A Study On Developing Meaning In Life Scale For Breast Cancer Patients And Its Preliminary Application

Objective To explore the conceptual model of meaning in life among breast cancer survivors and develop the Chinese Version of Meaning in life Scale based on Chinese cultural background. To explore the factors influencing meaning in life using the scale in order to provide theoretical evidence to improve meaning in life and quality of life for breast cancer survivors.Methods(1) A grounded theory approach was used and a depth interview was conducted with 23 breast cancer survivors to form the conceptual model of meaning in life.(2) Forming the initial items according to the literature review and the findings of qualitative study. The scale was developed through Dephil technique, item analysis. The internal consistency was tested with Cronbach α.(3) 137 breast cancer survivors were recruited using convenient sampling and One-way analysis of variance, correlation analysis and multiple stepwise regression analysis was performed to explore the influencing factors of meaning of life.Results(1) In the conceptual model of meaning in life for Chinese breast cancer survivors, meeting the needs was emerged as the core variable, explained that meaning in life included three dimensions: self-adjustment, relationship and self-actualization.(2) The Chinese Version of Meaning in life Scale consisted of 25 items and five factors including ‘acceptance and adaptation’, ‘life perspective’, ‘self-control’, ‘relationship’ and ‘purpose in life’. The five factors explained 62.721% of the variance and the factor loading ranged from 0.455 to 0.884. The Cronbach α for the scale was 0.881 and ranged from 0.778 to 0. 853 for each domain.(3) The average score of meaning in life was 91.26±15.25, the score of acceptance and adaptation was20.26±4.01, the score of life perspective was 22.76±4.00, the score of self-control was 18.06±3.61, the score of relationship was 18.96±3.33, the score of purpose in life was 11.22±1.95. All the scores were at a middle level.(4) The result of One-way analysis of variance and correlation analysis showed that age, education level, monthly income, type of payment and stages of disease, cancer related symptom, self-efficacy and social support were related to meaning in ife.(5) Multiple regression analysis revealed that stress reduction, severity symptom, extra-family support monthly income and education level were entered the model, accounted for 54% of the total variances.Conclusion(1) The Chinese Version of Meaning in Life performed good reliability and validity and provide an effective instrument to evaluate meaning in life among Chinese cancer survivors.(2) the participants were at a middle level of meaning in life. Stress reduction, severity symptom, extra-family support monthly income and education level were main influencing factors of meaning in life among Chinese breast cancer survivors. The results of this study provided theoretical evidence for Meaning- Making intervention and enhance meaning in life, finally to improve breast cancer survivors’ quality of life.