Research On What ‘Meaning’ Really Means for Cancer Patients Near the End of Life: Findings from a Mixed Methods Study

Background: The meaning of life plays a central role in every person’s life, and becomes particularly pronounced when confronting highly stressful life circumstances. There is a dearth of research specifically addressing the meaning-making process, and its result - meaning-made -and their impact on quality of life among cancer patient near the end of life. Objective: The study combined quantitative and qualitative methodologies; the primary aim was to expand the understanding of the role of meaning in life among cancer patients near the end of life and its effect on quality of life. Method: A total of 150 questionnaires and 20 in-depth interviews were completed with cancer patients near the end of life, who received treatment in either a home hospice setting or the Oncology Department at Rambam Hospital. Results: Regardless of place of treatment, nationality or religiousness, the participants reported moderate levels of overall quality of life and emotional distress, together with a very low physical quality of life, high meaning in life (meaning-made), and a low level of involvement in a current search for meaning (meaning-making process). In addition, only the meaning-made variable was associated with a higher quality of life. The content analysis of the in-depth interviews suggests that the search for meaning occurs at earlier stages along the disease pathway. Towards the end of life, the participants’ experience of life and its meaning is focused on the most intimate relationships and important elements - family, faith and, ultimately, the physical comfort and the possibility of enjoying the small and simple things in life, which each participant described according to his/her own personal preferences and inclinations. Conclusions: This study is one of the first to examine meaning in life, thus expanding the current understanding of the experience of meaning at the end of life, and the various roles that meaning-making and meaning-made play near the end of life. Both the quantitative and qualitative studies propose that, in contrast to meaning-made, the meaning-making process is a coping strategy seldom used by cancer patients near the end of life, and is unrelated to quality of life.