Adjustment to the COVID-19 pandemic: associations with global and situational meaning.

COVID-19 has created pervasive upheaval and uncertainty in communities around the world. This investigation evaluated associations between discrete dimensions of personal meaning and psychological adjustment to the pandemic among community residents in a southern US state. In this cross-sectional study, 544 respondents were assessed during a period of reopening but accelerating infection rates. Validated measures were used to evaluate theoretically distinct dimensions of perceived global meaning (Meaning-in-Life Questionnaire) and pandemic-specific meaning (Meaning in Illness Scale). Adjustment outcomes included perceived stress, pandemic-related helplessness, and acceptance of the pandemic. In multivariate models that controlled for demographic and pandemic-related factors, stronger attained global meaning (i.e., perceptions that life is generally meaningful) and attained situational meaning (i.e., perceptions that the pandemic experience was comprehensible) were related to better adjustment on all three outcomes (all p's < .001). In contrast, seeking situational meaning (i.e., ongoing efforts to find coherence in the situation) was associated with poorer adjustment on all indices (all p's < .001). Results offer novel information regarding theoretically salient dimensions of meaning, which may have direct relevance for understanding how community residents adapt to the challenges of a major public health crisis.

Inner posture as aspect of global meaning in healthcare: a conceptual analysis.

Based on our empirical research on global meaning in people with spinal cord injury and people with stroke, we formulated 'inner posture' as a concept in rehabilitation. Inner posture, as we concluded from our empirical data, refers to the way in which people bear what cannot be changed. It helps them to live with their injury. Considering that much has already been written about meaning from a variety of disciplines, the question arises whether the concept of inner posture adds something new to the existing literature, or is just another name for a phenomenon that has already been described before in different terms. In this paper, we aim to investigate this and to clarify our conceptualization, by comparing the concept of inner posture with influential concepts in healthcare literature which seem to be more or less related. In the work of Puchalski regarding spirituality, Pargament regarding religion, Eliott regarding hope and Frankl regarding attitude, we found definitions and descriptions that seemed to come close to the phenomenon we refer to as inner posture. Because these concepts have various theoretical backgrounds, the comparison can help to better understand our concept of inner posture, through a process of dialogue between traditions, following Gadamer's notion of dialogue as fusion of horizons of understanding. We conclude that inner posture differs from the other concepts in several ways. Some of these differences are more fundamental, other are partial. This suggests that we identified a new perspective on a phenomenon partially described earlier. The comparison also inspired us to slightly adjust our definition and to formulate new research questions.

Sources of meaning in cancer patients - influences on global meaning, anxiety and depression in a longitudinal study.

Although existential needs are highly prevalent in patients with cancer, specific sources of meaning have been little explored. We investigated whether specific sources of meaning predict global meaning and psychological distress. N = 258 patients with breast (45%), lung (39%) and gynaecological cancer (16%) completed a battery of validated questionnaires at T1. Six months later (T2), n = 183 (78%) patients participated again. The primary outcomes - sources of meaning, global meaning and psychosocial distress - were measured with the Sources of Meaning Profile-Revised (SOMP-R), Life Attitude Profile-Revised (LAP-R) and modules for depression and anxiety of the Patient Health Questionnaire (PHQ-9, GAD-7). Most important sources of meaning were 'engaging in personal relationships', 'preserving human values and ideals' and 'feeling financially secure'. Stepwise multivariate regression analyses controlling for demographic and medical factors revealed that 'engaging in personal relationships', 'preservation of culture and tradition' and 'interest in social and/or political causes' predicted lower depression. 'Leaving a legacy for the next generation' and 'feeling financially secure' predicted both higher depression and anxiety. The findings highlight the relevance of sources of meaning for the psychological well-being of cancer patients and point towards specific sources of meaning that should be focused in psychosocial interventions.

Purpose in Life of Elite Athletes after Spinal Cord Injury.

Background: Searching for the meaning of human existence is man's fundamental orientation. People are free to find meaning in their lives, and while they are not always free to choose the conditions of life, they are free to choose their attitude toward the conditions in which they find themselves. When people experience an unchangeable situation, the most important thing is the attitude they take toward it. This study aimed to identify the sense of meaning in life among elite athletes after a spinal cord injury (SCI) and to analyze the different aspects contributing to this domain. Methods: The study involved five athletes with at least national-level achievements in sports prior to a SCI. The study consisted of an interview using a communicator and filling out two online questionnaires-a personal questionnaire and the Purpose in Life Scale. Results: Analyzing the quantitative results, four participants achieved results indicating a high sense of meaning in life, while one participant achieved a significantly lower result. Conclusions: What affects one's purpose in life is not so much the objective physical limitation but how much physicality one perceives to have lost as a result of the injury. Elite athletes stay involved in the sporting environment, which prevents the loss of purpose and maintains a sense of meaning at a high level. Both telling the story of your own illness and listening to the stories of others help the process of self-healing.

Global meaning in people with stroke: Content and changes.

After a traumatic event like a stroke, people need to find meaning and control again. This study enhances knowledge on one of the driving principles behind meaning-making processes: global meaning. Global meaning refers to individuals' general orienting systems, comprising fundamental beliefs and life goals. Little is known about global meaning in people with stroke and whether global meaning changes after stroke. In this qualitative study, five aspects of global meaning were found: core values, relationships, worldview, identity and inner posture. Continuity in all aspects was reported, but worldview, identity and inner posture were also subjected to change.

Global meaning in people with spinal cord injury: Content and changes.

BACKGROUND: After spinal cord injury (SCI), people are confronted with abrupt discontinuity in almost all areas of life, leading to questions on how to live a meaningful life again. Global meaning refers to basic ideas and goals that guide people in giving meaning to their lives, in specific situations. Little is known about global meaning relating to SCI and whether global meaning changes after SCI. PURPOSE: The purpose of this study was twofold: (i) to explore the content of global meaning of people with SCI, and (ii) to explore whether or not global meaning changes after SCI. METHODS: In-depth semi-structured interviews were conducted with 16 people with SCI. Interviews were analyzed according to the method of grounded theory. RESULTS: (i) Five aspects of global meaning were found: core values, relationships, worldview, identity and inner posture. (ii) Overall, little change in the content of global meaning was found after SCI; specific aspects of global meaning were foregrounded after SCI. CONCLUSION: Five aspects of global meaning were found in people with SCI. Global meaning seems hardly subject to change.