Supportive Care in Cancer

, Volume 19, Issue 4, pp 513–520 | Cite as

Global meaning and meaning-related life attitudes: exploring their role in predicting depression, anxiety, and demoralization in cancer patients

  • Sigrun Vehling
  • Claudia Lehmann
  • Karin Oechsle
  • Carsten Bokemeyer
  • Andreas Krüll
  • Uwe Koch
  • Anja MehnertEmail author
Original Article


Goal of work

While significance of the concept of meaning in understanding adaptation to cancer is widely accepted, it has been little studied, especially in longitudinal data. This study aims to clarify the role of global meaning and meaning-related life attitudes (death acceptance and goal seeking) in predicting different aspects of psychological and existential distress by reference to a specified research model.

Patients and methods

At baseline (T1), a sample of 270 cancer patients was recruited. Data from 178 patients could be obtained after 3 months at T2. Patients completed the Life-Attitude-Profile—Revised assessing global meaning and meaning-related life attitudes, the Hospital Anxiety and Depression Scale, and the Demoralization Scale. Hierarchical regression analyses were carried out in two steps. Sociodemographic and physical factors were controlled.


Global meaning emerged as a significant negative predictor of depression (β = −0.27) (p ≤ 0.001) and demoralization (β = −0.27) (p ≤ 0.001). Death acceptance was a predictor of anxiety only (β = −0.21) (p ≤ 0.003), whereas goal seeking was a positive predictor of depression (β = 0.29) (p ≤ 0.001), anxiety (β = 0.36) (p ≤ 0.001), and demoralization (β = 0.35) (p ≤ 0.001).


Findings confirm a global sense of meaning as an important protecting factor regarding the development of distress symptoms. Results suggest that different dimensions of meaning contribute to different dimensions of psychological well-being, as they refer to different existential problems. The need for and relevance of meaning-focused interventions in cancer patients is strengthened.


Global meaning Death acceptance Goal seeking Demoralization Adjustment Cancer 



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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Sigrun Vehling
    • 1
  • Claudia Lehmann
    • 1
  • Karin Oechsle
    • 2
  • Carsten Bokemeyer
    • 2
  • Andreas Krüll
    • 3
  • Uwe Koch
    • 1
  • Anja Mehnert
    • 1
    Email author
  1. 1.Department of Medical PsychologyUniversity Medical Center Hamburg–EppendorfHamburgGermany
  2. 2.Department of Oncology/Hematology/Bone Marrow Transplantation/Pneumology, Hubertus Wald Tumor Centrum–University Cancer Center HamburgUniversity Medical Center Hamburg–EppendorfHamburgGermany
  3. 3.Department of RadiotherapyUniversity Medical Center Hamburg–EppendorfHamburgGermany

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