OBJECTIVE: Increasing meaning in life (MiL) among people experiencing disease or adversity may improve coping and resilience. The purpose of this review is to characterize the effects of MiL interventions.
DATA SOURCE: A systematic search of PubMed, PsycInfo, and Google Scholar was conducted encompassing the following parameters: meaning in life, purpose in life, or sense of purpose with randomized controlled trials.
STUDY INCLUSION & EXCLUSION CRITERIA: Randomized controlled trials (RCTs) of interventions with at least one outcome that measured improvement in MiL and were published in English between January 2000 and January 2020.
DATA EXTRACTION & SYNTHESIS: 33 randomized controlled trials (k = 35) were identified. Data were coded by authors and a research assistant for intervention type, control group type, and risk of bias. The random effects model of Review Manager 5.3 was used to produce SMD and evaluate heterogeneity.
RESULTS: The effect size for studies with a passive control group was SMD = 0.85 (95% CI 0.54 to 1.17) and for studies with an active control group was SMD = .032 (95% CI 0.09 to 0.55). Mindfulness programs produced the largest effect size (1.57) compared to passive controls, while narrative programs produced the largest effect relative to active controls (0.61). There was considerable heterogeneity in most estimates.
CONCLUSION: Several interventions increase MiL, including some that are relatively brief and do not require licensed professionals.
Awareness of this research is likely to be helpful in communicating with health care workers trained in disciplines other than medicine.
The authors acknowledge the limitation that most included studies were of non-clinical populations or those with cancer or other physical diseases, with only a few involving people with known psychiatric diagnoses.
Reasonable comparison of approaches; may be instructive.
As a doctor facing illness and death everyday, I know very well that the meaning of life is important and how much it changes the way patients and their relatives experience difficult times in hospital. It is surprising how many of us don't focus on this topic for our patients or ourselves. I think if doctors do not think about the fundamental meaning of their lives, it will be difficult to help patients to do so. Living in the 21st century, I think that it should be normal and usual in places of care to have this kind of help. Understanding that deep meaning about life is not a palliative care for suffering people, but it is what makes us completely human.