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Meaning-Centered Interventions for Patients With Advanced or Terminal Cancer

A Meta-analysis

Kang, Kyung-Ah, PhD, RN; Han, Suk-Jung, PhD, RN; Lim, Young-Sook, MS, RN; Kim, Shin-Jeong, PhD, RN

doi: 10.1097/NCC.0000000000000628
Article: PDF Only

Background For patients with advanced or terminal cancer undergoing hospice or palliative care, spiritual care based on meaning-centered intervention (MCI) has become an essential form of support.

Objective The aim of this study was to characterize MCI systematically and the effectiveness of hospice and palliative care for patients with advanced or terminal cancer.

Methods MEDLINE via PubMed, Cochrane Library CENTRAL, EMBASE, CINAHL, and several Korean electronic databases were searched from inception to May 2017. The RevMan 5.3 program of the Cochrane Library was used for data analysis.

Results A meta-analysis was conducted of 10 controlled trials (6 randomized and 4 nonrandomized) featuring 623 patients with cancer. Meaning-centered interventions were compared with usual care control groups or other psychosocial interventions. The weighted average effect sizes across studies were −0.96 (P < .001, I2 = 7%) for meaning in life, −0.37 (P = .002, I2 = 0%) for spiritual well-being, −0.48 (P < .001, I2 = 0%) for quality of life, −0.28 (P = .02, I2 = 0%) for anxiety, and −0.31 (P = .02, I2 = 17%) for physical symptoms.

Conclusion Spiritual care based on MCI may help to improve the physical, psychosocial, and spiritual well-being of patients with advanced or terminal cancer.

Implication for Practice Meaning-centered interventions could be a valuable way to enhance quality of life at the end stage for patients with advanced or terminal cancer.

Author Affiliations: Department of Nursing, Sahmyook University, Seoul (Drs Kang and Han, and Ms Lim); and Department of Nursing, Hallym University, Chuncheon (Dr Kim), South Korea.

This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science and ICT (2017R1A2B1009570).

The authors have no conflicts of interest to disclose.

Correspondence: Shin-Jeong Kim, PhD, Department of Nursing, Hallym University, 1 HallymDaeHak-gil, Chuncheon, Gangwon-do, Korea 200-702 (

Accepted for publication April 14, 2018.

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