Effects of Different Intervention Methods on Improving the Sense of Life Meaning in Cancer Patients: a Network Meta-analysis

Effects of Different Intervention Methods on Improving the Sense of Life Meaning in Cancer Patients: a Network Meta-analysis | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Effects of Different Intervention Methods on Improving the Sense of Life Meaning in Cancer Patients: a Network Meta-analysis Xiaoying Zhong, Weinan Lu, Ping Yuan, Yiying Zhang, Ting Fang, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5343754/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objective To evaluate the impact of different intervention programs on the sense of meaning in life for cancer patients using a network meta-analysis based on frequentist methods. Methods We conducted a computer search of databases including Web of Science, EMBASE, PubMed, CNKI, China Biomedical Database, Wanfang, and Weipu for interventional studies that could enhance the sense of meaning in life for cancer patients, with related indicators as outcomes. Statistical analysis was performed using Stata 16.0 software. This study has been approved by the Evidence-Based Nursing Center of Fudan University, registration number: ES20220915. Results A total of 20 studies were included, with 2,355 subjects and 13 types of interventions. The network meta-analysis showed that compared to conventional nursing, mindfulness therapy, health education, life review therapy, humanistic care-based nursing programs, and meaning therapy could all enhance the sense of meaning in life for cancer patients. The ranking probability indicated that mindfulness therapy was the most effective intervention, followed by health education and life review therapy. Conclusion Current evidence suggests that mindfulness therapy is the best intervention method for enhancing the sense of meaning in life for cancer patients. Therefore, healthcare providers should encourage and guide patients to engage in mindfulness training to improve their sense of meaning in life, enhance their physical and mental state, improve treatment outcomes and quality of life, and face life positively. Cancer patients intervention measures sense of meaning in life network meta-analysis Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Background According to the latest data from the National Cancer Center, in 2022, China reported 4.8247 million new cancer cases and 2.5742 million cancer-related deaths[ 1 ]. This indicates a continued upward trend in the incidence and mortality of malignant tumors, representing a significant public health issue in our country. Although recent years have seen the application of various treatment methods—such as radiotherapy, chemotherapy, surgery, targeted therapy, and immunotherapy—along with the introduction of new technologies and drugs that have, to some extent, improved patient survival rates and outcomes[ 2 ].However, many patients still struggle with the pain brought on by the disease, this includes the side effects of treatment and loss of physical function, leading to severe anxiety, depression, and fear of cancer recurrence[ 3 , 4 ]. Such challenges can leave patients feeling physically and mentally exhausted, unable to find meaning in life, and may even result in suicidal thoughts[ 2 ].The concept of the Meaning of Life (MIL) was first proposed by Frankl, suggesting that the meaning of life is a core human motivation, reflecting an individual's perception and sense of purpose[ 5 ]. When facing danger or setbacks, there is a profound need to explore and understand life’s goals and significance[ 6 ]. In positive psychology, meaning in life is closely linked to mental health, promoting physical and emotional well-being, enhancing resilience, and fostering a positive outlook[ 7 ]. Research indicates that a sense of meaning can alleviate suffering and mitigate negative psychological states such as depression and anxiety, potentially reducing the prevalence of thoughts associated with "death wish" [ 8 , 9 ]. The pursuit of the meaning of life is an intrinsic spiritual yearning of humans; only by delving into the essence of life can we transcend the fears induced by suffering, illness, and death, achieving a more composed and meaningful existence[ 10 ]. Currently, Scholars both domestically and internationally have launched various meaning-centered interventions to enhance cancer patients' sense of life meaning, treatment adherence, and confidence, promoting their positivity in facing the disease. Compared to conventional interventions, these have been proven to have distinct advantages, but there is no consensus on which intervention is the most effective. Therefore, this study uses randomized controlled trials (RCTs) and employs network meta-analysis to summarize and compare the effects of different meaning interventions on improving cancer patients' sense of life meaning. The aim is to evaluate the strengths and weaknesses of various interventions, making life meaning interventions for cancer patients more targeted and providing theoretical references and evidence-based support for clinical staff in enhancing patients' sense of life meaning. 1. Data and Methods This study has been reviewed by the Evidence-Based Nursing Center of Fudan University, with registration number: ES20220915. 1.1 Inclusion and Exclusion Criteria 1.1.1 Study Type: Randomized Controlled Trial (RCT). 1.1.2 Study Subjects: Patients diagnosed with malignant tumors according to the "Tumor Pathological Diagnosis Guidelines"[11]，who consent to participate and are aged ≥ 18 years. 1.1.3 Intervention Measures: A comparative analysis of 13 intervention methods, including meaning therapy, narrative nursing, life review therapy, humanistic care-based nursing plans, psychotherapy, multidisciplinary interventions, mind-body-spirit group therapy, massage therapy, dignity therapy, mindfulness therapy, palliative care, health education, and routine nursing. 1.1.4 Outcome Indicators: This includes cancer patients' meaning of life scales, such as the Meaning of Life Scale for Patients with Advanced Cancer, the Meaning of Life Scale for Cancer Patients, the Life Meaning Questionnaire, the Life Attitude Profile (LAP), and the Functional Assessment of Chronic Illness Therapy - Spiritual Well-Being Scale (FACIT-Sp). 1.1.5 Exclusion Criteria: ① Literature Type: Studies with unreasonable experimental design, procedures, or statistical methods; non-Chinese or non-English literature; literature that cannot be fully accessed or is duplicated. ② Intervention Measures: Interventions involving drugs, radiotherapy, chemotherapy, or other potentially contaminating measures. ③ Research Subjects: Patients with other severe psychological issues or mental disorders. ④ Outcome Indicators: Literature with incomplete research data or intervention durations too short to assess efficacy. 1.2 Literature Search Strategy Computer searches were conducted in PubMed, Embase, Cochrane Library, Web of Science, CNKI, WanFang Data, VIP, and CBM databases to collect relevant literature that meets the criteria, with the search timeframe from database inception to November 1, 2023. English search terms included: “Tumor/Cancer/Malignant/Neoplasm,” “meaning in life/meaning of life/life meaning/the meaning of life/sense of meaning in life,” and “study/practice/research/trial/RCT.” Chinese search terms included: “Cancer/Tumor,” “Meaning of Life/Meaning-Centered/Meaning Therapy/Life Review/Narrative Therapy/Dignity Therapy/Acceptance and Commitment Therapy/Integrative Interventions/Cancer Management and Meaningful Life,” and “Randomized/Research/Application.” The search combined subject headings and free terms, and the snowball method was used to manually search the references of included literature, along with tracking references from relevant systematic reviews or meta-analyses. 1.3 Literature Screening and Data Extraction NoteExpress was employed to manage the retrieved literature and eliminate duplicate entries. Two researchers independently screened the literature based on the established inclusion and exclusion criteria. Initially, they discarded articles with titles and abstracts that did not meet the requirements, followed by a review of the full texts to exclude any studies that failed to meet the criteria. In cases of disagreement during this process, a third researcher was consulted to facilitate discussion and reach a final decision. The data extraction process included basic information about the included studies, essential characteristics of the study subjects, clinical information, outcome indicators, and quality assessment-related details, among other relevant information. 1.4 Bias risk assessment of included studies Two researchers independently assessed the included RCTs according to the Cochrane Handbook 5.0.1 criteria for bias risk assessment of RCTs[12]. 1.5 Statistical analysis Network meta-analysis was performed using the random effects model of the frequentist framework of Stata 16.0 software. The thickness of the line in the evidence relationship diagram indicates the number of included studies, and the size of the sphere indicates the number of cases included in the intervention. The network evidence diagram was drawn using the Network package. The inconsistency model was first used for testing. If P >0.05, it means that the inconsistency is not significant, and the consistency model is used for fitting. Otherwise, the inconsistency model is used for fitting. The node splitting method was used for local inconsistency testing. P <0.05 was considered to be locally inconsistent. Since this study involved quantitative data and different studies used different outcome measurement tools, the standardized mean difference (SMD) and its 95% confidence interval (CI) were used to express it. If the 95% CI did not contain 0, it was considered to be statistically different. The effect size of the intervention was ranked according to the surface under the cumulative ranking (SUCRA). The larger the SUCRA, the better the efficacy of the intervention. Funnel plots were used to assess the variation and potential bias between studies. 2. Results 2.1 Literature search results A total of 2824 relevant articles were obtained in the initial review. After reviewing the titles, abstracts and duplicate articles, 174 articles remained. After repeated inspection and full-text reading, 20 studies were finally included in the network meta-analysis, including 2355 patients. The steps of the literature search are shown in Figure 1. 2.2 Basic characteristics of included studies Among the included literature, 7 were Chinese [13-19]and 13 were English[20-32], involving 13 interventions, including meaning therapy, narrative nursing, life review therapy, nursing plan based on humanistic care, psychotherapy, multidisciplinary intervention, body-mind-psychology group therapy, massage therapy, dignity therapy, mindfulness therapy, palliative care and health education, and routine care. The basic characteristics of the included literature are shown in Table 1. Table 1 Description of included studies (n=20) First author Country Year Sample Comparison Frequency and each duration Total intervention duration Outcome indicators (Life significance measurement scale) Ming Xing China 2017 18/20 MCP/CAU Each time ≤40min; interval 1~2d ≤6d Meaning of Life Scale for Advanced Cancer Patients (Compiled by Wu Yongsheng) Zhu Yufen China 2020 57/62 MCP/CAU 40-50minutes each time, once a week 3 weeks Meaning of Life Scale (MiLS) for Advanced Cancer Patients Zhang Jinmei China 2022 42/40 NN/CAU During hospitalization: <1h each time, 5 times in total, follow-up for 3 weeks after discharge, 30min/time, online supervision once a week During hospitalization Meaning of Life Scale for Advanced Cancer Patients (Compiled by Wu Yongsheng) Chen Ying China 2020 40/44 LRI/CAU Four meetings in total，Each time ≥ 45-60 minutes 2 weeks The Meaning in Life Questionnaire Gamze Teskereci, Turkey 2022 26/26 THC/CAU Five meetings in total，Each time ： 60-120 minutes 5 weeks Life Attitudes Questionnaire (LAP) Julienne E Bower America 2023 85/81/81 MT/EDU/CAU 2h/time, once a week 6 weeks meaning and peace subscale of the FACIT-Spiritual scale Karen Holtmaat Holland 2020 50/49/47 MCP/PSY/CAU 2h/week, 8 times in total 8 weeks the Personal Meaning Profile （PMP） Katherine M Piderman America 2014 54/63 MUL/CAU 90min/time，6 times in total 4 weeks FACIT-Sp Fei-Hsiu Hsiao China,Taiwan 2021 18/18 BMS/CAU 120min/1 time/week, 8 times in total 8 weeks Meaning of Life Questionnaire (MLQ) Pessin H America 2018 109/108/104 MCP/PSY/CAU 7 courses in total 2 months the Life Attitude Profile– Revised （LAP-R） Rosenfeld B America 2010 35/20 MCP/PSY 90 minutes/time, once a week 8 weeks FACIT-Sp First author Country Year Sample Comparison Frequency and each duration Total intervention duration Outcome indicators (Life significance measurement scale) Breitbart W America 2015 69/58 MCP/PSY 90 minutes/time, once a week 8 weeks FACIT-Sp Poppito S America 2012 41/37 MCP/TM 1h/1 time/week 7 weeks FACIT-Sp Melissa Henry Canada 2010 12/12 MCP/CAU Four meetings in total，Each time ：30-90min ≥2 months FACIT-Sp Julienne E Bower America 2015 39/32 MT/CAU 2h/time，6 times/week 6 weeks FACIT-Sp Michiyo Ando Japan 2010 34/34 LRI/CAU 30~60min/time，Two times in total, one week apart 1 weeks FACIT-Sp Esther Mok Hong Kong 2012 29/29 MCP/CAU The first time is 30-60 minutes; the second time is 15-30 minutes 2~3days Quality-of-Life Concerns in the End-of-Life （QOLC-E） Harvey Max Chochinov Canada 2011 108/111/107 PSY/DT/PC Three times in total, 30 minutes for the first time, 60 minutes for the second time, and 30 minutes for the third time 7~10 days FACIT-Sp Xiao Huimin China 2013 35/37 LRI/CAU The duration of each session depends on the patient's condition, a total of 3 sessions 3 weeks QOL（Quality-of-Life） Gary Rodin Canada 2018 113/121 CALM/CAU 3 to 6 treatments (45 to 60 minutes each) within 3 to 6 months 3~6 months FACIT-Sp Note: CAU: usual care; MCP: logotherapy; NN: narrative nursing; LRI: life review therapy; THC: humanistic care-based care plan; PSY: psychotherapy; MUL: multidisciplinary intervention; BMS: body-mind-psychology group therapy; TM: massage therapy; DT: dignity therapy; MT: mindfulness-based therapy; PC: palliative care; EDU: health education; FACIT-Sp: Functional Assessment of Chronic Illness Treatment-Mental Health Scale. 2.3 Assessment of Bias Risk in Included Studies Among the 20 articles included in this study, 4 were rated as Class A[18, 22, 30, 32] and the remaining were Class B. Regarding the generation of random sequences, 6 studies utilized stratified/block randomization; 5 studies employed computer randomization; 7 studies used random number tables, while the remaining 2 studies merely mentioned random grouping of study subjects without detailing the specific allocation methods used. For allocation concealment, 9 articles described the process, with 7 employing sealed envelope methods and 2 using staff independent of the trial groups for allocation; the others did not provide any information. In terms of blinding for study subjects and intervention providers, 5 studies implemented blinding, 2 did not use double blinding, and the remaining studies did not explicitly mention this. Concerning the blinding of outcome assessors, 6 studies clearly stated that different personnel collected the questionnaires, while the remaining studies did not specify the collectors; however, due to the nature of questionnaires, this was determined to be low risk. In terms of data completeness, 16 studies reported instances of sample dropout, but all provided detailed descriptions and conducted intention-to-treat analyses or other statistical descriptions. As shown in Figure 2. 2.4 Network Relationship Diagram The network relationship of different intervention measures is shown in Figure 3. Each dot in the figure represents an intervention method, the size of the dot represents the sample size, and the thickness of the line segment represents the number of studies. The existence of a line segment between two points indicates that there is a direct comparison between the two. In the network relationship diagram (Figure 3): There are direct or indirect comparisons between different intervention measures at the same time, which meets the basic conditions of network meta-analysis. It can be seen from the figure that the most research subjects participated in conventional care (CAU), and the most comparative studies were conducted between meaning therapy (MCP) and conventional care (CAU). 2.5 Results of network meta-analysis This study reported the effects of 13 different intervention measures on the meaning of life of cancer patients. The results of network meta-analysis showed that compared with the CAU group, MT (SMD=3.77, 95%CI=2.79~4.75), EDU (SMD=2.29, 95%CI=1.10~3.48), LRI (SMD=1.69, 95%CI=0.92~2.46), THC (SMD=1.52, 95%CI=0.16~2.88), and MCP (SMD=0.75, 95%CI=0.27~1.24) had statistically significant intervention effects on the meaning of life of cancer patients. Compared with the MCP group, MT (SMD=3.01, 95%CI=1.92~4.11), EDU (SMD=1.53, 95%CI=0.25~2.82), and LRI (SMD=0.94, 95%CI=0.03~1.85) have been shown to be statistically significant in improving the sense of life meaning in cancer patients. Compared with the PSY group, MT (SMD=3.37, 95%CI=2.17~4.56), EDU (SMD=1.89, 95%CI=0.52~3.26), and LRI (SMD=1.29, 95%CI=0.27~2.32) had statistically significant intervention effects on the sense of life meaning in cancer patients. Compared with the NN group, MUL group, BMS group, and DT group, the EDU group showed a better treatment effect. In addition, compared with EDU, LRI, THC, MCP, TM, PC, NN, MUL, PSY, BMS, DT, and CAU, the treatment effect of the MT group showed the best effect, and the results were statistically significant (p < 0.05), which further proved the unique intervention effect of mindfulness therapy. This intervention method can provide a reference for improving the sense of meaning in life in cancer patients. There was no statistical significance in the comparison between any two other interventions (P > 0.05), as shown in Table 2. Table 2 Network meta-analysis [SMD (95% CI)] MT 1.4 (0.30,2.67) EDU 2.07 (0.83,3.32) 0.59 (-0.82,2.01) LRI 2.25 (0.57,3.92) 0.77 (-1.04,2.57) 0.17 (-1.39,1.74) THC 3.01 (1.92,4.11) 1.53 (0.25,2.82) 0.94 (0.03,1.85) 0.77 (-0.68,2.21) MCP 3.11 (1.42,4.80) 1.63 (-0.19,3.45) 1.04 (-0.54,2.61) 0.86 (-1.07,2.80) 0.10 (-1.19,1.39) TM 3.27 (1.55,4.99) 1.79 (-0.06,3.64) 1.20 (-0.41,2.81) 1.02 (-0.94,2.99) 0.26 (-1.12,1.64) 0.16 (-1.73,2.05) PC 3.28 (1.66,4.89) 1.80 (0.04,3.55) 1.20 (-0.30,2.70) 1.03 (-0.84,2.90) 0.26 (-1.11,1.64) 0.17 (-1.72,2.05) 0.01 (-1.91,1.92) NN 3.37 (1.77,4.97) 1.89 (0.15,3.62) 1.29 (-0.19,2.77) 1.12 (-0.74,2.98) 0.35 (-1.00,1.71) 0.26 (-1.61,2.13) 0.10 (-1.80,1.99) 0.09 (-1.71,1.90) MUL 3.37 (2.17,4.56) 1.89 (0.52,3.26) 1.29 (0.27,2.32) 1.12 (-0.40,2.64) 0.35 (-0.25,0.96) 0.26 (-1.17,1.68) 0.10 (-1.14,1.34) 0.09 (-1.37,1.55) 0.00 (-1.44,1.44) PSY 3.42 (1.73,5.11) 1.94 (0.12,3.76) 1.35 (-0.23,2.92) 1.17 (-0.76,3.11) 0.41 (-1.05,1.87) 0.31 (-1.64,2.26) 0.15 (-1.82,2.12) 0.14 (-1.74,2.03) 0.05 (-1.82,1.92) 0.05 (-1.49,1.59) BMS 3.43 (1.70,5.15) 1.95 (0.10,3.79) 1.35 (-0.26,2.96) 1.18 (-0.78,3.14) 0.41 (-0.97,1.79) 0.32 (-1.57,2.20) 0.16 (-1.08,1.39) 0.15 (-1.76,2.06) 0.06 (-1.84,1.96) 0.06 (-1.18,1.30) 0.01 (-1.97,1.98) DT 3.77 (2.79,4.75) 2.29 (1.10,3.48) 1.69 (0.92,2.46) 1.52 (0.16,2.88) 0.75 (0.27,1.24) 0.66 (-0.72,2.03) 0.50 (-0.92,1.91) 0.49 (-0.80,1.78) 0.40 (-0.87,1.66) 0.40 (-0.28,1.08) 0.35 (-1.03,1.72) 0.34 (-1.07,1.75) CAU 2.6 Consistency test In this study, the meaning of life of cancer patients was used as the outcome indicator. The results of the inconsistency model test were: P=0.4915 (P>0.05), indicating that the overall inconsistency of the outcome indicator was not significant; the node splitting method was used for local inconsistency test, and the results showed that there was no local inconsistency between the direct comparison and indirect comparison of the outcome indicators (P>0.05), indicating that the consistency between all groups was good. 2.7 SUCRA result ranking The SUCRA value of each intervention measure represents the probability of each intervention measure being the best intervention. The results show that the intervention effects of different intervention measures on the meaning of life of cancer patients are ranked as follows: mindfulness therapy > health education > life review therapy > nursing plan based on humanistic care > meaning therapy > massage therapy > palliative care > narrative nursing > multidisciplinary intervention > psychotherapy > body-mind-psychology group therapy > dignity therapy > conventional care, see Table 3 and Figure 4. The results show that mindfulness therapy is the most effective intervention measure to improve the meaning of life of cancer patients, suggesting that conventional care is the least effective intervention measure to improve the meaning of life of cancer patients. Table 3 The ordering results of network meta-analysis ID and rank Treatment SUCRA（%） PrBest MeanRank Best MT 99.9 98.7 1.0 2nd EDU 87.3 0.8 2.5 3rd LRI 78.2 0.0 3.6 4th THC 71.1 0.5 4.5 5th MCP 49.9 0.0 7.0 6th TM 43.6 0.0 7.8 7th PC 38.7 0.0 8.4 8th NN 37.3 0.0 8.5 9th MUL 34.0 0.0 8.9 10th PSY 32.3 0.0 9.1 10th BMS 32.2 0.0 9.1 11th DT 31.7 0.0 9.2 12th CAU 13.9 0.0 11.3 2.8 Publication bias test The results of publication bias are presented using a corrected comparative funnel plot. The dots in the funnel plot represent the results of direct comparisons of different studies, the red vertical line represents the combined effect value, and the dotted line represents the 95% confidence interval. Figure 5 shows the publication bias results of the meaning of life score after different intervention measures. The points are basically symmetrically distributed around the red vertical line. Seven points fall outside the funnel, which may indicate publication bias. One point falls at the bottom of the funnel, which may indicate a very small sample effect. 3. Discussion The meaning of life is an individual’s perception and understanding of life goals and values. For cancer patients, this perception may be changed by the disease. Due to the invasion of the disease and the difficult treatment process, patients may experience depression, despair, and helplessness, leading them to question the meaning and value of life. Various measures aimed at improving the meaning of life of cancer patients have been carried out at home and abroad. These measures cover psychological, social, spiritual and therapeutic levels. The purpose is to help cancer patients rediscover the goals and values of life and improve their quality of life[ 33 ]. How medical staff choose the most effective, simple and easy method among various intervention measures is a key issue in clinical work. This will help achieve efficient care in the process of providing continuous meaning-of-life intervention to patients, thereby significantly improving patients' sense of meaning in life. The results of this study show that compared with other intervention methods, mindfulness therapy has the best effect on improving the sense of meaning in life of cancer patients. Studies have shown that some cancer patients experience positive psychological changes and growth during the anti-cancer process. This experience and growth can improve the patient's negative psychological state, enhance their life perception, and thus promote the quality of life of cancer patients[ 34 , 35 ].Mindfulness-based therapy originates from the Buddhist tradition. It is a psychotherapy method centered on mindfulness, emphasizing attention to current cognition, thoughts, and emotions, and not judging or reacting to anything[ 36 ].Mindfulness therapy mainly relieves depression, anxiety and other related symptoms by affecting the two major systems of cognition and emotion[ 37 ]. First, mindfulness practice regulates cognition through three brain networks[ 38 ], namely: the central executive network (CEN), the salience network (CN) and the default mode network (DMN). Systematic mindfulness practice can enable patients to focus on the present, improve their attention, and have a more correct and clear understanding of their own situation[ 39 ]. Secondly, mindfulness therapy can regulate the emotional system and play a role by helping patients regulate their emotions[ 40 ].The four key ways of regulating emotions through mindfulness are to enhance emotional awareness, change emotional responses, promote cognitive reappraisal, and change reward processing. It helps patients observe their own situations, strengthen their scrutiny of their own symptoms and emotions, and thus increase their ability to manage negative emotions[ 38 ]. As an economical, convenient, and easy-to-master psychological therapy, mindfulness encourages cancer patients to accept changes in their lives and turn to accepting loss and sadness rather than fighting symptoms. This acceptance is not the same as giving up, but rather acknowledging reality, prompting patients to look at their experiences from a new perspective. Through observation and reflection, patients can recognize that pain is just a constantly changing psychological event, thereby feeling the support of being connected to others and gaining energy and motivation in life[ 41 ]. Studies at home and abroad have shown that mindfulness therapy can effectively help cancer patients deal with their emotional problems more peacefully and accept the discomfort during treatment more quickly, such as anxiety, depression, low morale and other negative emotions, fatigue, weakness, pain and other related symptoms, thereby improving patients' ability to act, improving interpersonal relationships, helping them build self-confidence, preparing for future actions, and increasing their hope for life[ 42 , 43 ]. At the same time, studies have shown that mindfulness-based intervention therapy can reduce patients’ psychological distress and promote their mental health[ 44 ]. In view of this, according to the patient’s age, education level, and understanding level, we can help patients conduct mindfulness training with an appropriate intervention duration and easy to understand, so as to alleviate the physical and mental problems of cancer patients, face the disease and life with a more positive and optimistic attitude, and promote the meaning of their life. The results of the meta-analysis and the results of the ranking cumulative probability diagram show that, in addition to mindfulness therapy, health education and life review therapy can also improve the sense of meaning in life of cancer patients, and are superior to other intervention measures. Previous studies have shown that health education interventions related to the meaning of life can deepen patients' correct understanding of the disease and relieve negative emotions. The analysis results of Bower showed that health education can improve patients' depression after 6 months of intervention, but there are currently no studies in China to explain its long-term efficacy[ 20 ]. In the future, it is recommended that researchers pay more attention to the duration of health education interventions, and evaluate the medium- and long-term intervention effects of health education by extending the intervention time. At the same time, traditional health education models should be innovated to improve patients' treatment compliance and promote intervention effects. Unlike mindfulness therapy, life review is a psychotherapy method that focuses on reconstructing self-identity and promoting mental health by reviewing and integrating past experiences, thereby discovering the meaning of life. Chen Ying et al. [ 15 ]showed that life review can help cancer patients undergoing chemotherapy regain hope in life and improve their sense of meaning in life; Li Jiangyan[ 45 ]believes that cancer patients can gain new values and hope through life review, achieve the integration of life meaning, face death, and improve the quality of life and dignity at the end of their lives; Ando[ 30 ]found that short-term life review can not only improve the mental health of advanced cancer patients, but also alleviate their social and psychological distress. However, the application of life review therapy in China started relatively late, and there are relatively few intervention studies on cancer patients. In addition, there are certain deficiencies in the design and implementation steps of existing studies. Therefore, it is necessary to conduct rigorously designed, large-sample, multi-center studies to further confirm its effectiveness. In addition, the results of this study showed that the difference between nursing plans based on humanistic care and meaning therapy and conventional care was also statistically significant. A foreign study showed[ 22 ]that nursing plans based on humanistic care theory may help reduce the frequency and discomfort of chemotherapy for breast cancer patients and improve their hope and meaning in life. At present, there is no relevant research in China. There are many studies on meaning therapy. Analysis of domestic and foreign studies[ 13 , 21 , 25 ]showed that through meaning therapy, cancer patients can re-understand themselves, tap their potential, find the meaning of life, and thus improve their quality of life. At the same time, it can also effectively reduce the occurrence of related complications and improve treatment compliance. However, there is no statistically significant difference between massage therapy, palliative care, narrative care, multidisciplinary intervention, psychotherapy, body-mind-psychology group therapy, dignity therapy and other interventions and conventional care. After excluding low-quality literature, this meta-analysis can include fewer studies, and its effectiveness in improving the sense of meaning in life of cancer patients cannot be confirmed. Therefore, high-quality original research or systematic evaluation of the above interventions based on evidence-based thinking is needed in the future to verify its credibility. 4. Limitation However, this study has the following limitations: ① Only some of the included studies used blinding, which may have implementation and measurement bias; ② This study excluded low-quality studies and only conducted a meta-analysis of studies with quality evaluation grades A and B, resulting in a small number of included literature on some intervention methods, which may have publication bias; ③ Although the included research subjects were all cancer patients, the results may have certain heterogeneity due to differences in cancer type, stage, medical level, and intervention programs. In the later stage, high-quality, large-sample original research can be carried out, and intervention programs to enhance the sense of life meaning of cancer patients can be formulated based on evidence-based evidence. 5. Conclusion To sum up, this study included 20 studies. Although various intervention methods can improve the sense of life meaning of cancer patients to varying degrees, combined with the results of this network meta-analysis, mindfulness therapy is an intervention method with a relatively ideal effect in improving the sense of life meaning of cancer patients. It is recommended that in the future, when selecting intervention plans for patients in clinical practice, medical staff should consider the actual needs, personal wishes and application scenarios of patients while referring to evidence-based evidence. In addition, given that the sense of life meaning is constantly changing, long-term longitudinal follow-up studies need to be carried out from a more macro perspective in the future to explore the long-term intervention effects of various intervention measures on the meaning of life of patients. Declarations Ethics approval and consent to participate Fudan University under the registration number: ES20220915. Consent for publication Not applicable Competing interests All of the authors had no any personal, financial, commercial, or academic conflicts of interest separately. Funding This study was funded by General Project of Sichuan Aging Enterprise and Industrial Development Research Center 2023 (No. XJLL2023020);2022 Sichuan Provincial Medical Scientific Research Project Plan (No. S22059). Authors’ contributions XY-Z, WN-L: designed the research topic, performed literature screening, quality assessment and data analysis, and wrote and translated the manuscript. P-Y: performed literature search, analyzed data, and made written revisions to the manuscript. YY-Z, T-F, M-W: performed literature search and revised the manuscript. L-W, PP-L: collated the data and participated in the translation of the manuscript. LM-Z: guided the entire study design and manuscript writing process and made revision suggestions. All authors agreed to submit the final version. Acknowledgements The authors thank all the participants in this study. Author details 1 School of Nursing, Chengdu Medical College, Chengdu, Sichuan 610500, China. 2 The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan 610500,China. Disclosure Xiaoying Zhong, Weinan Lu, and Ping Yuan are co-first authors, Limei Zhang is the corresponding author. References Zheng RS, Chen R, Han BF, Wang SM, Li L, Sun KX, Zeng HM, Wei WW, He J: Cancer incidence and mortality in China, 2022 . Chinese journal of oncology 2024, 46 (3):221-231. Yanbo J, Na L, Hongmei L: Relationships among symptom distress, psychological resilience, andpositive emotions in cancer patients . Chinese Nursing Research 2017, 10 (31):1193-1197. Abbey G, Thompson SB, Hickish T, Heathcote D: A meta-analysis of prevalence rates and moderating factors for cancer-related post-traumatic stress disorder . PSYCHO-ONCOLOGY 2015, 24 (4):371-381. Caruso R, Nanni MG, Riba MB, Sabato S, Grassi L: The burden of psychosocial morbidity related to cancer: patient and family issues . INT REV PSYCHIATR 2017, 29 (5):389-402. Frankl VE: Search for meaning : Mount Mary College Milwaukee, WI, USA; 1984. Frankl VE: The Will to Meaning . Beijing: China Renmin University Press; 2015. Rongwei Z, Dan L: How to experience a meaningful life:Based on the integration of theoretical models on meaning in life . Advances in Psychological Science 2018, 26 (4):744-760. Guerrero-Torrelles M, Monforte-Royo C, Tomás-Sábado J, Marimon F, Porta-Sales J, Balaguer A: Meaning in life as a mediator between physical impairment and the wish to hasten death in patients with advanced cancer . J PAIN SYMPTOM MANAG 2017, 54 (6):826-834. Sun FK, Wu MK, Yao Y, Chiang CY, Lu CY: Meaning in life as a mediator of the associations among depression, hopelessness and suicidal ideation: A path analysis . J PSYCHIATR MENT HLT 2022, 29 (1):57-66. Wenrong Z: Research On Frankl ’ s Logotherapy . Anhui University; 2021. Pathology PMOS: Standardization for diagnostic tumor pathology . Chinese Journal of Pathology 2016, 45 (8). Higgins JP, Altman DG, Gotzsche PC, Juni P, Moher D, Oxman AD, Savovic J, Schulz KF, Weeks L, Sterne JA: The Cochrane Collaboration's tool for assessing risk of bias in randomised trials . BMJ-BRIT MED J 2011, 343 :d5928. Xing M, Jun ZJ: The construction and application of intervention for life meaning on advanced cancer patients . J NURS ADMIN 2017, 17 (3):195-198. Yufen Z, Guojun Z: Effects of logotherapy in patients with advanced lung cancer . Chinese Journal of Modern Nursing 2020, 36 (26):5076-5080. Chen Y, Xiao H, Zheng J, Zhang X, Lin X: Effects of a mind map-based life review programme on psychospiritual well-being in cancer patients undergoing chemotherapy: A randomised controlled trial . EUR J CANCER CARE 2020, 29 (3):e13221. Jinmei Z, Yumei L, Jie D, Fang L: The effect of narrative nursing on the meaning and quality of life in chemotherapy patients with advanced lung cancer . Chinese Journal of Practical Nursing 2022, 38 (30):2347-2355. Hsiao FH, Jow GM, Kuo WH, Chang KJ, Liu YF, Ho RT, Ng SM, Chan CL, Lai YM, Chen YT: The effects of psychotherapy on psychological well-being and diurnal cortisol patterns in breast cancer survivors . PSYCHOTHER PSYCHOSOM 2012, 81 (3):173-182. Esther Mok RN, Theresa Lai RN D, Shirley Ching RN: The meaning of life intervention for patients with advanced-stage cancer: development and pilot study . In Oncology nursing forum: 2012. Oncology Nursing Society; 2012:E480-E488. Xiao H, Kwong E, Pang S, Mok E: Effect of a life review program for Chinese patients with advanced cancer: a randomized controlled trial . CANCER NURS 2013, 36 (4):274-283. Bower JE, Partridge AH, Wolff AC, Cole SW, Irwin MR, Thorner ED, Joffe H, Petersen L, Crespi CM, Ganz PA: Improving biobehavioral health in younger breast cancer survivors: Pathways to Wellness trial secondary outcomes . JNCI-J NATL CANCER I 2023, 115 (1):83-92. Breitbart W, Pessin H, Rosenfeld B, Applebaum AJ, Lichtenthal WG, Li Y, Saracino RM, Marziliano AM, Masterson M, Tobias K et al : Individual meaning-centered psychotherapy for the treatment of psychological and existential distress: A randomized controlled trial in patients with advanced cancer . CANCER-AM CANCER SOC 2018, 124 (15):3231-3239. Teskereci G, Yangın H, Kulakaç Ö: Effects of a nursing care program based on the theory of human caring on women diagnosed with gynecologic cancer: a pilot study from Turkey . J PSYCHOSOC ONCOL 2022, 40 (1):45-61. Chochinov HM, Kristjanson LJ, Breitbart W, McClement S, Hack TF, Hassard T, Harlos M: Effect of dignity therapy on distress and end-of-life experience in terminally ill patients: a randomised controlled trial . LANCET ONCOL 2011, 12 (8):753-762. Piderman KM, Johnson ME, Frost MH, Atherton PJ, Satele DV, Clark MM, Lapid MI, Sloan JA, Rummans TA: Spiritual quality of life in advanced cancer patients receiving radiation therapy . Psycho ‐ Oncology 2014, 23 (2):216-221. Holtmaat K, van der Spek N, Lissenberg Witte B, Breitbart W, Cuijpers P, Verdonck De Leeuw I: Long ‐ term efficacy of meaning ‐ centered group psychotherapy for cancer survivors: 2 ‐ Year follow ‐ up results of a randomized controlled trial . Psycho ‐ oncology 2020, 29 (4):711-718. Breitbart W, Rosenfeld B, Gibson C, Pessin H, Poppito S, Nelson C, Tomarken A, Timm AK, Berg A, Jacobson C: Meaning ‐ centered group psychotherapy for patients with advanced cancer: a pilot randomized controlled trial . Psycho ‐ oncology 2010, 19 (1):21-28. Breitbart W, Rosenfeld B, Pessin H, Applebaum A, Kulikowski J, Lichtenthal WG: Meaning-centered group psychotherapy: an effective intervention for improving psychological well-being in patients with advanced cancer . J CLIN ONCOL 2015, 33 (7):749-754. Breitbart W, Poppito S, Rosenfeld B, Vickers AJ, Li Y, Abbey J, Olden M, Pessin H, Lichtenthal W, Sjoberg D et al : Pilot randomized controlled trial of individual meaning-centered psychotherapy for patients with advanced cancer . J CLIN ONCOL 2012, 30 (12):1304-1309. Bower JE, Crosswell AD, Stanton AL, Crespi CM, Winston D, Arevalo J, Ma J, Cole SW, Ganz PA: Mindfulness meditation for younger breast cancer survivors: a randomized controlled trial . CANCER-AM CANCER SOC 2015, 121 (8):1231-1240. Ando M, Morita T, Akechi T, Okamoto T: Efficacy of short-term life-review interviews on the spiritual well-being of terminally ill cancer patients . J PAIN SYMPTOM MANAG 2010, 39 (6):993-1002. Rodin G, Lo C, Rydall A, Shnall J, Malfitano C, Chiu A, Panday T, Watt S, An E, Nissim R: Managing cancer and living meaningfully (CALM): a randomized controlled trial of a psychological intervention for patients with advanced cancer . J CLIN ONCOL 2018, 36 (23):2422-2432. Henry M, Cohen SR, Lee V, Sauthier P, Provencher D, Drouin P, Gauthier P, Gotlieb W, Lau S, Drummond N: The Meaning ‐ Making intervention (MMi) appears to increase meaning in life in advanced ovarian cancer: A randomized controlled pilot study . Psycho ‐ oncology 2010, 19 (12):1340-1347. de Medeiros BBV, Yolanda A, Ramos Pereira E, Silva CRA, Mary R: The Meaning of Life and Religious Coping in the Fight Against Cancer: A Study with Oncology Patients in Brazil in Light of Viktor Frankl's Theory . Journal of religion and health 2024, 63 (2):1373-1389. Peng X, Su Y, Huang W, Hu X: Status and factors related to posttraumatic growth in patients with lung cancer: A STROBE-compliant article . MEDICINE 2019, 98 (7):e14314. Li L, Hou Y, Kang F, Wei X: The mediating and moderating roles of resilience in the relationship between anxiety, depression, and post-traumatic growth among breast cancer patients based on structural equation modeling: an observational study . MEDICINE 2020, 99 (50):e23273. Weirui X: The lost and reversion of the theory of human natureof the Mindfulness Psychotherapy . Jilin University; 2011. ZHU Kemeng WXZQ: Research progress of mindfulness therapy in the treatment of commonmentaldiseases . Chinese Journal of Nervous and Mental Diseases 2023, 49 (10):636-641. Wielgosz J, Goldberg SB, Kral TR, Dunne JD, Davidson RJ: Mindfulness meditation and psychopathology . ANNU REV CLIN PSYCHO 2019, 15 (1):285-316. Bauer C, Whitfield-Gabrieli S, Díaz JL, Pasaye EH, Barrios FA: From state-to-trait meditation: Reconfiguration of central executive and default mode networks . ENEURO 2019, 6 (6). Tang Y, Hölzel BK, Posner MI: The neuroscience of mindfulness meditation . NAT REV NEUROSCI 2015, 16 (4):213-225. Carlson LE: Mindfulness ‐ based interventions for coping with cancer . ANN NY ACAD SCI 2016, 1373 (1):5-12. Li J, Li C, Puts M, Wu YC, Lyu MM, Yuan B, Zhang JP: Effectiveness of mindfulness-based interventions on anxiety, depression, and fatigue in people with lung cancer: A systematic review and meta-analysis. INT J NURS STUD 2023, 140 :104447. Soleymani Moghadam M, Parvizifard A, Foroughi A, Ahmadi SM, Farshchian N: An investigation of the effect of mindfulness-integrated cognitive behavior therapy on demoralization, body image, and sexual function in Iranian women with breast cancer: a randomized controlled trial . J CANCER RES CLIN 2024, 150 (3):128. Oner Cengiz H, Bayir B, Sayar S, Demirtas M: Effect of mindfulness-based therapy on spiritual well-being in breast cancer patients: a randomized controlled study . SUPPORT CARE CANCER 2023, 31 (7):438. Ll Jiang-yan XYZX: A Practical Exploration of Life Review Therapy for the Intervention of Fearof Death in Terminal Cancer Patients . Medicine & Philosophy 2022, 43 (10):29-32. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. 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03:38:27","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5343754/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5343754/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":69447791,"identity":"222d43ba-447a-4884-add2-576183b7eedb","added_by":"auto","created_at":"2024-11-20 12:11:57","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":59824,"visible":true,"origin":"","legend":"\u003cp\u003eSteps of literature retrieval\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-5343754/v1/3b3ca2ffd7d4e9552ee42170.png"},{"id":69446244,"identity":"f9e48435-4fa9-4e8a-bda3-8f7055d484ed","added_by":"auto","created_at":"2024-11-20 12:03:57","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":60016,"visible":true,"origin":"","legend":"\u003cp\u003eBias risk assessment for included studies\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-5343754/v1/d4af0d0d2f0d8b1c0c32090d.png"},{"id":69447793,"identity":"eb4d9184-21f3-4ae5-8120-0fe2e696d464","added_by":"auto","created_at":"2024-11-20 12:11:57","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":65729,"visible":true,"origin":"","legend":"\u003cp\u003eNetwork figure about efficient evidence\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-5343754/v1/27c1f938612aadf0a2b3e130.png"},{"id":69448027,"identity":"e9bcf4f2-8f9d-458c-94e3-711a832ed878","added_by":"auto","created_at":"2024-11-20 12:19:57","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":151209,"visible":true,"origin":"","legend":"\u003cp\u003eCumulative probabilities\u003c/p\u003e","description":"","filename":"4.png","url":"https://assets-eu.researchsquare.com/files/rs-5343754/v1/3daa2177cb10afdb61ba762e.png"},{"id":69446245,"identity":"de082416-8a8c-4f87-92d0-1472dc9e8d6f","added_by":"auto","created_at":"2024-11-20 12:03:57","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":57957,"visible":true,"origin":"","legend":"\u003cp\u003eFunnel chart\u003c/p\u003e","description":"","filename":"5.png","url":"https://assets-eu.researchsquare.com/files/rs-5343754/v1/21b4fb2b28501487e35d1c34.png"},{"id":72115598,"identity":"592ef7f3-36e3-4586-b7fa-3fae7a8bf433","added_by":"auto","created_at":"2024-12-22 22:01:17","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2192779,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5343754/v1/e8cb1170-5aa9-48ce-abc0-23237730fe39.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Effects of Different Intervention Methods on Improving the Sense of Life Meaning in Cancer Patients: a Network Meta-analysis","fulltext":[{"header":"Background","content":"\u003cp\u003eAccording to the latest data from the National Cancer Center, in 2022, China reported 4.8247\u0026nbsp;million new cancer cases and 2.5742\u0026nbsp;million cancer-related deaths[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. This indicates a continued upward trend in the incidence and mortality of malignant tumors, representing a significant public health issue in our country. Although recent years have seen the application of various treatment methods\u0026mdash;such as radiotherapy, chemotherapy, surgery, targeted therapy, and immunotherapy\u0026mdash;along with the introduction of new technologies and drugs that have, to some extent, improved patient survival rates and outcomes[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e].However, many patients still struggle with the pain brought on by the disease, this includes the side effects of treatment and loss of physical function, leading to severe anxiety, depression, and fear of cancer recurrence[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Such challenges can leave patients feeling physically and mentally exhausted, unable to find meaning in life, and may even result in suicidal thoughts[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e].The concept of the Meaning of Life (MIL) was first proposed by Frankl, suggesting that the meaning of life is a core human motivation, reflecting an individual's perception and sense of purpose[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. When facing danger or setbacks, there is a profound need to explore and understand life\u0026rsquo;s goals and significance[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. In positive psychology, meaning in life is closely linked to mental health, promoting physical and emotional well-being, enhancing resilience, and fostering a positive outlook[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Research indicates that a sense of meaning can alleviate suffering and mitigate negative psychological states such as depression and anxiety, potentially reducing the prevalence of thoughts associated with \"death wish\" [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. The pursuit of the meaning of life is an intrinsic spiritual yearning of humans; only by delving into the essence of life can we transcend the fears induced by suffering, illness, and death, achieving a more composed and meaningful existence[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eCurrently, Scholars both domestically and internationally have launched various meaning-centered interventions to enhance cancer patients' sense of life meaning, treatment adherence, and confidence, promoting their positivity in facing the disease. Compared to conventional interventions, these have been proven to have distinct advantages, but there is no consensus on which intervention is the most effective. Therefore, this study uses randomized controlled trials (RCTs) and employs network meta-analysis to summarize and compare the effects of different meaning interventions on improving cancer patients' sense of life meaning. The aim is to evaluate the strengths and weaknesses of various interventions, making life meaning interventions for cancer patients more targeted and providing theoretical references and evidence-based support for clinical staff in enhancing patients' sense of life meaning.\u003c/p\u003e"},{"header":"1. Data and Methods","content":"\u003cp\u003eThis study has been reviewed by the Evidence-Based Nursing Center of Fudan University, with registration number: ES20220915.\u003c/p\u003e\n\u003cp\u003e1.1 Inclusion and Exclusion Criteria \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e1.1.1 Study Type: Randomized Controlled Trial (RCT). \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e1.1.2 Study Subjects: Patients diagnosed with malignant tumors according to the \"Tumor Pathological Diagnosis Guidelines\"[11]，who consent to participate and are aged ≥ 18 years. \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e1.1.3 Intervention Measures: A comparative analysis of 13 intervention methods, including meaning therapy, narrative nursing, life review therapy, humanistic care-based nursing plans, psychotherapy, multidisciplinary interventions, mind-body-spirit group therapy, massage therapy, dignity therapy, mindfulness therapy, palliative care, health education, and routine nursing.\u003c/p\u003e\n\u003cp\u003e1.1.4 Outcome Indicators: This includes cancer patients' meaning of life scales, such as the Meaning of Life Scale for Patients with Advanced Cancer, the Meaning of Life Scale for Cancer Patients, the Life Meaning Questionnaire, the Life Attitude Profile (LAP), and the Functional Assessment of Chronic Illness Therapy - Spiritual Well-Being Scale (FACIT-Sp).\u003c/p\u003e\n\u003cp\u003e1.1.5 Exclusion Criteria: ① Literature Type: Studies with unreasonable experimental design, procedures, or statistical methods; non-Chinese or non-English literature; literature that cannot be fully accessed or is duplicated. ② Intervention Measures: Interventions involving drugs, radiotherapy, chemotherapy, or other potentially contaminating measures. ③ Research Subjects: Patients with other severe psychological issues or mental disorders. ④ Outcome Indicators: Literature with incomplete research data or intervention durations too short to assess efficacy.\u003c/p\u003e\n\u003cp\u003e1.2 Literature Search Strategy \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eComputer searches were conducted in PubMed, Embase, Cochrane Library, Web of Science, CNKI, WanFang Data, VIP, and CBM databases to collect relevant literature that meets the criteria, with the search timeframe from database inception to November 1, 2023. English search terms included: “Tumor/Cancer/Malignant/Neoplasm,” “meaning in life/meaning of life/life meaning/the meaning of life/sense of meaning in life,” and “study/practice/research/trial/RCT.” Chinese search terms included: “Cancer/Tumor,” “Meaning of Life/Meaning-Centered/Meaning Therapy/Life Review/Narrative Therapy/Dignity Therapy/Acceptance and Commitment Therapy/Integrative Interventions/Cancer Management and Meaningful Life,” and “Randomized/Research/Application.” The search combined subject headings and free terms, and the snowball method was used to manually search the references of included literature, along with tracking references from relevant systematic reviews or meta-analyses.\u003c/p\u003e\n\u003cp\u003e1.3 Literature Screening and Data Extraction\u003c/p\u003e\n\u003cp\u003eNoteExpress was employed to manage the retrieved literature and eliminate duplicate entries. Two researchers independently screened the literature based on the established inclusion and exclusion criteria. Initially, they discarded articles with titles and abstracts that did not meet the requirements, followed by a review of the full texts to exclude any studies that failed to meet the criteria. In cases of disagreement during this process, a third researcher was consulted to facilitate discussion and reach a final decision. The data extraction process included basic information about the included studies, essential characteristics of the study subjects, clinical information, outcome indicators, and quality assessment-related details, among other relevant information.\u003c/p\u003e\n\u003cp\u003e1.4 Bias risk assessment of included studies\u003c/p\u003e\n\u003cp\u003eTwo researchers independently assessed the included RCTs according to the Cochrane Handbook 5.0.1 \u0026nbsp; criteria for bias risk assessment of RCTs[12].\u003c/p\u003e\n\u003cp\u003e1.5 Statistical analysis\u003c/p\u003e\n\u003cp\u003eNetwork meta-analysis was performed using the random effects model of the frequentist framework of Stata 16.0 software. The thickness of the line in the evidence relationship diagram indicates the number of included studies, and the size of the sphere indicates the number of cases included in the intervention. The network evidence diagram was drawn using the Network package. The inconsistency model was first used for testing. If \u003cem\u003eP\u003c/em\u003e\u0026gt;0.05, it means that the inconsistency is not significant, and the consistency model is used for fitting. Otherwise, the inconsistency model is used for fitting. The node splitting method was used for local inconsistency testing. \u003cem\u003eP\u003c/em\u003e\u0026lt;0.05 was considered to be locally inconsistent. Since this study involved quantitative data and different studies used different outcome measurement tools, the standardized mean difference (SMD) and its 95% confidence interval (CI) were used to express it. If the 95% CI did not contain 0, it was considered to be statistically different. The effect size of the intervention was ranked according to the surface under the cumulative ranking (SUCRA). The larger the SUCRA, the better the efficacy of the intervention. Funnel plots were used to assess the variation and potential bias between studies.\u003c/p\u003e"},{"header":"2. Results","content":"\u003cp\u003e2.1 Literature search results\u003c/p\u003e\n\u003cp\u003eA total of 2824 relevant articles were obtained in the initial review. After reviewing the titles, abstracts and duplicate articles, 174 articles remained. After repeated inspection and full-text reading, 20 studies were finally included in the network meta-analysis, including 2355 patients. The steps of the literature search are shown in Figure 1.\u003c/p\u003e\n\u003cp\u003e2.2 Basic characteristics of included studies\u003c/p\u003e\n\u003cp\u003eAmong the included literature, 7 were Chinese\u0026nbsp;[13-19]and 13 were English[20-32], involving 13 interventions, including meaning therapy, narrative nursing, life review therapy, nursing plan based on humanistic care, psychotherapy, multidisciplinary intervention, body-mind-psychology group therapy, massage therapy, dignity therapy, mindfulness therapy, palliative care and health education, and routine care. The basic characteristics of the included literature are shown in Table 1.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1 \u0026nbsp;Description of included studies (n=20)\u003c/strong\u003e\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"748\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 14.9533%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFirst author\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.94526%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCountry\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.00801%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYear\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.2777%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSample\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.1495%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eComparison\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.8224%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency and each duration\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.749%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal intervention duration\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.0948%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOutcome indicators\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(Life significance measurement scale)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 14.9533%;\"\u003e\n \u003cp\u003eMing Xing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.94526%;\"\u003e\n \u003cp\u003eChina\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.00801%;\"\u003e\n \u003cp\u003e2017\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.2777%;\"\u003e\n \u003cp\u003e18/20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.1495%;\"\u003e\n \u003cp\u003eMCP/CAU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.8224%;\"\u003e\n \u003cp\u003eEach time \u0026le;40min; interval 1~2d\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.749%;\"\u003e\n \u003cp\u003e\u0026le;6d\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.0948%;\"\u003e\n \u003cp\u003eMeaning of Life Scale for Advanced Cancer Patients (Compiled by Wu Yongsheng)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 14.9533%;\"\u003e\n \u003cp\u003eZhu Yufen\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.94526%;\"\u003e\n \u003cp\u003eChina\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.00801%;\"\u003e\n \u003cp\u003e2020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.2777%;\"\u003e\n \u003cp\u003e57/62\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.1495%;\"\u003e\n \u003cp\u003eMCP/CAU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.8224%;\"\u003e\n \u003cp\u003e40-50minutes each time, once a week\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.749%;\"\u003e\n \u003cp\u003e3 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.0948%;\"\u003e\n \u003cp\u003eMeaning of Life Scale (MiLS) for Advanced Cancer Patients\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 14.9533%;\"\u003e\n \u003cp\u003eZhang Jinmei\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.94526%;\"\u003e\n \u003cp\u003eChina\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.00801%;\"\u003e\n \u003cp\u003e2022\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.2777%;\"\u003e\n \u003cp\u003e42/40\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.1495%;\"\u003e\n \u003cp\u003eNN/CAU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.8224%;\"\u003e\n \u003cp\u003eDuring hospitalization: \u0026lt;1h each time, 5 times in total, follow-up for 3 weeks after discharge, 30min/time, online supervision once a week\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.749%;\"\u003e\n \u003cp\u003eDuring hospitalization\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.0948%;\"\u003e\n \u003cp\u003eMeaning of Life Scale for Advanced Cancer Patients (Compiled by Wu Yongsheng)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 14.9533%;\"\u003e\n \u003cp\u003eChen Ying\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.94526%;\"\u003e\n \u003cp\u003eChina\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.00801%;\"\u003e\n \u003cp\u003e2020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.2777%;\"\u003e\n \u003cp\u003e40/44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.1495%;\"\u003e\n \u003cp\u003eLRI/CAU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.8224%;\"\u003e\n \u003cp\u003eFour meetings in total，Each time \u0026ge; 45-60 minutes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.749%;\"\u003e\n \u003cp\u003e2 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.0948%;\"\u003e\n \u003cp\u003eThe Meaning in Life Questionnaire\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 14.9533%;\"\u003e\n \u003cp\u003eGamze\u0026nbsp;Teskereci,\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.94526%;\"\u003e\n \u003cp\u003eTurkey\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.00801%;\"\u003e\n \u003cp\u003e2022\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.2777%;\"\u003e\n \u003cp\u003e26/26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.1495%;\"\u003e\n \u003cp\u003eTHC/CAU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.8224%;\"\u003e\n \u003cp\u003eFive meetings in total，Each time\u0026nbsp;：\u0026nbsp;60-120 minutes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.749%;\"\u003e\n \u003cp\u003e5 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.0948%;\"\u003e\n \u003cp\u003eLife Attitudes Questionnaire (LAP)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 14.9533%;\"\u003e\n \u003cp\u003eJulienne E Bower\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.94526%;\"\u003e\n \u003cp\u003e\u0026nbsp;America\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.00801%;\"\u003e\n \u003cp\u003e2023\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.2777%;\"\u003e\n \u003cp\u003e85/81/81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.1495%;\"\u003e\n \u003cp\u003eMT/EDU/CAU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.8224%;\"\u003e\n \u003cp\u003e2h/time, once a week\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.749%;\"\u003e\n \u003cp\u003e6 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.0948%;\"\u003e\n \u003cp\u003emeaning and peace subscale of the FACIT-Spiritual scale\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 14.9533%;\"\u003e\n \u003cp\u003eKaren Holtmaat\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.94526%;\"\u003e\n \u003cp\u003eHolland\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.00801%;\"\u003e\n \u003cp\u003e2020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.2777%;\"\u003e\n \u003cp\u003e50/49/47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.1495%;\"\u003e\n \u003cp\u003eMCP/PSY/CAU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.8224%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2h/week, 8 times in total\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.749%;\"\u003e\n \u003cp\u003e8 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.0948%;\"\u003e\n \u003cp\u003ethe Personal Meaning Profile\u0026nbsp;（PMP）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 14.9533%;\"\u003e\n \u003cp\u003eKatherine M Piderman\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.94526%;\"\u003e\n \u003cp\u003eAmerica\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.00801%;\"\u003e\n \u003cp\u003e2014\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.2777%;\"\u003e\n \u003cp\u003e54/63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.1495%;\"\u003e\n \u003cp\u003eMUL/CAU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.8224%;\"\u003e\n \u003cp\u003e90min/time，6 times in total\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.749%;\"\u003e\n \u003cp\u003e4 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.0948%;\"\u003e\n \u003cp\u003eFACIT-Sp\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 14.9533%;\"\u003e\n \u003cp\u003eFei-Hsiu Hsiao\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.94526%;\"\u003e\n \u003cp\u003eChina,Taiwan\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.00801%;\"\u003e\n \u003cp\u003e2021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.2777%;\"\u003e\n \u003cp\u003e18/18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.1495%;\"\u003e\n \u003cp\u003eBMS/CAU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.8224%;\"\u003e\n \u003cp\u003e120min/1 time/week, 8 times in total\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.749%;\"\u003e\n \u003cp\u003e8 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.0948%;\"\u003e\n \u003cp\u003eMeaning of Life Questionnaire (MLQ)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 14.9533%;\"\u003e\n \u003cp\u003ePessin H\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.94526%;\"\u003e\n \u003cp\u003eAmerica\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.00801%;\"\u003e\n \u003cp\u003e2018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.2777%;\"\u003e\n \u003cp\u003e109/108/104\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.1495%;\"\u003e\n \u003cp\u003eMCP/PSY/CAU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.8224%;\"\u003e\n \u003cp\u003e7 courses in total\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.749%;\"\u003e\n \u003cp\u003e2 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.0948%;\"\u003e\n \u003cp\u003ethe Life Attitude Profile\u0026ndash;\u003c/p\u003e\n \u003cp\u003eRevised\u0026nbsp;（LAP-R）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 14.9533%;\"\u003e\n \u003cp\u003eRosenfeld B\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.94526%;\"\u003e\n \u003cp\u003eAmerica\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.00801%;\"\u003e\n \u003cp\u003e2010\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.2777%;\"\u003e\n \u003cp\u003e35/20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.1495%;\"\u003e\n \u003cp\u003eMCP/PSY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.8224%;\"\u003e\n \u003cp\u003e90 minutes/time, once a week\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.749%;\"\u003e\n \u003cp\u003e8 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.0948%;\"\u003e\n \u003cp\u003eFACIT-Sp\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 14.9533%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.94526%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.00801%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.2777%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.1495%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.8224%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.749%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.0948%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 14.9533%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFirst author\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.94526%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCountry\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.00801%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYear\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.2777%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSample\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.1495%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eComparison\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.8224%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency and each duration\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.749%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal intervention duration\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.0948%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOutcome indicators\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(Life significance measurement scale)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 14.9533%;\"\u003e\n \u003cp\u003eBreitbart W\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.94526%;\"\u003e\n \u003cp\u003eAmerica\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.00801%;\"\u003e\n \u003cp\u003e2015\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.2777%;\"\u003e\n \u003cp\u003e69/58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.1495%;\"\u003e\n \u003cp\u003eMCP/PSY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.8224%;\"\u003e\n \u003cp\u003e90 minutes/time, once a week\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.749%;\"\u003e\n \u003cp\u003e8 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.0948%;\"\u003e\n \u003cp\u003eFACIT-Sp\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 14.9533%;\"\u003e\n \u003cp\u003e\u0026nbsp;Poppito S\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.94526%;\"\u003e\n \u003cp\u003eAmerica\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.00801%;\"\u003e\n \u003cp\u003e2012\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.2777%;\"\u003e\n \u003cp\u003e41/37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.1495%;\"\u003e\n \u003cp\u003eMCP/TM\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.8224%;\"\u003e\n \u003cp\u003e1h/1 time/week\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.749%;\"\u003e\n \u003cp\u003e7 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.0948%;\"\u003e\n \u003cp\u003eFACIT-Sp\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 14.9533%;\"\u003e\n \u003cp\u003eMelissa Henry\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.94526%;\"\u003e\n \u003cp\u003eCanada\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.00801%;\"\u003e\n \u003cp\u003e2010\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.2777%;\"\u003e\n \u003cp\u003e12/12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.1495%;\"\u003e\n \u003cp\u003eMCP/CAU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.8224%;\"\u003e\n \u003cp\u003eFour meetings in total，Each time\u0026nbsp;：30-90min\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.749%;\"\u003e\n \u003cp\u003e\u0026ge;2 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.0948%;\"\u003e\n \u003cp\u003eFACIT-Sp\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 14.9533%;\"\u003e\n \u003cp\u003eJulienne E Bower\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.94526%;\"\u003e\n \u003cp\u003eAmerica\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.00801%;\"\u003e\n \u003cp\u003e2015\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8.2777%;\"\u003e\n \u003cp\u003e39/32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.1495%;\"\u003e\n \u003cp\u003eMT/CAU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.8224%;\"\u003e\n \u003cp\u003e2h/time，6 times/week\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.749%;\"\u003e\n \u003cp\u003e6 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.0948%;\"\u003e\n \u003cp\u003eFACIT-Sp\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 14.9533%;\"\u003e\n \u003cp\u003eMichiyo Ando\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.94526%;\"\u003e\n \u003cp\u003eJapan\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.00801%;\"\u003e\n \u003cp\u003e2010\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8.2777%;\"\u003e\n \u003cp\u003e34/34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.1495%;\"\u003e\n \u003cp\u003eLRI/CAU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.8224%;\"\u003e\n \u003cp\u003e30~60min/time，Two times in total, one week apart\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.749%;\"\u003e\n \u003cp\u003e1 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21.0948%;\"\u003e\n \u003cp\u003eFACIT-Sp\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 14.9533%;\"\u003e\n \u003cp\u003eEsther Mok\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8.94526%;\"\u003e\n \u003cp\u003eHong Kong\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.00801%;\"\u003e\n \u003cp\u003e2012\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8.2777%;\"\u003e\n \u003cp\u003e29/29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.1495%;\"\u003e\n \u003cp\u003eMCP/CAU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.8224%;\"\u003e\n \u003cp\u003eThe first time is 30-60 minutes; the second time is 15-30 minutes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.749%;\"\u003e\n \u003cp\u003e2~3days\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21.0948%;\"\u003e\n \u003cp\u003eQuality-of-Life Concerns in the End-of-Life\u0026nbsp;（QOLC-E）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 14.9533%;\"\u003e\n \u003cp\u003eHarvey Max\u0026nbsp;Chochinov\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8.94526%;\"\u003e\n \u003cp\u003eCanada\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.00801%;\"\u003e\n \u003cp\u003e2011\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.2777%;\"\u003e\n \u003cp\u003e108/111/107\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.1495%;\"\u003e\n \u003cp\u003ePSY/DT/PC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.8224%;\"\u003e\n \u003cp\u003eThree times in total, 30 minutes for the first time, 60 minutes for the second time, and 30 minutes for the third time\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.749%;\"\u003e\n \u003cp\u003e7~10 days\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.0948%;\"\u003e\n \u003cp\u003eFACIT-Sp\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 14.9533%;\"\u003e\n \u003cp\u003eXiao Huimin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8.94526%;\"\u003e\n \u003cp\u003eChina\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.00801%;\"\u003e\n \u003cp\u003e2013\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8.2777%;\"\u003e\n \u003cp\u003e35/37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.1495%;\"\u003e\n \u003cp\u003eLRI/CAU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.8224%;\"\u003e\n \u003cp\u003eThe duration of each session depends on the patient\u0026apos;s condition, a total of 3 sessions\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.749%;\"\u003e\n \u003cp\u003e3 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21.0948%;\"\u003e\n \u003cp\u003eQOL（Quality-of-Life）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 14.9533%;\"\u003e\n \u003ch5\u003eGary Rodin\u0026nbsp;\u003c/h5\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8.94526%;\"\u003e\n \u003cp\u003e\u0026nbsp;Canada \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.00801%;\"\u003e\n \u003cp\u003e2018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8.2777%;\"\u003e\n \u003cp\u003e113/121\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.1495%;\"\u003e\n \u003cp\u003eCALM/CAU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.8224%;\"\u003e\n \u003cp\u003e3 to 6 treatments (45 to 60 minutes each) within 3 to 6 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.749%;\"\u003e\n \u003cp\u003e3~6\u003c/p\u003e\n \u003cp\u003emonths\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21.0948%;\"\u003e\n \u003cp\u003eFACIT-Sp\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eNote: CAU: usual care; MCP: logotherapy; NN: narrative nursing; LRI: life review therapy; THC: humanistic care-based care plan; PSY: psychotherapy; MUL: multidisciplinary intervention; BMS: body-mind-psychology group therapy; TM: massage therapy; DT: dignity therapy; MT: mindfulness-based therapy; PC: palliative care; EDU: health education; FACIT-Sp: Functional Assessment of Chronic Illness Treatment-Mental Health Scale.\u003c/p\u003e\n\u003cp\u003e2.3 Assessment of Bias Risk in Included Studies \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAmong the 20 articles included in this study, 4 were rated as Class A[18, 22, 30, 32] and the remaining were Class B. Regarding the generation of random sequences, 6 studies utilized stratified/block randomization; 5 studies employed computer randomization; 7 studies used random number tables, while the remaining 2 studies merely mentioned random grouping of study subjects without detailing the specific allocation methods used. For allocation concealment, 9 articles described the process, with 7 employing sealed envelope methods and 2 using staff independent of the trial groups for allocation; the others did not provide any information. In terms of blinding for study subjects and intervention providers, 5 studies implemented blinding, 2 did not use double blinding, and the remaining studies did not explicitly mention this. Concerning the blinding of outcome assessors, 6 studies clearly stated that different personnel collected the questionnaires, while the remaining studies did not specify the collectors; however, due to the nature of questionnaires, this was determined to be low risk. In terms of data completeness, 16 studies reported instances of sample dropout, but all provided detailed descriptions and conducted intention-to-treat analyses or other statistical descriptions. As shown in Figure 2.\u003c/p\u003e\n\u003cp\u003e2.4 Network Relationship Diagram\u003c/p\u003e\n\u003cp\u003eThe network relationship of different intervention measures is shown in Figure 3. Each dot in the figure represents an intervention method, the size of the dot represents the sample size, and the thickness of the line segment represents the number of studies. The existence of a line segment between two points indicates that there is a direct comparison between the two.\u003c/p\u003e\n\u003cp\u003eIn the network relationship diagram (Figure 3): There are direct or indirect comparisons between different intervention measures at the same time, which meets the basic conditions of network meta-analysis. It can be seen from the figure that the most research subjects participated in conventional care (CAU), and the most comparative studies were conducted between meaning therapy (MCP) and conventional care (CAU).\u003c/p\u003e\n\u003cp\u003e2.5 Results of network meta-analysis\u003c/p\u003e\n\u003cp\u003eThis study reported the effects of 13 different intervention measures on the meaning of life of cancer patients. The results of network meta-analysis showed that compared with the CAU group, MT (SMD=3.77, 95%CI=2.79~4.75), EDU (SMD=2.29, 95%CI=1.10~3.48), LRI (SMD=1.69, 95%CI=0.92~2.46), THC (SMD=1.52, 95%CI=0.16~2.88), and MCP (SMD=0.75, 95%CI=0.27~1.24) had statistically significant intervention effects on the meaning of life of cancer patients. Compared with the MCP group, MT (SMD=3.01, 95%CI=1.92~4.11), EDU (SMD=1.53, 95%CI=0.25~2.82), and LRI (SMD=0.94, 95%CI=0.03~1.85) have been shown to be statistically significant in improving the sense of life meaning in cancer patients. Compared with the PSY group, MT (SMD=3.37, 95%CI=2.17~4.56), EDU (SMD=1.89, 95%CI=0.52~3.26), and LRI (SMD=1.29, 95%CI=0.27~2.32) had statistically significant intervention effects on the sense of life meaning in cancer patients. Compared with the NN group, MUL group, BMS group, and DT group, the EDU group showed a better treatment effect. In addition, compared with EDU, LRI, THC, MCP, TM, PC, NN, MUL, PSY, BMS, DT, and CAU, the treatment effect of the MT group showed the best effect, and the results were statistically significant (p \u0026lt; 0.05), which further proved the unique intervention effect of mindfulness therapy. This intervention method can provide a reference for improving the sense of meaning in life in cancer patients. There was no statistical significance in the comparison between any two other interventions (P \u0026gt; 0.05), as shown in Table 2.\u003c/p\u003e\n\u003cp\u003eTable 2 \u0026nbsp;Network meta-analysis [SMD (95% CI)]\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"790\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003eMT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e1.4\u003c/p\u003e\n \u003cp\u003e(0.30,2.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003eEDU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e2.07\u003c/p\u003e\n \u003cp\u003e(0.83,3.32)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e0.59\u003c/p\u003e\n \u003cp\u003e(-0.82,2.01)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003eLRI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e2.25\u003c/p\u003e\n \u003cp\u003e(0.57,3.92)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e0.77\u003c/p\u003e\n \u003cp\u003e(-1.04,2.57)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e0.17\u003c/p\u003e\n \u003cp\u003e(-1.39,1.74)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003eTHC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e3.01\u003c/p\u003e\n \u003cp\u003e(1.92,4.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e1.53\u003c/p\u003e\n \u003cp\u003e(0.25,2.82)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e0.94\u003c/p\u003e\n \u003cp\u003e(0.03,1.85)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e0.77\u003c/p\u003e\n \u003cp\u003e(-0.68,2.21)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003eMCP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e3.11\u003c/p\u003e\n \u003cp\u003e(1.42,4.80)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e1.63\u003c/p\u003e\n \u003cp\u003e(-0.19,3.45)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e1.04\u003c/p\u003e\n \u003cp\u003e(-0.54,2.61)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e0.86\u003c/p\u003e\n \u003cp\u003e(-1.07,2.80)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e0.10\u003c/p\u003e\n \u003cp\u003e(-1.19,1.39)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003eTM\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e3.27\u003c/p\u003e\n \u003cp\u003e(1.55,4.99)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e1.79\u003c/p\u003e\n \u003cp\u003e(-0.06,3.64)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e1.20\u003c/p\u003e\n \u003cp\u003e(-0.41,2.81)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e1.02\u003c/p\u003e\n \u003cp\u003e(-0.94,2.99)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e0.26\u003c/p\u003e\n \u003cp\u003e(-1.12,1.64)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e0.16\u003c/p\u003e\n \u003cp\u003e(-1.73,2.05)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003ePC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e3.28\u003c/p\u003e\n \u003cp\u003e(1.66,4.89)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e1.80\u003c/p\u003e\n \u003cp\u003e(0.04,3.55)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e1.20\u003c/p\u003e\n \u003cp\u003e(-0.30,2.70)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e1.03\u003c/p\u003e\n \u003cp\u003e(-0.84,2.90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e0.26\u003c/p\u003e\n \u003cp\u003e(-1.11,1.64)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e0.17\u003c/p\u003e\n \u003cp\u003e(-1.72,2.05)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e0.01\u003c/p\u003e\n \u003cp\u003e(-1.91,1.92)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003eNN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e3.37\u003c/p\u003e\n \u003cp\u003e(1.77,4.97)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e1.89\u003c/p\u003e\n \u003cp\u003e(0.15,3.62)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e1.29\u003c/p\u003e\n \u003cp\u003e(-0.19,2.77)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e1.12\u003c/p\u003e\n \u003cp\u003e(-0.74,2.98)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e0.35\u003c/p\u003e\n \u003cp\u003e(-1.00,1.71)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e0.26\u003c/p\u003e\n \u003cp\u003e(-1.61,2.13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e0.10\u003c/p\u003e\n \u003cp\u003e(-1.80,1.99)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e0.09\u003c/p\u003e\n \u003cp\u003e(-1.71,1.90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003eMUL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e3.37\u003c/p\u003e\n \u003cp\u003e(2.17,4.56)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e1.89\u003c/p\u003e\n \u003cp\u003e(0.52,3.26)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e1.29\u003c/p\u003e\n \u003cp\u003e(0.27,2.32)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e1.12\u003c/p\u003e\n \u003cp\u003e(-0.40,2.64)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e0.35\u003c/p\u003e\n \u003cp\u003e(-0.25,0.96)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e0.26\u003c/p\u003e\n \u003cp\u003e(-1.17,1.68)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e0.10\u003c/p\u003e\n \u003cp\u003e(-1.14,1.34)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e0.09\u003c/p\u003e\n \u003cp\u003e(-1.37,1.55)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e0.00\u003c/p\u003e\n \u003cp\u003e(-1.44,1.44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003ePSY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e3.42\u003c/p\u003e\n \u003cp\u003e(1.73,5.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e1.94\u003c/p\u003e\n \u003cp\u003e(0.12,3.76)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e1.35\u003c/p\u003e\n \u003cp\u003e(-0.23,2.92)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e1.17\u003c/p\u003e\n \u003cp\u003e(-0.76,3.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e0.41\u003c/p\u003e\n \u003cp\u003e(-1.05,1.87)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e0.31\u003c/p\u003e\n \u003cp\u003e(-1.64,2.26)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e0.15\u003c/p\u003e\n \u003cp\u003e(-1.82,2.12)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e0.14\u003c/p\u003e\n \u003cp\u003e(-1.74,2.03)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003cp\u003e(-1.82,1.92)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003cp\u003e(-1.49,1.59)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003eBMS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e3.43\u003c/p\u003e\n \u003cp\u003e(1.70,5.15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e1.95\u003c/p\u003e\n \u003cp\u003e(0.10,3.79)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e1.35\u003c/p\u003e\n \u003cp\u003e(-0.26,2.96)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e1.18\u003c/p\u003e\n \u003cp\u003e(-0.78,3.14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e0.41\u003c/p\u003e\n \u003cp\u003e(-0.97,1.79)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e0.32\u003c/p\u003e\n \u003cp\u003e(-1.57,2.20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e0.16\u003c/p\u003e\n \u003cp\u003e(-1.08,1.39)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e0.15\u003c/p\u003e\n \u003cp\u003e(-1.76,2.06)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e0.06\u003c/p\u003e\n \u003cp\u003e(-1.84,1.96)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e0.06\u003c/p\u003e\n \u003cp\u003e(-1.18,1.30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e0.01\u003c/p\u003e\n \u003cp\u003e(-1.97,1.98)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003eDT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e3.77\u003c/p\u003e\n \u003cp\u003e(2.79,4.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e2.29\u003c/p\u003e\n \u003cp\u003e(1.10,3.48)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e1.69\u003c/p\u003e\n \u003cp\u003e(0.92,2.46)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e1.52\u003c/p\u003e\n \u003cp\u003e(0.16,2.88)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e0.75\u003c/p\u003e\n \u003cp\u003e(0.27,1.24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e0.66\u003c/p\u003e\n \u003cp\u003e(-0.72,2.03)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e0.50\u003c/p\u003e\n \u003cp\u003e(-0.92,1.91)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e0.49\u003c/p\u003e\n \u003cp\u003e(-0.80,1.78)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e0.40\u003c/p\u003e\n \u003cp\u003e(-0.87,1.66)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e0.40\u003c/p\u003e\n \u003cp\u003e(-0.28,1.08)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e0.35\u003c/p\u003e\n \u003cp\u003e(-1.03,1.72)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003e0.34\u003c/p\u003e\n \u003cp\u003e(-1.07,1.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.69231%;\"\u003e\n \u003cp\u003eCAU\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e2.6 Consistency test\u003c/p\u003e\n\u003cp\u003eIn this study, the meaning of life of cancer patients was used as the outcome indicator. The results of the inconsistency model test were: P=0.4915 (P\u0026gt;0.05), indicating that the overall inconsistency of the outcome indicator was not significant; the node splitting method was used for local inconsistency test, and the results showed that there was no local inconsistency between the direct comparison and indirect comparison of the outcome indicators (P\u0026gt;0.05), indicating that the consistency between all groups was good.\u003c/p\u003e\n\u003cp\u003e2.7 SUCRA result ranking\u003c/p\u003e\n\u003cp\u003eThe SUCRA value of each intervention measure represents the probability of each intervention measure being the best intervention. The results show that the intervention effects of different intervention measures on the meaning of life of cancer patients are ranked as follows: mindfulness therapy \u0026gt; health education \u0026gt; life review therapy \u0026gt; nursing plan based on humanistic care \u0026gt; meaning therapy \u0026gt; massage therapy \u0026gt; palliative care \u0026gt; narrative nursing \u0026gt; multidisciplinary intervention \u0026gt; psychotherapy \u0026gt; body-mind-psychology group therapy \u0026gt; dignity therapy \u0026gt; conventional care, see Table 3 and Figure 4. The results show that mindfulness therapy is the most effective intervention measure to improve the meaning of life of cancer patients, suggesting that conventional care is the least effective intervention measure to improve the meaning of life of cancer patients.\u003c/p\u003e\n\u003cp\u003eTable 3 \u0026nbsp;The ordering results of network meta-analysis\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"795\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 19.8594%;\"\u003e\n \u003cp\u003eID and rank\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003eTreatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003eSUCRA（%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003ePrBest\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003eMeanRank\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 19.8594%;\"\u003e\n \u003cp\u003eBest\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003eMT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003e99.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003e98.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003e1.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 19.8594%;\"\u003e\n \u003cp\u003e2nd\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003eEDU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003e87.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003e0.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003e2.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 19.8594%;\"\u003e\n \u003cp\u003e3rd\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003eLRI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003e78.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003e3.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 19.8594%;\"\u003e\n \u003cp\u003e4th\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003eTHC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003e71.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003e0.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003e4.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 19.8594%;\"\u003e\n \u003cp\u003e5th\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003eMCP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003e49.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003e7.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 19.8594%;\"\u003e\n \u003cp\u003e6th\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003eTM\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003e43.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003e7.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 19.8594%;\"\u003e\n \u003cp\u003e7th\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003ePC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003e38.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003e8.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 19.8594%;\"\u003e\n \u003cp\u003e8th\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003eNN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003e37.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003e8.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 19.8594%;\"\u003e\n \u003cp\u003e9th\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003eMUL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003e34.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003e8.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 19.8594%;\"\u003e\n \u003cp\u003e10th\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003ePSY\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003e32.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003e9.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 19.8594%;\"\u003e\n \u003cp\u003e10th\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003eBMS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003e32.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003e9.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 19.8594%;\"\u003e\n \u003cp\u003e11th\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003eDT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003e31.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003e9.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 19.8594%;\"\u003e\n \u003cp\u003e12th\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003eCAU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003e13.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.0351%;\"\u003e\n \u003cp\u003e11.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e2.8 Publication bias test\u003c/p\u003e\n\u003cp\u003eThe results of publication bias are presented using a corrected comparative funnel plot. The dots in the funnel plot represent the results of direct comparisons of different studies, the red vertical line represents the combined effect value, and the dotted line represents the 95% confidence interval. Figure 5 shows the publication bias results of the meaning of life score after different intervention measures. The points are basically symmetrically distributed around the red vertical line. Seven points fall outside the funnel, which may indicate publication bias. One point falls at the bottom of the funnel, which may indicate a very small sample effect.\u003c/p\u003e"},{"header":"3. Discussion","content":"\u003cp\u003eThe meaning of life is an individual\u0026rsquo;s perception and understanding of life goals and values. For cancer patients, this perception may be changed by the disease. Due to the invasion of the disease and the difficult treatment process, patients may experience depression, despair, and helplessness, leading them to question the meaning and value of life. Various measures aimed at improving the meaning of life of cancer patients have been carried out at home and abroad. These measures cover psychological, social, spiritual and therapeutic levels. The purpose is to help cancer patients rediscover the goals and values of life and improve their quality of life[\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. How medical staff choose the most effective, simple and easy method among various intervention measures is a key issue in clinical work. This will help achieve efficient care in the process of providing continuous meaning-of-life intervention to patients, thereby significantly improving patients' sense of meaning in life.\u003c/p\u003e \u003cp\u003eThe results of this study show that compared with other intervention methods, mindfulness therapy has the best effect on improving the sense of meaning in life of cancer patients. Studies have shown that some cancer patients experience positive psychological changes and growth during the anti-cancer process. This experience and growth can improve the patient's negative psychological state, enhance their life perception, and thus promote the quality of life of cancer patients[\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e].Mindfulness-based therapy originates from the Buddhist tradition. It is a psychotherapy method centered on mindfulness, emphasizing attention to current cognition, thoughts, and emotions, and not judging or reacting to anything[\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e].Mindfulness therapy mainly relieves depression, anxiety and other related symptoms by affecting the two major systems of cognition and emotion[\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e]. First, mindfulness practice regulates cognition through three brain networks[\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e], namely: the central executive network (CEN), the salience network (CN) and the default mode network (DMN). Systematic mindfulness practice can enable patients to focus on the present, improve their attention, and have a more correct and clear understanding of their own situation[\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e]. Secondly, mindfulness therapy can regulate the emotional system and play a role by helping patients regulate their emotions[\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e].The four key ways of regulating emotions through mindfulness are to enhance emotional awareness, change emotional responses, promote cognitive reappraisal, and change reward processing. It helps patients observe their own situations, strengthen their scrutiny of their own symptoms and emotions, and thus increase their ability to manage negative emotions[\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]. As an economical, convenient, and easy-to-master psychological therapy, mindfulness encourages cancer patients to accept changes in their lives and turn to accepting loss and sadness rather than fighting symptoms. This acceptance is not the same as giving up, but rather acknowledging reality, prompting patients to look at their experiences from a new perspective. Through observation and reflection, patients can recognize that pain is just a constantly changing psychological event, thereby feeling the support of being connected to others and gaining energy and motivation in life[\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e]. Studies at home and abroad have shown that mindfulness therapy can effectively help cancer patients deal with their emotional problems more peacefully and accept the discomfort during treatment more quickly, such as anxiety, depression, low morale and other negative emotions, fatigue, weakness, pain and other related symptoms, thereby improving patients' ability to act, improving interpersonal relationships, helping them build self-confidence, preparing for future actions, and increasing their hope for life[\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e, \u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e]. At the same time, studies have shown that mindfulness-based intervention therapy can reduce patients\u0026rsquo; psychological distress and promote their mental health[\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e]. In view of this, according to the patient\u0026rsquo;s age, education level, and understanding level, we can help patients conduct mindfulness training with an appropriate intervention duration and easy to understand, so as to alleviate the physical and mental problems of cancer patients, face the disease and life with a more positive and optimistic attitude, and promote the meaning of their life.\u003c/p\u003e \u003cp\u003eThe results of the meta-analysis and the results of the ranking cumulative probability diagram show that, in addition to mindfulness therapy, health education and life review therapy can also improve the sense of meaning in life of cancer patients, and are superior to other intervention measures. Previous studies have shown that health education interventions related to the meaning of life can deepen patients' correct understanding of the disease and relieve negative emotions. The analysis results of Bower showed that health education can improve patients' depression after 6 months of intervention, but there are currently no studies in China to explain its long-term efficacy[\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. In the future, it is recommended that researchers pay more attention to the duration of health education interventions, and evaluate the medium- and long-term intervention effects of health education by extending the intervention time. At the same time, traditional health education models should be innovated to improve patients' treatment compliance and promote intervention effects.\u003c/p\u003e \u003cp\u003eUnlike mindfulness therapy, life review is a psychotherapy method that focuses on reconstructing self-identity and promoting mental health by reviewing and integrating past experiences, thereby discovering the meaning of life. Chen Ying et al. [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]showed that life review can help cancer patients undergoing chemotherapy regain hope in life and improve their sense of meaning in life; Li Jiangyan[\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e]believes that cancer patients can gain new values and hope through life review, achieve the integration of life meaning, face death, and improve the quality of life and dignity at the end of their lives; Ando[\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]found that short-term life review can not only improve the mental health of advanced cancer patients, but also alleviate their social and psychological distress. However, the application of life review therapy in China started relatively late, and there are relatively few intervention studies on cancer patients. In addition, there are certain deficiencies in the design and implementation steps of existing studies. Therefore, it is necessary to conduct rigorously designed, large-sample, multi-center studies to further confirm its effectiveness.\u003c/p\u003e \u003cp\u003eIn addition, the results of this study showed that the difference between nursing plans based on humanistic care and meaning therapy and conventional care was also statistically significant. A foreign study showed[\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]that nursing plans based on humanistic care theory may help reduce the frequency and discomfort of chemotherapy for breast cancer patients and improve their hope and meaning in life. At present, there is no relevant research in China. There are many studies on meaning therapy. Analysis of domestic and foreign studies[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]showed that through meaning therapy, cancer patients can re-understand themselves, tap their potential, find the meaning of life, and thus improve their quality of life. At the same time, it can also effectively reduce the occurrence of related complications and improve treatment compliance. However, there is no statistically significant difference between massage therapy, palliative care, narrative care, multidisciplinary intervention, psychotherapy, body-mind-psychology group therapy, dignity therapy and other interventions and conventional care. After excluding low-quality literature, this meta-analysis can include fewer studies, and its effectiveness in improving the sense of meaning in life of cancer patients cannot be confirmed. Therefore, high-quality original research or systematic evaluation of the above interventions based on evidence-based thinking is needed in the future to verify its credibility.\u003c/p\u003e"},{"header":"4. Limitation","content":"\u003cp\u003eHowever, this study has the following limitations: ① Only some of the included studies used blinding, which may have implementation and measurement bias; ② This study excluded low-quality studies and only conducted a meta-analysis of studies with quality evaluation grades A and B, resulting in a small number of included literature on some intervention methods, which may have publication bias; ③ Although the included research subjects were all cancer patients, the results may have certain heterogeneity due to differences in cancer type, stage, medical level, and intervention programs. In the later stage, high-quality, large-sample original research can be carried out, and intervention programs to enhance the sense of life meaning of cancer patients can be formulated based on evidence-based evidence.\u003c/p\u003e"},{"header":"5. Conclusion","content":"\u003cp\u003eTo sum up, this study included 20 studies. Although various intervention methods can improve the sense of life meaning of cancer patients to varying degrees, combined with the results of this network meta-analysis, mindfulness therapy is an intervention method with a relatively ideal effect in improving the sense of life meaning of cancer patients. It is recommended that in the future, when selecting intervention plans for patients in clinical practice, medical staff should consider the actual needs, personal wishes and application scenarios of patients while referring to evidence-based evidence. In addition, given that the sense of life meaning is constantly changing, long-term longitudinal follow-up studies need to be carried out from a more macro perspective in the future to explore the long-term intervention effects of various intervention measures on the meaning of life of patients.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFudan University under the registration number: ES20220915.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll of the authors had no any personal, financial, commercial, or academic conflicts of interest separately.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was funded by General Project of Sichuan Aging Enterprise and Industrial Development Research Center 2023 (No. XJLL2023020);2022 Sichuan Provincial Medical Scientific Research Project Plan (No. S22059).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors’ contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eXY-Z, WN-L: designed the research topic, performed literature screening, quality assessment and data analysis, and wrote and translated the manuscript. P-Y: performed literature search, analyzed data, and made written revisions to the manuscript. YY-Z, T-F, M-W: performed literature search and revised the manuscript. L-W, PP-L: collated the data and participated in the translation of the manuscript. LM-Z: guided the entire study design and manuscript writing process and made revision suggestions. All authors agreed to submit the final version.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors thank all the participants in this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor details\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e1\u003c/sup\u003eSchool of Nursing, Chengdu Medical College, Chengdu, Sichuan 610500, China.\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e2\u003c/sup\u003eThe First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan 610500,China.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDisclosure\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eXiaoying Zhong, Weinan Lu, and Ping Yuan are co-first authors, Limei Zhang is the corresponding author.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eZheng RS, Chen R, Han BF, Wang SM, Li L, Sun KX, Zeng HM, Wei WW, He J: \u003cstrong\u003eCancer incidence and mortality in China, 2022\u003c/strong\u003e. \u003cem\u003eChinese journal of oncology\u003c/em\u003e 2024, \u003cstrong\u003e46\u003c/strong\u003e(3):221-231.\u003c/li\u003e\n \u003cli\u003eYanbo J, Na L, Hongmei L: \u003cstrong\u003eRelationships among symptom distress, psychological resilience, andpositive emotions in cancer patients\u003c/strong\u003e. \u003cem\u003eChinese Nursing Research\u003c/em\u003e 2017, \u003cstrong\u003e10\u003c/strong\u003e(31):1193-1197.\u003c/li\u003e\n \u003cli\u003eAbbey G, Thompson SB, Hickish T, Heathcote D: \u003cstrong\u003eA meta-analysis of prevalence rates and moderating factors for cancer-related post-traumatic stress disorder\u003c/strong\u003e. \u003cem\u003ePSYCHO-ONCOLOGY\u003c/em\u003e 2015, \u003cstrong\u003e24\u003c/strong\u003e(4):371-381.\u003c/li\u003e\n \u003cli\u003eCaruso R, Nanni MG, Riba MB, Sabato S, Grassi L: \u003cstrong\u003eThe burden of psychosocial morbidity related to cancer: patient and family issues\u003c/strong\u003e. \u003cem\u003eINT REV PSYCHIATR\u003c/em\u003e 2017, \u003cstrong\u003e29\u003c/strong\u003e(5):389-402.\u003c/li\u003e\n \u003cli\u003eFrankl VE: \u003cem\u003eSearch for meaning\u003c/em\u003e: Mount Mary College Milwaukee, WI, USA; 1984.\u003c/li\u003e\n \u003cli\u003eFrankl VE: \u003cem\u003eThe Will to Meaning\u003c/em\u003e. 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Statistical analysis was performed using Stata 16.0 software. This study has been approved by the Evidence-Based Nursing Center of Fudan University, registration number: ES20220915. \u003cstrong\u003eResults\u003c/strong\u003e A total of 20 studies were included, with 2,355 subjects and 13 types of interventions. The network meta-analysis showed that compared to conventional nursing, mindfulness therapy, health education, life review therapy, humanistic care-based nursing programs, and meaning therapy could all enhance the sense of meaning in life for cancer patients. The ranking probability indicated that mindfulness therapy was the most effective intervention, followed by health education and life review therapy.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion \u003c/strong\u003eCurrent evidence suggests that mindfulness therapy is the best intervention method for enhancing the sense of meaning in life for cancer patients. Therefore, healthcare providers should encourage and guide patients to engage in mindfulness training to improve their sense of meaning in life, enhance their physical and mental state, improve treatment outcomes and quality of life, and face life positively.\u003c/p\u003e","manuscriptTitle":"Effects of Different Intervention Methods on Improving the Sense of Life Meaning in Cancer Patients: a Network Meta-analysis","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-11-20 12:03:52","doi":"10.21203/rs.3.rs-5343754/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"b094f57f-f772-400e-94c1-3db8521c3262","owner":[],"postedDate":"November 20th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-12-22T21:53:09+00:00","versionOfRecord":[],"versionCreatedAt":"2024-11-20 12:03:52","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5343754","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5343754","identity":"rs-5343754","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}