title: Meaning in life in palliative care patients.
abstract: BACKGROUND
  The construct "meaning in life" (MiL) has recently raised the interest of clinicians working in psycho-oncology and end-of-life care and has become a topic of scientific investigation.
  
  
  OBJECTIVE
  The aim of this study was to compare MiL in palliative care (PC) patients with a representative sample of the German population.
  
  
  METHODS
  In this cross-sectional study, all PC patients treated in the PC inpatient unit and through the PC consult service at Ludwig-Maximilians-University Hospital, Munich, from May 2005 to July 2007 were eligible to participate. Patients were interviewed by a doctoral student, psychologist, or physician, all previously trained to administer the Schedule for Meaning in Life Evaluation (SMiLE) in a standardized way. In the SMiLE, respondents first list individual areas that provide meaning to their life before rating their current level of importance and satisfaction with each area. Overall indices of weighting (IoW, range 20-100), satisfaction (IoS, range 0-100), and weighted satisfaction (IoWS, range 0-100) are calculated.
  
  
  RESULTS
  One hundred PC patients completed the SMiLE: the IoS was 70.2 ± 19.7, the IoW was 84.7 ± 11.5, and the IoWS was 72.0 ± 19.4. The representative sample (n=977) scored significantly higher in the IoS (82.8 ± 14.7) and IoWS (83.3 ± 14.8) but not in the IoW (85.6 ± 12.3). Compared with healthy individuals, PC patients are more likely to list partner, friends, leisure, spirituality, well-being, nature/animals, and pleasure as meaningful areas. Examining the satisfaction ratings, it is noteworthy that PC patients' satisfaction scores are fairly high (and not lower than their healthy counterparts') in a number of domains: family, partner, home/garden, spirituality, and finances. On the other hand, they score significantly lower in nature/animals, leisure, friends, well-being, altruism, work, pleasure, and health.
  
  
  CONCLUSIONS
  These findings underscore the potential of the SMiLE for identifying areas that are particularly important to individuals, and that can be targeted by the PC team to improve overall life satisfaction at the end of life.
authors.affiliation: Interdisciplinary Center for Palliative Medicine, Ludwig-Maximilians-University, Munich, Germany. martin@fegg.de
authors.forename: Martin Johannes
authors.initials: MJ
authors.lastname: Fegg
authors.forename: Monika
authors.initials: M
authors.lastname: Brandstätter
authors.forename: Mechtild
authors.initials: M
authors.lastname: Kramer
authors.forename: Monika
authors.initials: M
authors.lastname: Kögler
authors.forename: Sigrid
authors.initials: S
authors.lastname: Haarmann-Doetkotte
authors.forename: Gian Domenico
authors.initials: GD
authors.lastname: Borasio
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000523:psychology*; D010549:Personal Satisfaction; D011788:Quality of Life; D012044:Regression Analysis; D029181:Spirituality; D019452:Terminally Ill / Q000523:psychology*