title: Meaning in life experience at the end of life: validation of the Hindi version of the Schedule for Meaning in Life Evaluation and a cross-cultural comparison between Indian and German palliative care patients.
abstract: BACKGROUND
  The experience of Meaning in Life (MiL) is a major protective factor against feelings of hopelessness and wishes for hastened death in palliative care (PC) patients. However, most instruments for MiL assessment have been developed only in Western countries so far. Little is known about MiL experience in Asian PC patients.
  
  
  OBJECTIVE
  This study aimed to provide a Hindi version of the Schedule for Meaning in Life Evaluation (SMiLE), test its feasibility and validity in Indian PC patients, and compare the results with previous studies in Germany.
  
  
  METHODS
  Indian PC patients in a hospice for the destitute were eligible to participate in this cross-sectional study. In the SMiLE instrument, respondents individually listed MiL-giving areas before rating their satisfaction with and importance of these areas. Overall indices of satisfaction (IoS, range 0-100), weighting (IoW, range 0-100), and weighted satisfaction (IoWS, range 0-100) were calculated.
  
  
  RESULTS
  A Hindi forward-backward translation of the SMiLE was made. Two hundred fifty-eight Indian PC patients took part in the study (response rate 93.5%). Convergent validity of the SMiLE was found with the World Health Organization Quality of Life-Brief version (r = 0.17; P = 0.008) and the Idler Index of Religiosity (public religiousness: r = 0.25, P < 0.001 and private religiousness: r = 0.29, P < 0.001). Indian PC patients' IoW was 65.8 ± 22.1, IoS 68.6 ± 17.4, and IoWS 70.2 ± 17.0. In multivariate analyses of covariance, they differed significantly from German PC patients only in IoW (IoW: 84.8 ± 11.5, P < 0.001; IoS: 70.2 ± 19.7; IoWS: 72.0 ± 19.4). Compared with Germans, Indians more often listed spirituality (P < 0.001) and social commitment (P < 0.001) and less often social relations (P = 0.008).
  
  
  CONCLUSIONS
  Preliminary results indicate good feasibility and validity of the Hindi version of the SMiLE. MiL experience also seems to be a coping resource for Indian PC patients.
authors.affiliation: Department of Palliative Medicine, Ludwig-Maximilians-University, Munich, Germany.
authors.forename: Dorothea
authors.initials: D
authors.lastname: Kudla
authors.affiliation: Jesu Ashram, Matigara, Darjeeling District, West Bengal, India.
authors.forename: Julius
authors.initials: J
authors.lastname: Kujur
authors.affiliation: Jesu Ashram, Matigara, Darjeeling District, West Bengal, India.
authors.forename: Sumanti
authors.initials: S
authors.lastname: Tigga
authors.affiliation: Jesu Ashram, Matigara, Darjeeling District, West Bengal, India.
authors.forename: Prakash
authors.initials: P
authors.lastname: Tirkey
authors.affiliation: Jesu Ashram, Matigara, Darjeeling District, West Bengal, India.
authors.forename: Punita
authors.initials: P
authors.lastname: Rai
authors.affiliation: Department of Palliative Medicine, Ludwig-Maximilians-University, Munich, Germany. Electronic address: martin@fegg.de.
authors.forename: Martin Johannes
authors.initials: MJ
authors.lastname: Fegg
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D005240:Feasibility Studies; D005260:Female; D005858:Germany; D006738:Hospices; D006801:Humans; D007194:India; D007802:Language; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000523:psychology*; D011203:Poverty; D011788:Quality of Life; D026712:Value of Life; D055815:Young Adult
keywords: Germany; India; Meaning in Life; Schedule for Meaning in Life Evaluation; cross-cultural comparison; palliative care