Iran Journal of Nursing

Introduction
One of the most common types of cancer is blood cancer. This disease is always considered more negative than other diseases in the public mind due to the difficulty of the treatment process or sometimes its incurability, and unpredictable onset with no specific symptom. Leukemia is a malignant and progressive disease of hematopoiesis, which is related to the proliferation and incomplete development of white blood cells. According to the cell of origin, this disease has two lymphocytic or myelogenous types, while according to the rapidity of proliferation, it is classified as chronic and acute. According to this division, there are four groups of leukemia including acute lymphocytic, acute myelogenous, chronic lymphocytic and chronic myelogenous. Leukemia accounts for 8% of all cancers in the human population and is the fifth most common cancer in the world.
When patients find out that they have cancer, the meaning of life for them is affected. Meaning of life is thought to improve the well-being of patients. It is a basic need for people with cancer and is a motivation to continue to be alive. To successfully adapt to situations and maintain mental health, meaning in life is needed, especially for people with chronic diseases. In life-threatening diseases such as cancer, having meaning in life helps to accept the disease and continue the treatment. Other studies also have emphasized the necessity of examining the meaning of life in cancer patients. This study aims to investigate the meaning of life in Iranian people with leukemia.

Methods 
This is a descriptive study. Participants were 200 people with leukemia admitted to the oncology departments of two hospitals in Tehran, Iran, in 2022, who were selected according to the inclusion criteria using a continuous sampling method. The data collection tools included a demographic form and Steger’s meaning of life questionnaire (MLQ), as a self-report tool. The instruments took about 20-30 minutes to complete, and the entire data collection process lasted 4 months. Descriptive statistics and inferential statistics (analysis of variance, independent t-test) were used for data analysis in SPSS software, version 16. 

Results
The mean MLQ score was 57.13±11.39. Also, the mean score for the dimension of presence of meaning (29.14±5.90) was higher than the score for the dimension of search for meaning (27.98±6.21). In the presence of meaning domain, the item “my life has no clear purpose “ had the highest score. In the search for meaning domain, the item “ I am searching for meaning in my life” was the highest score. The MLQ score was significantly different only based on marital status (P=0.011).Tukey’s post hoc test for pairwise comparison showed that the mean MLQ score in married patients was significantly higher. 

Conclusion 
The results of this research can be a step towards the implementation of training programs based on meaning of life by nurses for people with leukemia to improve the presence of meaning in life and the search for it in these patients. It is recommended that the nurses working in the oncology departments should familiarize themselves with the concept of the meaning of life and its dimensions based on the holistic care approach so that they can pay attention to it at the bedside.

Ethical Considerations
Compliance with ethical guidelines
This study was approved by the ethics committee of Iran University of Medical Sciences (Code: IR.IUMS.REC.1401.636). All ethical principles were considered in this study. The participants were informed about the study objectives and methods. They were also 
assured of the confidentiality of their information and were free to leave the study at any time, and if desired, the research results would be available to them.

Funding
This study was extracted from the master’s thesis of the first author at the Department of Psychiatric Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran. The study was funded by Iran University of Medical Sciences.

Authors' contributions
Conceptualization, project management: Marjan Ahmadi and Marjan Mardani Hamooleh; investigation: Marjan Mardani Hamooleh and Naima Seyedfatemi; data analysis: Shima Haghani; Editing and review: Marjan Mardani Hamooleh

Conflict of interest
The authors declared no conflict of interest.

Acknowledgments
The authors would like to thank all the patients who participated in this study for their cooperation.

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