title: Targeting those with decreased meaning and peace: a supportive care opportunity.
abstract: OBJECTIVE
  To evaluate if an individual's level of meaning/peace (M/P) predicts various quality of life (QOL) and mental well-being measures. To identify targets that might enhance the overall spiritual well-being and QOL of ovarian cancer patients.
  
  
  METHODS
  Multi-site analysis of women with newly diagnosed stages II-IV ovarian, primary peritoneal, or fallopian tube cancer. Patients completed the following surveys: Functional Assessment of Chronic Illness Therapy-Ovarian (FACT-O), Functional Assessment of Chronic Illness Therapy-Spiritual (FACIT-Sp), Edmonton Symptom Assessment System (ESAS), Hospital Anxiety and Depression Scale (HADS), Templer's Death Anxiety Scale (DAS), Herth Hope Index (HHI), and Brief Multidimensional Measure of Religiousness/Spirituality (BMMRS). Linear regression models were created to examine the effect of M/P (FACIT-Sp) upon QOL, symptoms, and other measures of mental well-being. These models adjusted for the effect of site, race, age, stage, anaphylaxis to chemotherapy, and partner status as potential confounders.
  
  
  RESULTS
  This study enrolled 104 patients from three separate sites. After adjusting for potential confounders, it was found that higher M/P predicted better QOL (FACT-O) (p < 0.0001). Higher M/P also predicted decreased death anxiety, depression, and anxiety (p ≤ 0.005). Finally, higher M/P predicted increased hope and coping scores (p ≤ 0.0005).
  
  
  CONCLUSIONS
  Level of M/P is associated with several important mental and physical health states. This information may allow providers to identify patients at increased risk for mental/physical distress and may facilitate early referral to targeted psychotherapy interventions focused on improving patient QOL and decreasing anxiety and depression.
authors.affiliation: Department of Gynecologic Oncology and Reproductive Medicine, Unit 1362F, The University of Texas MD Anderson Cancer Center, 1155 Herman Pressler, Houston, TX, 77030, USA, AJBrown@mdanderson.org.
authors.forename: Alaina J
authors.initials: AJ
authors.lastname: Brown
authors.forename: Charlotte C
authors.initials: CC
authors.lastname: Sun
authors.forename: Diana
authors.initials: D
authors.lastname: Urbauer
authors.forename: Donna S
authors.initials: DS
authors.lastname: Zhukovsky
authors.forename: Charles
authors.initials: C
authors.lastname: Levenback
authors.forename: Michael
authors.initials: M
authors.lastname: Frumovitz
authors.forename: Premal H
authors.initials: PH
authors.lastname: Thaker
authors.forename: Diane C
authors.initials: DC
authors.lastname: Bodurka
authors.forename: Lois M
authors.initials: LM
authors.lastname: Ramondetta
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000209:etiology / Q000628:therapy; D003863:Depression / Q000209:etiology / Q000628:therapy; D005185:Fallopian Tube Neoplasms / Q000523:psychology / Q000628:therapy; D005260:Female; D005833:Genital Neoplasms, Female / Q000523:psychology* / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D026441:Mind-Body Therapies / Q000379:methods*; D010051:Ovarian Neoplasms / Q000523:psychology / Q000628:therapy; D010534:Peritoneal Neoplasms / Q000523:psychology / Q000628:therapy; D011613:Psychotherapy; D011788:Quality of Life; D029181:Spirituality