To advance meaning in life (MIL) research, it is crucial to integrate it with the broader meaning literature, which includes important additional concepts (e.g., meaning frameworks) and principles (e.g., terror management). A tripartite view, which conceptualizes MIL as consisting of 3 subconstructs—comprehension, purpose, and mattering—may facilitate such integration. Here, we outline how a tripartite view may relate to key concepts from within MIL research (e.g., MIL judgments and feelings) and within the broader meaning research (e.g., meaning frameworks, meaning making). On the basis of this framework, we review the broader meaning literature to derive a theoretical context within which to understand and conduct further research on comprehension, purpose, and mattering. We highlight how future research may examine the interrelationships among the 3 MIL subconstructs, MIL judgments and feelings, and meaning frameworks.

Background Whereas religion/spirituality (R/S) is important in its own right for many cancer patients, a large body of research has examined whether R/S is also associated with better physical health outcomes. This literature has been characterized by heterogeneity in sample composition, measures of R/S, and measures of physical health. In an effort to synthesize previous findings, we conducted a meta-analysis of the relationship between R/S and patient-reported physical health in cancer patients. Methods A search of PubMed, PsycInfo, CINAHL, and Cochrane Library yielded 2,073 abstracts, which were independently evaluated by pairs of raters. Meta-analysis was conducted on 497 effect sizes from 101 unique samples encompassing over 32,000 adult cancer patients. R/S measures were categorized into affective, behavioral, cognitive, and ‘other’ dimensions. Physical health measures were categorized into physical well-being, functional well-being, and physical symptoms. Average estimated correlations (Fisher's z) were calculated using generalized estimating equations with robust variance estimation. Results Overall R/S was associated with overall physical health (z=.153, p<.001); this relationship was not moderated by sociodemographic or clinical variables. Affective R/S was associated with physical well-being (z=.167, p<.001), functional well-being (z=.343, p<.001), and physical symptoms (z=.282, p<.001). Cognitive R/S was associated with physical well-being (z=.079, p<.05) and functional well-being (z=.090, p<.01). ‘Other’ R/S was associated with functional well-being (z=.100, p<.05). Conclusions Results of the current meta-analysis suggest that greater R/S is associated with better patient-reported physical health. These results underscore the importance of attending to patients’ religious and spiritual needs as part of comprehensive cancer care.

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Purpose Religion and spirituality (R/S) are patient-centered factors and often resources for managing the emotional sequelae of the cancer experience. Studies investigating the relationship between R/S (e.g., beliefs, experiences, coping) and mental health (e.g., depression, anxiety, well-being) in cancer have used very heterogeneous measures, with correspondingly inconsistent results. A meaningful synthesis of these findings has been lacking; thus, the purpose of this study was to conduct a meta-analysis of the research on R/S and mental health. Methods Four electronic databases were systematically reviewed and 2,073 abstracts met initial selection criteria. Reviewer pairs applied standardized coding schemes to extract correlational indices of the relationship between R/S and mental health. A total of 617 effect sizes from 148 eligible studies were synthesized using meta-analytic generalized estimating equations; subgroup analyses were performed to examine moderators of effects. Results The estimated mean correlation (Fisher z) was 0.19 (95% CI 0.16–0.23), which varied as a function of R/S dimension: affective, z=0.38 (95% CI 0.33-0.43); behavioral, z=0.03 (95% CI -0.02-0.08); cognitive, z=0.10 (95% CI 0.06-0.14); and ‘other,’ z=0.08 (95% CI 0.03-0.13). Aggregate, study-level demographic and clinical factors were not predictive of the relationship between R/S and mental health. There was little indication of publication or reporting biases. Conclusions The relationship between R/S and mental health is generally a positive one. The strength of that relationship is modest and varies as a function of R/S dimensions and mental health domains assessed. Identification of optimal R/S measures and more sophisticated methodological approaches are needed to advance research.

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Background Religion and spirituality (R/S) play an important role in the daily lives of many cancer patients. There has been great interest in determining whether R/S factors are related to clinically-relevant health outcomes. This meta-analytic review examined associations between dimensions of R/S and social health (e.g., social roles and relationships). Methods A systematic search of PubMed, PsycInfo, Cochrane Library, and CINAHL databases was conducted, and data were extracted by four pairs of investigators. Bivariate associations between specific R/S dimensions and social health outcomes were examined in a meta-analysis using a generalized estimating equation (GEE) approach. Results A total of 78 independent samples encompassing 14,277 patients were included in the meta-analysis. Social health was significantly associated with overall R/S (Fisher z effect size = .20, P< .001), and with each of the R/S dimensions (affective R/S effect size = .32, P< .001; cognitive R/S effect size = .11, P< .01; behavioral R/S effect size = .08, P < .05; and ‘other’ R/S effect size = .13, P < .001). Within these dimensions, specific variables tied to social health included spiritual well-being, spiritual struggle, images of God, R/S beliefs, and composite R/S measures (all P’s < .05). None of the demographic or clinical moderating variables examined was significant. Conclusions Several R/S dimensions are modestly associated with patients’ capacity to maintain satisfying social roles and relationships in the context of cancer. Further research is needed to examine the temporal nature of these associations and the mechanisms that underlie them.

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