methods

This study included 360 colorectal cancer patients receiving chemotherapy at a third-class hospital in Wuxi, China, from November 2023 to June 2024. The severity of each item of PTSD was assessed using the DSM-5 Checklist (PCL-5). A network analysis approach was conducted in R to pinpoint core symptoms and investigate notable edge connections within the network.

Results

The accuracy and stability of the PTSD network structure model were relatively good, and the results indicated that robust connections emerged between avoidance of thoughts and avoidance of reminders, hypervigilance and exaggerated startle response, and loss of interest and detachment. The most central node was emotional cue reactivity, which was more closely connected with other symptoms, while self-destructive/reckless behavior was the lowest central node.

Conclusion

Emotional cue reactivity was proved to be the most prominent symptom in the PTSD symptom network in colorectal cancer patients treated with chemotherapy, and targeting it in interventions could lead to substantial improvements.

Effectiveness of meaning-centered interventions on anxiety and depressive symptoms, sense of meaning, and quality of life in patients with advanced cancer: a meta-analysis of randomized controlled trials

OBJECTIVE

The effect of Meaning-Centered Interventions (MCI) in advanced cancer patients requires further comprehensive research.

METHODS

Two researchers independently searched the PubMed, EMBASE, SCOPUS, Cochrane, and PsycINFO databases to investigate the impact of MCI on anxiety and depressive symptoms, sense of meaning, and quality of life (QoL) in patients with advanced cancer from inception to April 2024. Statistical analyses were conducted using standardized mean difference (SMD) as the effect size with Stata 17.0 software for analysis, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was employed to assess the certainty of evidence.

RESULTS

Data from 12 eligible studies, involving a total of 1,459 participants, were included in the review. The analysis found that 3 studies with 321 participants reported an improvement in the quality of life (QoL) of patients with advanced cancer within one month after the intervention, compared to the control group (SMD, 0.27; 95% CI, 0.03 to 0.52; I2 = 0%; p = 0.03). However, this effect did not persist during the 2-6 months following the intervention. In addition, 4 studies with 434 participants indicated that MCI was associated with an enhanced sense of meaning (SMD, 0.22; 95% CI, 0.09 to 0.36; I2 = 0%; p = 0.002). Furthermore, 8 studies with 1,192 participants and 7 studies with 1,156 participants found that MCI was associated with a reduction in depressive symptoms (SMD, -0.15; 95% CI, -0.24 to -0.05; I2 = 44.8%; p = 0.002) and anxiety symptoms (SMD, -0.16; 95% CI, -0.26 to -0.07; I2 = 46.3%; p = 0.001), respectively.

CONCLUSIONS

Moderate-quality evidence indicates that MCI enhances the sense of meaning among patients with advanced cancer and reduces depressive and anxiety symptoms, but it does not improve their QoL.

Increased risk of hallucinations among people with cancer: Role of loneliness, job satisfaction, sleep and a moderated-mediated model of anxiety and life satisfaction

Being diagnosed with cancer and coping with fears about potential death might trigger acute distress. Previous research found that patients with cancer are 1.85 times more at risk of developing mental illness. Whereas previous studies investigated the risk of schizophrenia, no studies have investigated the risk of individual psychotic symptoms such as hallucinations. This was an analysis of the English Longitudinal Study of Ageing involving 7586 adults of whom 1082 have cancer. There were 19 (0.3%) who self-reported hallucinations, and logistic regression showed that cancer patients had higher odds of hallucinating. Loneliness, discrimination, poor job satisfaction, poor life satisfaction, anxiety, low level of autonomy/control and having restless sleep were also associated with hallucinations. Cancer patients had higher odds of poor life satisfaction, which was also predicted by loneliness, discrimination, job satisfaction, anxiety symptoms, autonomy/control and restless sleep. Further results of a moderated mediation model showed that cancer, loneliness, and job satisfaction were directly associated with hallucinations, and life satisfaction was a mediator. Anxiety symptoms also moderated the relationships with hallucinations. Cancer is associated with a higher risk of hallucinations, and other aspects of mental wellbeing (e.g., anxiety and life satisfaction) are also important. Interventions are needed which safeguard mental health after cancer diagnosis and during treatment.

Understanding Young Adult Cancer Survivors' Engagement with Cancer Storylines in Entertainment Media Narratives

Purpose: Some young adult cancer survivors (YACS; ages 18-39) struggle to incorporate their cancer experiences into their identities. Using stories, or narratives, is a new approach that could help YACS to integrate cancer and their identity. These stories offer opportunities to experience perspectives outside of oneself, which can build validation and self-compassion. However, little is known about whether stories about cancer (i.e., the threat itself) are beneficial. Method: YACS completed an online survey about their engagement with cancer storylines in entertainment media narratives (e.g., books, movies, and television shows). They also described their reactions to encountering these storylines in entertainment media. Results: Participants (n = 108) were primarily White. Participants who sought cancer storylines reported a more positive impact of cancer on their sense of purpose and identity. Among YACS who had completed treatment, cancer storylines were sought after treatment more than during treatment. In addition, compared with their peers, participants who identified as Black reported greater cancer storyline seeking both during and after treatment. Nearly half of participants (n = 45, 47.4%) described reactions to cancer-related storylines as positive or mixed, primarily owing to feelings of inspiration or validation. Conclusion: Consuming cancer storylines can offer some benefits for YACS, especially among those finished with treatment and those who identify as Black. However, not all YACS responded positively, so future research should investigate which YACS could benefit most from cancer-related storylines. Nonetheless, entertainment media narratives represent a novel approach to supporting YACS' integration of cancer into their identity.

Spiritual well-being, faith, meaning in life, peace, and purpose in life for cancer-related fatigue: systematic review with meta-analysis and meta-regressions

BACKGROUND

Cancer-related fatigue is associated with spiritual distress. Spiritual well-being, characterized by the presence of factors such as meaning in life or purpose in life, seems to play an important role in the management of symptoms of cancer. Currently, the number of studies evaluating the association between cancer-related fatigue and spiritual well-being is increasing and no systematic review has been conducted.

AIM

To summarize the association between cancer-related fatigue and spiritual well-being, faith, meaning in life, peace, and purpose in life.

DESIGN

A systematic review with meta-analysis.

DATA SOURCES

The CINAHL, Embase, PsycINFO, and PubMed databases were searched from inception to 9 October 2023. We considered studies evaluating the cross-sectional or longitudinal association between cancer-related fatigue and the spiritual factors above mentioned. The Joanna Briggs Institute Checklist for Analytical Cross-Sectional Studies and the Quality in Prognosis Studies tool assessed the methodological quality of cross-sectional and longitudinal studies, respectively. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system rated the certainty of evidence. Meta-analyses, meta-regressions, subgroup meta-analyses, and sensitivity analyses were conducted.

RESULTS

A total of 13 studies were included and no longitudinal findings were found. One meta-analysis showed that cancer-related fatigue may be negatively correlated with spiritual well-being (r =  - 0.37 (95%CI - 0.44 to - 0.28) p < 0.01). In addition, another meta-analysis found the correlation between cancer-related fatigue and faith was not statistically significant (r =  - 0.25 (95%CI - 0.66 to 0.28) p = 0.36).

CONCLUSIONS

Cancer-related fatigue may be correlated with spiritual well-being. However, the certainty of evidence was very low across the meta-analyzed outcomes.

IMPLICATIONS FOR CANCER SURVIVORS

A negative correlation was observed between spiritual well-being and cancer-related fatigue.