Annals of Behavioral Medicine

, Volume 35, Issue 3, pp 275–284

Physical Sequelae and Depressive Symptoms in Gynecologic Cancer Survivors: Meaning in Life as a Mediator

  • Laura E. Simonelli
  • Jeffrey Fowler
  • G. Larry Maxwell
  • Barbara L. Andersen
Original Article

DOI: 10.1007/s12160-008-9029-8

Cite this article as:
Simonelli, L.E., Fowler, J., Maxwell, G.L. et al. ann. behav. med. (2008) 35: 275. doi:10.1007/s12160-008-9029-8

Abstract

Background

Continuing symptoms and poor health following cancer treatments may alter meaning in life for cancer survivors. Gynecologic cancer survivors are particularly troubled with physical sequelae. In addition, for the most common sites of disease, such as breast and gynecologic cancers, the prevalence of depression is also high.

Purpose

This study tests meaning in life as a mechanism for the relationship between physical symptoms and depressive symptoms.

Methods

Gynecologic cancer survivors (N = 260) participated. Measures of physical sequelae (nurse rated symptoms/signs, patient-reported gynecologic symptoms), meaning in life (harmony, life purpose, spirituality, and conversely, confusion and loss), and depressive symptoms were obtained at the time of a routine clinical follow-up visit 2–10 years following the completion of treatment. Latent variables were defined, and structural equation modeling tested a mediator model.

Results

Analyses support partial mediation. That is, survivors with more physical sequelae also reported lower levels of meaning in life, which was associated with higher levels of depressive symptoms.

Conclusions

Gynecologic cancer patients have been neglected in psychosocial research, and findings highlight the importance of existential issues in their lives. While many adjust well, those with persistent physical functioning deficits may experience depressive symptoms. By appreciating the role of meaning in their experience, we may help survivors foster their own growth and perspectives important for their future.

Keywords

Meaning Depression Gynecologic cancer Survivor Symptoms 

Copyright information

© The Society of Behavioral Medicine 2008

Authors and Affiliations

  • Laura E. Simonelli
    • 1
  • Jeffrey Fowler
    • 1
  • G. Larry Maxwell
    • 1
  • Barbara L. Andersen
    • 1
  1. 1.Department of PsychologyThe Ohio State UniversityColumbusUSA

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