Meaning-making and psychological adjustment to cancer: development of an intervention and pilot results

Oncol Nurs Forum. 2006 Nov 3;33(2):291-302. doi: 10.1188/06.ONF.291-302.

Abstract

Purpose/objectives: To develop an intervention that uniquely addresses the existential impact of cancer through meaning-making coping strategies and to explore the intervention's impact on psychological adjustment.

Design: Descriptive, qualitative approach to develop the intervention; one-group pre- and post-test design to pilot test the intervention.

Setting: Patients' homes or ambulatory oncology clinics affiliated with a university health center in eastern Canada.

Sample: 18 participants who were newly diagnosed in the past three months (n = 14), had completed treatment (n = 1), or were facing recurrence (n = 3) of breast (n = 10) or colorectal (n = 8) cancer.

Methods: Data were collected during interviews using a prototype intervention for trauma patients, and content was analyzed on an ongoing basis to fit the needs of the cancer population. Pretest and post-test questionnaires were administered to determine the intervention's effect.

Main research variables: Meaning-making intervention (MMI), patients' background variables, disease- or treatment-related symptoms, and psychological adjustment.

Findings: The MMI for patients with cancer consisted of as many as four two-hour, individualized sessions and involved the acknowledgment of losses and life threat, the examination of critical past challenges, and plans to stay committed to life goals. At post-test, participants significantly improved in self-esteem and reported a greater sense of security in facing the uncertainty of cancer.

Conclusions: Findings suggest that meaning-making coping can be facilitated and lead to positive psychological outcomes following a cancer diagnosis.

Implications for nursing: The MMI offers a potentially effective and structured approach to address and monitor cancer-related existential issues. Findings are useful for designing future randomized, controlled trials.

Publication types

  • Clinical Trial

MeSH terms

  • Adaptation, Psychological*
  • Adult
  • Aged
  • Breast Neoplasms / psychology
  • Cognitive Behavioral Therapy / methods
  • Colorectal Neoplasms / psychology
  • Female
  • Humans
  • Life Change Events
  • Male
  • Middle Aged
  • Neoplasms / psychology*
  • Neoplasms / therapy
  • Patient Satisfaction
  • Pilot Projects
  • Psychotherapy / methods*
  • Psychotherapy, Group / methods
  • Qualitative Research
  • Self Efficacy
  • Treatment Outcome