Development of a method investigating meaning in life in cancer patients

Meaning in life is an important source of adaptation to somatic diseases. Aim: To validate the SMiLE (Schedule for the Meaning in Life Evaluation), a qualitative and quantitative instrument evaluating the meaning in life perceived by patients suffering from advanced cancers. The first step of this project is to develop and evaluate psychotherapeutic interventions. Methods: Cancer out patients in a palliative phase of disease were approached and possibly included. The SMiLE is an instrument, which helps patients to identify a maximum of seven fields which produces or could produce meaning in life. The relative importance of each field is weightened by means of a visual scale. The overall meaning in life is scored by a visual analogue scale ranging from –3 to 3. Patients are then asked to rate their satisfaction for each field and to define its importance on VAS ranging from 0 to 5. Face validity, feasibility and acceptability is also evaluated by VAS. Reliability has been assessed by test/retest at a three days interval in a sample of medical students. External validity will be evaluated by means of a comparison with the under-scale MEANING of the questionnaire FACIT-Sp and a VAS measuring the perception of the total meaning given in life. With the index of Karnofsky, VAS of physical symptoms and the Edmonton Symptom Assessment Scale potential sources of confounding variables are identified. Generalisation, comparison with a healthy population and cross-cultural differences will be evaluated by means of research centres (Lausanne, Munich, Dublin). Results: After 1 year of study, 99 patients are included in the study. So far, results indicate satisfying face validity, feasibility and acceptability. Further results will be presented in march 2007 at Nurnberg congress. Conclusion: Preliminary results indicate that the SMiLE is an adequate instrument to identify and evaluate fields that produce or could produce meaning in life in patients with advanced cancer.