Background: Understanding the state of the science linking meaning, purpose, and spirituality (MPS) to health outcomes is key to advancing the integration of MPS into lifestyle medicine. Objective: This review aimed to summarize existing research on the use of MPS in lifestyle medicine and healthcare, emphasizing gaps and proposing directions for future research. Methods: A narrative literature review of articles abstracted in PubMed was conducted in conjunction with an in-person summit on MPS and lifestyle medicine in March 2025. This narrative review was organized around the existing science linking MPS to health outcomes, measures of MPS, potential mechanisms accounting for the links between MPS and health outcomes, MPS interventions, potential moderators of the effects, and directions for future research. Results: There are consistent, small to moderate effects that link MPS to increased longevity, improved physical and mental health, and better well-being. Several psychometrically supported measures of MPS exist. Interventions incorporating MPS, especially for populations with advanced illnesses, show promise to improve health and well-being. MPS likely contributes to health through several biopsychosocial pathways. Conclusion: Future work is needed to examine the impact of implementing MPS into lifestyle medicine practice, using rigorous methods, and evaluating its effect on patient outcomes.
GeorgeLSParkCL. Meaning in life as comprehension, purpose, and mattering: toward integration and new research questions. Rev Gen Psychol. 2016;20(3):205-220. doi:10.1037/gpr0000077
2.
McKnightPEKashdanTB. Purpose in life as a system that creates and sustains health and Well-Being: an integrative, testable theory. Rev Gen Psychol. 2009;13(3):242-251. doi:10.1037/a0017152
3.
KashdanTBGoodmanFRMcKnightPEBrownBRumR. Purpose in life: a resolution on the definition, conceptual model, and optimal measurement. Am Psychol. 2023;79:838-853. doi:10.1037/amp0001223
4.
BalboniTAVanderWeeleTJDoan-SoaresSD, et al.Spirituality in serious illness and health. JAMA. 2022;328(2):184-197. doi:10.1001/jama.2022.11086
5.
PuchalskiCMVitilloRHullSKRellerN. Improving the spiritual dimension of whole person care: reaching national and international consensus. J Palliat Med. 2014;17(6):642-656. doi:10.1089/jpm.2014.9427
6.
LongKNGSymonsXVanderWeeleTJ, et al.Spirituality as A determinant of health: emerging policies, practices, and systems. Health Aff. 2024;43(6):783-790. doi:10.1377/hlthaff.2023.01643
7.
KimESChenYNakamuraJSRyffCDVanderWeeleTJ. Sense of purpose in life and subsequent physical, behavioral, and psychosocial health: an outcome-wide approach. Am J Health Promot. 2022;36(1):137-147. doi:10.1177/08901171211038545
8.
ShibaKKubzanskyLDWilliamsDRVanderWeeleTJKimES. Purpose in life and 8-year mortality by gender and race/ethnicity among older adults in the U.S. Prev Med. 2022;164:107310. doi:10.1016/j.ypmed.2022.107310
9.
KimESStrecherVJRyffCD. Purpose in life and use of preventive health care services. Proc Natl Acad Sci U S A. 2014;111(46):16331-16336. doi:10.1073/pnas.1414826111
10.
AftabALeeEEKlausF, et al.Meaning in life and its relationship with physical, mental, and cognitive functioning: a Study of 1,042 community-dwelling adults across the lifespan. J Clin Psychiatry. 2019;81(1):19m13064. doi:10.4088/JCP.19m13064
11.
RippeJM. Lifestyle medicine: the health promoting power of daily habits and practices. Am J Lifestyle Med. 2018;12(6):499-512. doi:10.1177/1559827618785554
12.
LippmanDStumpMVeazeyE, et al.Foundations of lifestyle medicine and its evolution. Mayo Clin Proc Innov Qual Outcomes. 2024;8(1):97-111. doi:10.1016/j.mayocpiqo.2023.11.004
13.
MerloGSnellmanLSugdenSG. Connectedness: the updated and expanded pillar of lifestyle psychiatry and lifestyle medicine. Am J Lifestyle Med. 2025;19(8):15598276251345455. doi:10.1177/15598276251345455
14.
PollardKJGittelsohnJPatelP, et al.Lifestyle medicine practitioners implementing a greater proportion of lifestyle medicine experience less burnout. Am J Health Promot. 2023;37(8):1121-1132. doi:10.1177/08901171231182875
15.
OuzzaniMHammadyHFedorowiczZElmagarmidA. Rayyan-a web and mobile app for systematic reviews. Syst Rev. 2016;5(1):210. doi:10.1186/s13643-016-0384-4
16.
AlimujiangAWienschABossJ, et al.Association between life purpose and mortality among US adults older than 50 years. JAMA Netw Open. 2019;2(5):e194270. doi:10.1001/jamanetworkopen.2019.4270
17.
ShibaKKubzanskyLDWilliamsDRVanderWeeleTJKimES. Associations between purpose in life and mortality by SES. Am J Prev Med. 2021;61(2):e53-e61. doi:10.1016/j.amepre.2021.02.011
18.
CohenRBavishiCRozanskiA. Purpose in life and its relationship to all-cause mortality and cardiovascular events: a meta-analysis. Psychosom Med. 2016;78(2):122-133.
19.
MusichSWangSSKraemerSHawkinsKWickerE. Purpose in life and positive health outcomes among older adults. Popul Health Manag. 2018;21(2):139-147. doi:10.1089/pop.2017.0063
20.
KimESDelaneySWKubzanskyLD. Sense of purpose in life and cardiovascular disease: underlying mechanisms and future directions. Curr Cardiol Rep. 2019;21(11):135. doi:10.1007/s11886-019-1222-9
21.
LewisNAHoferSMBennettDAHillPL. Sense of purpose in life and extending the cognitive healthspan: evidence from multistate survival modeling. Aging Neuropsychol Cognit. 2025;32(2):237-251. doi:10.1080/13825585.2024.2373846
22.
BoylePABuchmanASBarnesLLBennettDA. Effect of a purpose in life on risk of incident Alzheimer disease and mild cognitive impairment in community-dwelling older persons. Arch Gen Psychiatry. 2010;67(3):304-310. doi:10.1001/archgenpsychiatry.2009.208
23.
SutinDARLuchettiMAschwandenDStephanYSeskerAATerraccianoA. Sense of meaning and purpose in life and risk of incident dementia: new data and meta-analysis. Arch Gerontol Geriatr. 2023;105:104847. doi:10.1016/j.archger.2022.104847
24.
StegerMFMannJRMichelsPCooperTC. Meaning in life, anxiety, depression, and general health among smoking cessation patients. J Psychosom Res. 2009;67(4):353-358. doi:10.1016/j.jpsychores.2009.02.006
25.
Van der HeydenKDezutterJBeyersW. Meaning in life and depressive symptoms: a person-oriented approach in residential and community-dwelling older adults. Aging Ment Health. 2015;19(12):1063-1070. doi:10.1080/13607863.2014.995589
26.
MorseJLLuongGPrinceMAStegerMF. Disentangling trait and daily experiences of uncertainty and meaning in life: implications for daily anxiety, negative affect, and somatic symptoms. Anxiety Stress Coping. 2024;37(1):127-142. doi:10.1080/10615806.2023.2201000
27.
HeX-XWangX-QStegerMF, et al.Meaning in life and psychological distress: a meta-analysis. J Res Pers. 2023;104:104381. doi:10.1016/j.jrp.2023.104381
28.
OstafinBDProulxT. Meaning in life and resilience to stressors. Anxiety Stress Coping. 2020;33(6):603-622. doi:10.1080/10615806.2020.1800655
29.
DewitteLDezutterJ. Meaning reflectivity in later life: the relationship between reflecting on meaning in life, presence and search for meaning, and depressive symptoms in older adults over the Age of 75. Front Psychol. 2021;12:726150. doi:10.3389/fpsyg.2021.726150
30.
VosJ. Cardiovascular disease and meaning in life: a systematic literature review and conceptual model. Palliat Support Care. 2021;19(3):367-376. doi:10.1017/S1478951520001261
31.
BernardMBraunschweigGFeggMJBorasioGD. Meaning in life and perceived quality of life in Switzerland: results of a representative survey in the German, French and Italian regions. Health Qual Life Outcomes. 2015;13:160. doi:10.1186/s12955-015-0353-y
32.
KimESKawachiIChenYKubzanskyLD. Association between purpose in life and objective measures of physical function in older adults. JAMA Psychiatry. 2017;74(10):1039-1045. doi:10.1001/jamapsychiatry.2017.2145
33.
SutinARLuchettiMStephanYCanadaBTerraccianoA. Purpose in life and risk of Falls: a meta-analysis of cross-sectional and prospective associations. Gerontol Geriatr Med. 2024;10:23337214241236039. doi:10.1177/23337214241236039
34.
RasmussenNHSmithSAMaxsonJA, et al.Association of HbA1c with emotion regulation, intolerance of uncertainty, and purpose in life in type 2 diabetes mellitus. Prim Care Diabetes. 2013;7(3):213-221. doi:10.1016/j.pcd.2013.04.006
35.
KimESShibaKBoehmJKKubzanskyLD. Sense of purpose in life and five health behaviors in older adults. Prev Med. 2020;139:106172. doi:10.1016/j.ypmed.2020.106172
36.
AntunesGAFankFAmaral da RochaARZarpellonMG. El propósito de vida de las personas mayores está asociado con la actividad física vigorosa. Retos. %08/%14. 2025;71:23-32. doi:10.47197/retos.v71.115032
37.
SutinARStephanYKekäläinenTLuchettiMTerraccianoA. Purpose in life and accelerometer-measured physical activity among older adults. Psychol Health. 2025;40(1):126-140. doi:10.1080/08870446.2023.2200414
38.
HookerSAMastersKS. Daily meaning salience and physical activity in previously inactive exercise initiates. Health Psychol. 2018;37(4):344-354. doi:10.1037/hea0000599
39.
SacksDBaxterBCampbellBCV, et al.Multisociety consensus quality improvement revised consensus statement for endovascular therapy of acute Ischemic stroke. Int J Stroke. 2018;13(6):612-632. doi:10.1177/1747493018778713
40.
GuoYQinKYuY, et al.Physical exercise can enhance meaning in life of college students: the chain mediating role of self-efficacy and life satisfaction. Original Research. Front Psychol. 2024;14:2023. doi:10.3389/fpsyg.2023.1306257
41.
KekäläinenTLuchettiMTerraccianoAGamaldoAASliwinskiMJSutinAR. Momentary associations between physical activity, affect, and purpose in life. Ann Behav Med. 2024;58(11):752-762. doi:10.1093/abm/kaae051
42.
HookerSAMastersKS. Purpose in life is associated with physical activity measured by accelerometer. J Health Psychol. 2016;21(6):962-971. doi:10.1177/1359105314542822
43.
ZhaoHLiYShiL. A chain mediation model reveals the association between physical exercise and sense of meaning in life in college students. Sci Rep. 2025;15(1):28345. doi:10.1038/s41598-025-13710-z
44.
KimESHershnerSDStrecherVJ. Purpose in life and incidence of sleep disturbances. J Behav Med. 2015;38(3):590-597. doi:10.1007/s10865-015-9635-4
45.
KimESRyffCHassettABrummettCYehCStrecherV. Sense of purpose in life and likelihood of future illicit drug use or prescription medication misuse. Psychosom Med. 2020;82(7):715-721. doi:10.1097/psy.0000000000000842
46.
SchwebelFJWilsonADPearsonMRMcCoolMWWitkiewitzK. Finding purpose: integrated latent profile and machine learning analyses identify purpose in life as an important predictor of high-functioning recovery after alcohol treatment. Addict Behav. 2025;165:108273. doi:10.1016/j.addbeh.2025.108273
47.
KonkolÿTBBachnerYGKushnirTKoppMS. Relationship between meaning in life and smoking status: results of a national representative survey. Addict Behav. 2009;34(1):117-120. doi:10.1016/j.addbeh.2008.09.001
48.
KonkolÿTBBachnerYGMartosTKushnirT. Meaning in life: does it play a role in smoking?Subst Use Misuse. 2009;44(11):1566-1577. doi:10.1080/10826080802495096
49.
WestonSJHillPLMroczekDK. Associations for sense of purpose with smoking and health outcomes among adults with diabetes. Int J Behav Med. 2024;31(4):538-548. doi:10.1007/s12529-023-10191-0
50.
RushCLHookerSARossKMFrersAKPetersJCMastersKS. Brief report: meaning in life is mediated by self-efficacy in the prediction of physical activity. J Health Psychol. 2021;26(5):753-757. doi:10.1177/1359105319828172
51.
FredricksonBL. The broaden-and-build theory of positive emotions. Philos Trans R Soc Lond B Biol Sci. 2004;359(1449):1367-1378. doi:10.1098/rstb.2004.1512
52.
JohnstoneR. Religion in Society: A Sociology of Religion. Routledge; 2015.
53.
KoenigHVTPeteetJR. Handbook of Religion and Health. 3rd ed. Oxford University Press; 2023.
54.
LevinJ. Religion and Medicine: A History of the Encounter Between Humanity's Two Greatest Institutions. Oxford University Press; 2020.
55.
RobertsKAYamaneD. Religion in Sociological Perspective. Sage Publications; 2015.
56.
BrighamA. Observations on the Influence of Religion upon the Health and Physical Welfare of Mankind. Capen & Lyon: Marsh; 1835.
57.
FerraroKFKimS. Health benefits of religion among Black and White older adults? Race, religiosity, and C-reactive protein. Soc Sci Med. 2014;120:92-99.
58.
GeorgeLKKinghornWAKoenigHGGammonPBlazerDG. Why gerontologists should care about empirical research on religion and health: transdisciplinary perspectives. Gerontol. 2013;53(6):898-906.
BestMButowPOlverI. Doctors discussing religion and spirituality: a systematic literature review. Palliat Med. 2016;30(4):327-337.
61.
ÇoruhBAyeleHPughMMulliganT. Does religious activity improve health outcomes? A critical review of the recent literature. Explore. 2005;1(3):186-191.
62.
HosseiniSChaurasiaAOremusM. The effect of religion and spirituality on cognitive function: a systematic review. Gerontol. 2019;59(2):e76-e85.
63.
MullenK. Religion and health: a review of the literature. Int J Sociol Soc Pol. 1990;10(1):85-96.
64.
OmanDSymeSL. Weighing the evidence: what is revealed by 100+ meta-analyses and systematic reviews of religion/spirituality and health? In OmanD. (Ed.), Why religion and spirituality matter for public health: Evidence, implications, and resources. 2018; 261-281. Springer International Publishing/Springer Nature. https://doi.org/10.1007/978-3-319-73966-3_15
65.
RewLWongYJ. A systematic review of associations among religiosity/spirituality and adolescent health attitudes and behaviors. J Adolesc Health. 2006;38(4):433-442.
66.
TownsendMKladderVAyeleHMulliganT. Systematic review of clinical trials examining the effects of religion on health. South Med J. 2002;95(12):1429-1435.
67.
BuckACWilliamsDRMusickMASternthalMJ. An examination of the relationship between multiple dimensions of religiosity, blood pressure, and hypertension. Soc Sci Med. 2009;68(2):314-322.
68.
GillumRF. Frequency of attendance at religious services and leisure-time physical activity in American women and men: the Third National Health and Nutrition Examination Survey. Ann Behav Med. 2006;31(1):30-35.
69.
GillumRF. Frequency of attendance at religious services, overweight, and obesity in American women and men: the Third National Health and Nutrition Examination Survey. Ann Epidemiol. 2006;16(9):655-660.
70.
GillumRFIngramDD. Frequency of attendance at religious services, hypertension, and blood pressure: the Third National Health and Nutrition Examination Survey. Psychosom Med. 2006;68(3):382-385.
71.
BruceMAMartinsDDuruK, et al.Church attendance, allostatic load and mortality in middle aged adults. PLoS One. 2017;12(5):e0177618.
72.
Group FINIoAW. Multi Dimentional Measurement of Religiousness Spirituality for Use in Health Research. John E. Fetzer Institute; 2003.
73.
UnderwoodLGTeresiJA. The daily spiritual experience scale: development, theoretical description, reliability, exploratory factor analysis, and preliminary construct validity using health-related data. Ann Behav Med. 2002;24(1):22-33.
74.
FrazierEF. The Negro Church in America/The Black Church Since Frazier. Schocken; 1974.
75.
LincolnCE. The Black Church Since Frazier. Schocken Books; 1974.
76.
BruceMAThorpeJRJSchneiderRHHerczAEWilliamsSFNorrisKC. Contemplative practices as a form of stress management for patients with kidney disease. CJASN. 2025;10:2215.
77.
BruceMASkrine JeffersKKing RobinsonJNorrisKC. Contemplative practices: a strategy to improve health and reduce disparities. Int J Environ Res Public Health. 2018;15(10):2253.
78.
AbbottRAWhearRRodgersLR, et al.Effectiveness of mindfulness-based stress reduction and mindfulness based cognitive therapy in vascular disease: a systematic review and meta-analysis of randomised controlled trials. J Psychosom Res. 2014;76(5):341-351. doi:10.1016/j.jpsychores.2014.02.012
79.
GautamSKiranUV. Clinical effects of yoga and meditational practices on the holistic health of chronic kidney disease patients: a systematic review. Cureus. 2024;16(4):e57546. doi:10.7759/cureus.57546
80.
KhanalMKKarimiLSaundersP, et al.The promising role of Transcendental Meditation in the prevention and treatment of cardiometabolic diseases: a systematic review. Obes Rev. 2024;25(10):e13800.
81.
SchneiderRHMarwahaKSalernoJ. Meditation in prevention and treatment of cardiovascular disease: an evidence-based review. The principles and practice of yoga in cardiovascular medicine. 2022;303-325. https://www.ncbi.nlm.nih.gov/books/NBK599366/.
82.
SlimmenSTimmermansOMikolajczak-DegrauweKOenemaA. How stress-related factors affect mental wellbeing of university students A cross-sectional study to explore the associations between stressors, perceived stress, and mental wellbeing. PLoS One. 2022;17(11):e0275925.
83.
LevineGNLangeRABairey‐MerzCN, et al.Meditation and cardiovascular risk reduction: a scientific statement from the American Heart Association. J Am Heart Assoc. 2017;6(10):e002218.
84.
de Jager MeezenbroekEGarssenBvan den BergMvan DierendonckDVisserASchaufeliWB. Measuring spirituality as a universal human experience: a review of spirituality questionnaires. J Relig Health. 2012;51(2):336-354. doi:10.1007/s10943-010-9376-1
85.
KoenigHG. Religion, spirituality, and health: the research and clinical implications. ISRN Psychiatry. 2012;2012:278730. doi:10.5402/2012/278730
86.
KoenigHG. MSJAMA: religion, spirituality, and medicine: application to clinical practice. JAMA. 2000;284(13):1708.
87.
StegerMFFrazierPOishiSKalerM. The meaning in life questionnaire: assessing the presence of and search for meaning in life. J Counsel Psychol. 2006;53(1):80-93.
88.
NaghiyaeeMBahmaniBAsgariA. The psychometric properties of the meaning in life questionnaire (MLQ) in patients with life-threatening illnesses. Sci World J. 2020;2020:8361602. doi:10.1155/2020/8361602
89.
GeorgeLSParkCL. The Multidimensional Existential Meaning Scale: a tripartite approach to measuring meaning in life. J Posit Psychol. 2017;12(6):613-627. doi:10.1080/17439760.2016.1209546
90.
SalsmanJMSchaletBDParkCL, et al.Assessing meaning & purpose in life: development and validation of an item bank and short forms for the NIH PROMIS((R)). Qual Life Res. 2020;29(8):2299-2310. doi:10.1007/s11136-020-02489-3
91.
ScheierMFWroschCBaumA, et al.The Life Engagement Test: assessing purpose in life. J Behav Med. 2006;29(3):291-298. doi:10.1007/s10865-005-9044-1
92.
RyffCDKeyesCLM. The structure of psychological well-being revisited. J Pers Soc Psychol. 1995;69(4):719-727. doi:10.1037/0022-3514.69.4.719
93.
AnandarajahGHightE. Spirituality and medical practice: using the HOPE questions as a practical tool for spiritual assessment. Am Fam Physician. 2001;63(1):81-89.
94.
SleethGGottliebPSrinivasanAThaddeusUMennilloMAnandarajahG. Evaluation of the HOPE spiritual assessment model: a scoping review of international interest, applications and studies over 20+ years. BMC Palliat Care. 2025;24(1):191. doi:10.1186/s12904-025-01809-z
95.
PuchalskiCRomerAL. Taking a spiritual history allows clinicians to understand patients more fully. J Palliat Med. 2000;3(1):129-137. Spring. doi:10.1089/jpm.2000.3.129
96.
Fetzer Institute. (2003/1999). Multidimensional measurement of religiousness/spirituality for use in health research: a report of the Fetzer Institute/National Institute on Aging Working Group. Kalamazoo M.
97.
MastersKSCareyKBMaistoSA, et al.Psychometric examination of the brief multidimensional measure of Religiousness/Spirituality among college students. Int J Psychol Relig. 2009;19(2):106-120. doi:10.1080/10508610802711194
98.
NeffJA. Exploring the dimensionality of “Religiosity” and “Spirituality’ in the Fetzer multidimensional measure. J Sci Study Relig. 2006;45(3):449-459. doi:10.1111/j.1468-5906.2006.00318.x
99.
LaceJWHandalPJ. Confirming the tripartite structure of the Duke University religion index: a methodological approach. J Relig Health. 2018;57(2):704-716. doi:10.1007/s10943-017-0556-0
100.
KoenigHGCohenHJBlazerDG, et al.Religious coping and depression among elderly, hospitalized medically ill men. Am J Psychiatry. 1992;149(12):1693-1700. doi:10.1176/ajp.149.12.1693
101.
PargamentKFeuilleMBurdzyD. The brief RCOPE: current psychometric status of a short measure of religious coping. Religions. 2011;2(1):51-76.
102.
TarakeshwarNPargamentKIMahoneyA. Initial development of a measure of religious coping among Hindus. J Community Psychol. 2003;31(6):607-628. doi:10.1002/jcop.10071
103.
RosmarinDHPargamentKIKrumreiEJFlannellyKJ. Religious coping among Jews: development and initial validation of the JCOPE. J Clin Psychol. 2009;65(7):670-683. doi:10.1002/jclp.20574
104.
PhillipsREMichelleCCOemigCHietbrinkLVonnegutE. Validation of a Buddhist coping measure among primarily Non-Asian Buddhists in the United States. J Sci Study Relig. 2012;51(1):156-172. doi:10.1111/j.1468-5906.2012.01620.x
105.
CanadaALMurphyPEFitchettGPetermanAHSchoverLR. A 3-factor model for the FACIT-Sp. Psychooncology. 2008;17(9):908-916. doi:10.1002/pon.1307
106.
PetermanAHFitchettGBradyMJHernandezLCellaD. Measuring spiritual well-being in people with cancer: the functional assessment of chronic illness therapy--Spiritual Well-being Scale (FACIT-Sp). Ann Behav Med. 2002;24(1):49-58. Winter. doi:10.1207/S15324796ABM2401_06
107.
SheihamA. Dentistry for an ageing population: responsibilities and future trends. Dent Update. 1990;17(2):70-72. 74, 76.
108.
KoenigHG. Concerns about measuring “spirituality” in research. J Nerv Ment Dis. 2008;196(5):349-355. doi:10.1097/NMD.0b013e31816ff796
109.
SutinARLuchettiMStephanYTerraccianoA. Sense of purpose in life and motivation, barriers, and engagement in physical activity and sedentary behavior: test of a mediational model. J Health Psychol. 2022;27(9):2068-2078. doi:10.1177/13591053211021661
110.
YemiscigilAVlaevI. The bidirectional relationship between sense of purpose in life and physical activity: a longitudinal study. J Behav Med. 2021;44(5):715-725. doi:10.1007/s10865-021-00220-2
111.
NakamuraJSLeeMTChenFS, et al.Identifying pathways to increased volunteering in older US adults. Sci Rep. 2022;12(1):12825. doi:10.1038/s41598-022-16912-x
112.
NicholBWilsonRRodriguesAHaightonC. Exploring the effects of volunteering on the social, mental, and physical health and well-being of volunteers: an umbrella review. Voluntas. 2023;1:1-32. doi:10.1007/s11266-023-00573-z
113.
WardSWomickJTitovaLKingL. Meaning in life and coping with everyday stressors. Pers Soc Psychol Bull. 2023;49(3):460-476. doi:10.1177/01461672211068910
114.
FogelmanNCanliT. Purpose in Life’ as a psychosocial resource in healthy aging: an examination of cortisol baseline levels and response to the trier social stress test. NPJ Aging Mech Dis. 2015;1:15006. doi:10.1038/npjamd.2015.6
115.
BurrowALSprengRN. Waiting with purpose: a reliable but small association between purpose in life and impulsivity. Pers Individ Dif. 2016;90:187-189. doi:10.1016/j.paid.2015.11.010
116.
BoylePAYuLGambleKJBennettDA. Temporal discounting is associated with an increased risk of mortality among community-based older persons without dementia. PLoS One. 2013;8(6):e67376. doi:10.1371/journal.pone.0067376
117.
SutinARLuchettiMAschwandenD, et al.Sense of purpose in life and concurrent loneliness and risk of incident loneliness: an individual-participant meta-analysis of 135,227 individuals from 36 cohorts. J Affect Disord. 2022;309:211-220. doi:10.1016/j.jad.2022.04.084
118.
HillPLOlaruGAllemandM. Do associations between sense of purpose, social support, and loneliness differ across the adult lifespan?Psychol Aging. 2023;38(4):345-355. doi:10.1037/pag0000733
119.
LeeGMartinP. Testing the reciprocal relationship between social networks and purpose in life among older adults: application of a random intercept cross-lagged Panel model. J Aging Health. 2023;35(9):699-707. doi:10.1177/08982643231156721
120.
SutinARStephanYLuchettiMTerraccianoA. Purpose in life and markers of immunity and inflammation: testing pathways of episodic memory. J Psychosom Res. 2023;174:111487. doi:10.1016/j.jpsychores.2023.111487
121.
VagniniKMMorozink BoylanJAdamsMMastersKS. Multidimensional religiousness and spirituality are associated with lower Interleukin-6 and C-Reactive protein at midlife: findings from the midlife in the United States Study. Ann Behav Med. 2024;58(8):552-562. doi:10.1093/abm/kaae032
122.
Tussing-HumphreysLMThomsonJLOnufrakSJ. A church-based pilot Study designed to improve dietary quality for rural, lower Mississippi Delta, African American adults. J Rel Health. 2015;54(2):455-469. doi:10.1007/s10943-014-9823-5
123.
SchwingelAGálvezP. Divine interventions: Faith-Based approaches to health promotion programs for latinos. J Rel Health. 2016;55(6):1891-1906. doi:10.1007/s10943-015-0156-9
124.
JaregoMFerreira-ValenteAQueiroz-GarciaI, et al.Are prayer-based interventions effective pain management options? A systematic review and meta-analysis of randomized controlled trials. J Rel Health. 2023;62(3):1780-1809. doi:10.1007/s10943-022-01709-z
125.
YousofvandVTorabiMOshvandiK, et al.Impact of a spiritual care program on the sleep quality and spiritual health of Muslim stroke patients: a randomized controlled trial. Complement Ther Med. 2023;77:102981. doi:10.1016/j.ctim.2023.102981
126.
MichaelFS. Making Meaning in Life: A Thematic Review of Successful Experimental Psychological and Psychotherapeutic Interventions. Atlantis Press; 2022:5-20.
127.
BreitbartWPessinHRosenfeldB, et al.Individual meaning-centered psychotherapy for the treatment of psychological and existential distress: a randomized controlled trial in patients with advanced cancer. Cancer. 2018;124(15):3231-3239. doi:10.1002/cncr.31539
128.
BreitbartWRosenfeldBPessinHApplebaumAKulikowskiJLichtenthalWG. 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. doi:10.1200/jco.2014.57.2198
129.
RosenfeldBChamHPessinHBreitbartW. Why is Meaning-Centered Group Psychotherapy (MCGP) effective? Enhanced sense of meaning as the mechanism of change for advanced cancer patients. Psychooncology. 2018;27(2):654-660. doi:10.1002/pon.4578
130.
RosaWERobertsKESchlakAE, et al.The critical need for a meaning-centered team-level intervention to address healthcare provider distress now. Int J Environ Res Public Health. 2022;19(13):7801. doi:10.3390/ijerph19137801
131.
van DoornikSFWGlashouwerKAOstafinBDde JongPJ. The effects of a meaning-centered intervention on meaning in life and eating disorder symptoms in undergraduate women with high weight and shape concerns: a randomized controlled trial. Behav Ther. 2024;55(1):177-190. doi:10.1016/j.beth.2023.05.012
132.
Guerrero-TorrellesMMonforte-RoyoCRodríguez-PratAPorta-SalesJBalaguerA. Understanding meaning in life interventions in patients with advanced disease: a systematic review and realist synthesis. Palliat Med. 2017;31(9):798-813. doi:10.1177/0269216316685235
133.
van AgterenJBartholomaeusJSteainsELoLGeraceA. Using a technology-based meaning and purpose intervention to improve well-being: a randomised controlled study. J Happiness Stud. 2021;22(8):3571-3591. doi:10.1007/s10902-021-00383-4
134.
KlussmanKNicholsALLangerJ. Meaning gained versus meaning lost: the effects of meaning salience on anxiety and depression during the coronavirus pandemic. Int J Psychol. 2021;56(6):834-842. doi:10.1002/ijop.12788
135.
HookerSACrainALMueggeJ, et al.Applying meaning and self-determination theory to the development of a web-based mHealth physical activity intervention: proof-of-concept pilot study. JMIR Form Res. 2024;8:e55722. doi:10.2196/55722
136.
MastersKSRossKMHookerSAWooldridgeJL. A psychometric approach to theory-based behavior change intervention development: example from the Colorado meaning-activity project. Ann Behav Med. 2018;52(6):463-473. doi:10.1093/abm/kay023
137.
WillrothECMroczekDKHillPL. Maintaining sense of purpose in midlife predicts better physical health. J Psychosom Res. 2021;145:110485. doi:10.1016/j.jpsychores.2021.110485
138.
ParkCLPustejovskyJETrevinoK, et al.Effects of psychosocial interventions on meaning and purpose in adults with cancer: a systematic review and meta-analysis. Cancer. 2019;125(14):2383-2393. doi:10.1002/cncr.32078
139.
IzguNMetinZGErogluHSemerciRParsH. Impact of spiritual interventions in individuals with cancer: a systematic review and meta-analysis. Eur J Oncol Nurs. 2024;71:102646. doi:10.1016/j.ejon.2024.102646
140.
RobinsonSKissaneDWBrookerJBurneyS. A review of the construct of demoralization: history, definitions, and future directions for palliative care. Am J Hosp Palliat Care. 2016;33(1):93-101. doi:10.1177/1049909114553461
141.
BernardMBerchtoldAStrasserFGamondiCBorasioGD. Meaning in life and quality of life: palliative care patients versus the general population. BMJ Support Palliat Care. 2024;14(e3):e2537-e2545. doi:10.1136/bmjspcare-2020-002211
142.
KangKAHanSJLimYSKimSJ. Meaning-Centered interventions for patients with advanced or terminal cancer: a meta-analysis. Cancer Nurs. 2019;42(4):332-340. doi:10.1097/NCC.0000000000000628
143.
CandyBJonesLVaragunamMSpeckPTookmanAKingM. Spiritual and religious interventions for well-being of adults in the terminal phase of disease. Cochrane Database Syst Rev. 2012;1(5):CD007544. doi:10.1002/14651858.CD007544.pub2
144.
AustinPDLeeWKeallRLovellMR. Efficacy of spiritual interventions in palliative care: an umbrella review of systematic reviews. Palliat Med. 2025;39(1):70-85. doi:10.1177/02692163241287650
145.
AlizadehSChavanM. Cultural competence dimensions and outcomes: a systematic review of the literature. Health Soc Care Community. 2016;24(6):e117-e130. doi:10.1111/hsc.12293
146.
Delgado-GuayMOPalmaADuarteE, et al.Association between spirituality, religiosity, spiritual pain, symptom distress, and quality of life among Latin American patients with advanced cancer: a multicenter Study. J Palliat Med. 2021;24(11):1606-1615. doi:10.1089/jpm.2020.0776
147.
SunMTianXPengYWangZLuYXiaoW. Effects of meaning therapy on spirituality, psychological health, and quality of life in patients with cancer: a systematic review and meta-analysis of randomized controlled trials. Asia Pac J Oncol Nurs. 2024;11(4):100388. doi:10.1016/j.apjon.2024.100388
