Meaning in life assessed with the “Schedule for Meaning in Life Evaluation” (SMiLE): a comparison between a cancer patient and student sample
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- Stiefel, F., Krenz, S., Zdrojewski, C. et al. Support Care Cancer (2008) 16: 1151. doi:10.1007/s00520-007-0394-9
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The aims of the study were (a) to assess individual meaning in life (MiL) in a mixed sample of cancer patients with the Schedule for Meaning in Life Evaluation (SMiLE), (b) to evaluate the acceptability of its French version, and (c) to compare it to a student sample.
Materials and methods
Consecutive cancer patients (N = 100) treated as outpatients in the University Hospital Lausanne (N = 80) and in a nearby hospice (N = 20) were evaluated with the SMiLE, a reliable and validated respondent-generated instrument for the assessment of MiL. The respondents list three to seven areas, which provide meaning to their life and rate the level of importance (weighting) and satisfaction of each area. Indices of total weighting (index of weighting (IoW), range 20–100), total satisfaction (index of satisfaction (IoS), range 0–100), and total weighted satisfaction (index of weighted satisfaction (IoWS), range 0–100) are calculated.
Patients most often indicated areas related to relationships as providing MiL, while material things were listed less often. Since satisfaction with relevant areas was high, cancer patients reported the same level of weighted satisfaction (IoWS) as a healthy student sample, assessed with the SMiLE in a prior validation study. Patients judged the SMiLE as reflecting well their MiL, not distressing to fill in and were moderately positive with regard to its helpfulness.
MiL of cancer patients was surprisingly high, possibly due to the “response shift” of the severely ill. The SMiLE might become a useful tool for research and an opener to communication between patients and clinicians about this highly relevant topic in cancer care. Further studies with larger sample sizes and different designs, complemented by qualitative research, are needed to deepen our understanding of this so characteristically human topic, which is so easy to perceive and so difficult to grasp.