A formative evaluation of a brief intervention on meaning-making in the re-entry phase after curative cancer...

Patients in the re-entry phase (that is, the first 18 months after curative cancer treatment) may use meaning-making to deal with existential concerns imposed by cancer and related changes in life. The purpose of the current study was to conduct a formative evaluation of an intervention aimed at supporting patients' meaning-making process and motivating them to pick up life during the re-entry phase.

Patients were included after finishing systemic treatment for breast cancer or melanoma. The intervention comprised a single one-hour conversation guided by a spiritual counselor who explored patients' sources of meaning, in order to support them in dealing with existential concerns and changes in life in the re-entry phase. The evaluation included semi-structured interviews concerning the intervention and questionnaires assessing mental adjustment to cancer, psycho-spiritual wellbeing and meaning in life.

Qualitative interviews with 14 participants demonstrated an overall positive experience and appreciation of the intervention. Patients reported several benefits: reflection on existential concerns and sources of meaning, validation of sources of meaning, insights regarding the use of sources of meaning, and motivation to pick up life; and to a lesser extent: prioritizing, identifying meaningful goals, or undertaking specific action. Patients made suggestions on how to tailor the intervention more to their needs. Quantitative data showed increases on the subscales autonomy, goal-orientedness, and fairness of life with small effect sizes.

This study showed that an intervention to support patients with breast cancer or melanoma in the process of meaning-making in the re-entry phase after systemic treatment was positively experienced and well appreciated. It supported meaning-making, particularly through reflection on, validation and utilization of sources of meaning, and supporting motivation to pick up life. The results of the current study can be used to optimize the intervention, which can be further evaluated in a multicenter study.