Global meaning and meaning-related life attitudes: exploring their role in predicting depression, anxiety, and demoralization in cancer patients

被引:75
作者
Vehling, Sigrun [1 ]
Lehmann, Claudia [1 ]
Oechsle, Karin [2 ]
Bokemeyer, Carsten [2 ]
Kruell, Andreas [3 ]
Koch, Uwe [1 ]
Mehnert, Anja [1 ]
机构
[1] Univ Med Ctr Hamburg Eppendorf, Dept Med Psychol, D-20246 Hamburg, Germany
[2] Univ Med Ctr Hamburg Eppendorf, Dept Oncol Hematol Bone Marrow Transplantat Pneum, Hubertus Wald Tumor Ctr, Univ Canc Ctr Hamburg, D-20246 Hamburg, Germany
[3] Univ Med Ctr Hamburg Eppendorf, Dept Radiotherapy, D-20246 Hamburg, Germany
关键词
Global meaning; Death acceptance; Goal seeking; Demoralization; Adjustment; Cancer; BREAST-CANCER; GROUP-PSYCHOTHERAPY; GERMAN VERSION; DEATH ANXIETY; DIAGNOSIS; DISTRESS; INTERVENTIONS; ADJUSTMENT; SURVIVORS; OPTIMISM;
D O I
10.1007/s00520-010-0845-6
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
While significance of the concept of meaning in understanding adaptation to cancer is widely accepted, it has been little studied, especially in longitudinal data. This study aims to clarify the role of global meaning and meaning-related life attitudes (death acceptance and goal seeking) in predicting different aspects of psychological and existential distress by reference to a specified research model. At baseline (T1), a sample of 270 cancer patients was recruited. Data from 178 patients could be obtained after 3 months at T2. Patients completed the Life-Attitude-Profile-Revised assessing global meaning and meaning-related life attitudes, the Hospital Anxiety and Depression Scale, and the Demoralization Scale. Hierarchical regression analyses were carried out in two steps. Sociodemographic and physical factors were controlled. Global meaning emerged as a significant negative predictor of depression (beta = -0.27) (p a parts per thousand currency signaEuro parts per thousand 0.001) and demoralization (beta = -0.27) (p a parts per thousand currency signaEuro parts per thousand 0.001). Death acceptance was a predictor of anxiety only (beta = -0.21) (p a parts per thousand currency signaEuro parts per thousand 0.003), whereas goal seeking was a positive predictor of depression (beta = 0.29) (p a parts per thousand currency signaEuro parts per thousand 0.001), anxiety (beta = 0.36) (p a parts per thousand currency signaEuro parts per thousand 0.001), and demoralization (beta = 0.35) (p a parts per thousand currency signaEuro parts per thousand 0.001). Findings confirm a global sense of meaning as an important protecting factor regarding the development of distress symptoms. Results suggest that different dimensions of meaning contribute to different dimensions of psychological well-being, as they refer to different existential problems. The need for and relevance of meaning-focused interventions in cancer patients is strengthened.
引用
收藏
页码:513 / 520
页数:8
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