Effectiveness of meaning-centered interventions on anxiety and depressive symptoms, sense of meaning, and quality of life in patients with advanced cancer: a meta-analysis of randomized controlled trials

Objective: The effect of Meaning-Centered Interventions (MCI) in advanced cancer patients requires further comprehensive research.

Methods: Two researchers independently searched the PubMed, EMBASE, SCOPUS, Cochrane, and PsycINFO databases to investigate the impact of MCI on anxiety and depressive symptoms, sense of meaning, and quality of life (QoL) in patients with advanced cancer from inception to April 2024. Statistical analyses were conducted using standardized mean difference (SMD) as the effect size with Stata 17.0 software for analysis, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was employed to assess the certainty of evidence.

Results: Data from 12 eligible studies, involving a total of 1,459 participants, were included in the review. The analysis found that 3 studies with 321 participants reported an improvement in the quality of life (QoL) of patients with advanced cancer within one month after the intervention, compared to the control group (SMD, 0.27; 95% CI, 0.03 to 0.52; I² = 0%; p = 0.03). However, this effect did not persist during the 2-6 months following the intervention. In addition, 4 studies with 434 participants indicated that MCI was associated with an enhanced sense of meaning (SMD, 0.22; 95% CI, 0.09 to 0.36; I² = 0%; p = 0.002). Furthermore, 8 studies with 1,192 participants and 7 studies with 1,156 participants found that MCI was associated with a reduction in depressive symptoms (SMD, -0.15; 95% CI, -0.24 to -0.05; I² = 44.8%; p = 0.002) and anxiety symptoms (SMD, -0.16; 95% CI, -0.26 to -0.07; I² = 46.3%; p = 0.001), respectively.

Conclusions: Moderate-quality evidence indicates that MCI enhances the sense of meaning among patients with advanced cancer and reduces depressive and anxiety symptoms, but it does not improve their QoL.