title: Meaning in life mediates the relationship between social and physical functioning and distress in cancer survivors.
abstract: OBJECTIVE
  Impairments in physical and social functioning are often associated with distress for the cancer survivor. Impaired functioning may also lead individuals to question previously held beliefs about meaning in life. Meaning in life was hypothesized to mediate the relationship between functioning and distress.
  
  
  METHODS
  Two studies were conducted. In the cross-sectional study (I), cancer survivors (N=420) were accrued via the Internet and completed measures of social and physical functioning, meaning and distress. In the longitudinal study (II), breast cancer survivors (N=167) completed measures of functioning at 18 months, meaning at 24 months and distress at 30 months post-diagnosis.
  
  
  RESULTS
  In Study I, meaning in life was a significant, partial mediator for both of the effects of physical and social functioning impairments on heightened distress. In Study II, significant indirect effects of functioning impairments on distress through meaning were replicated even when functioning and distress were measured 1 year apart. The relationship of social functioning and distress was fully mediated by meaning in life, whereas the relationship of physical functioning and distress was partially mediated by meaning.
  
  
  CONCLUSIONS
  The negative social and physical sequelae of cancer are associated with heightened distress, and this association appears to be accounted for, in part, by patients' loss of meaning in their lives.
authors.affiliation: H. Lee Moffitt Cancer Center, University of South Florida, USA.
authors.forename: Heather S
authors.initials: HS
authors.lastname: Jim
authors.forename: Barbara L
authors.initials: BL
authors.lastname: Andersen
mesh_terms: D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D019369:Life; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology / Q000401:mortality* / Q000523:psychology*; D012720:Severity of Illness Index; D012919:Social Behavior; D011795:Surveys and Questionnaires; D015996:Survival Rate; D017741:Survivors / Q000523:psychology*