Hope and Related Variables in Italian Cancer Patients

The effects of spiritual wellbeing on life satisfaction in hematologic cancer patients aged 65 and older in Turkey: mediating role of hope

BACKGROUND

The mediating role of hope in the effects of spiritual wellbeing on life satisfaction in elderly haematologic cancer patients in Turkey was investigated in the present study.

METHODS

The study was conducted in a descriptive, cross-sectional and correlational design. The study was conducted with 150 patients aged 65 and older who were diagnosed with haematologic cancer and who were referred to a university hospital haematology clinic and outpatient clinic. Research data were collected with Descriptive Information Form, Dispositional Hope Scale (DHS), Spiritual Well-being Scale (FACIT-Sp-12) and Satisfaction with Life Scale (SWLS).

RESULTS

FACIT-Sp-12 score was 37.25 ± 7.29; DHS score was 40.42 ± 8.29, SWLS score was 16.24 ± 8.79. FACIT-Sp-12 (β = 0.668) and DHS (β = 0.226) were found to affect SWLS positively. In terms of the effect of FACIT-Sp-12 on SWLS, DHS has a mediating role and makes the positive effect of FACIT-Sp-12 on SWLS stronger (β = 0.771).

CONCLUSIONS

Spiritual wellbeing levels of the participants in our study were found to be high, while their levels of satisfaction with life and hope were found to be moderate. It was also concluded that spiritual wellbeing had a direct effect on satisfaction with life and an indirect effect through the mediating role of hope.

Risk factors associated with loneliness among mexican-origin adults in southern Arizona

This study examines factors associated with symptoms of loneliness among a sample (n = 213) of mostly Mexican-origin adults at risk of chronic diseases in Southern Arizona's Pima, Yuma, and Santa Cruz counties. It uses baseline data from a community-based participatory research partnership and multinominal logistic regression models. Controlling for chronic diseases and sociodemographic characteristics, perceived social support and hope exhibit negative main effects on loneliness when comparing individuals who experienced loneliness for 5-7 days in the preceding week with those who did not encounter such feelings during the same period (adjusted odds ratio, AOR = 0.49 and 0.47; 95% confidence interval, CI = 0.34-0.73 and 0.29-0.75, respectively). However, when considered together, perceived social support and hope display a positive and statistically significant combined effect on loneliness (AOR = 1.03; 95% CI = 1.01-1.06). Holding all covariates constant, individuals reporting loneliness for 5-7 days exhibit a relative risk ratio of 1.24 (95% CI = 1.06-1.46) for a one-unit increase in physical problem severity compared to those who do not experience loneliness. Moreover, being 65 years old or older (AOR = 0.16, 95% CI = 0.03-0.84), and having been born in Mexico and lived in the US for less than 30 years (AOR = 0.12, 95% CI = 0.02-0.74) are associated with negative main effects on loneliness when comparing individuals who experienced loneliness 1-2, and 5-7 days in the preceding week with those who did not feel loneliness during the same timeframe, respectively. Recognizing the crucial role of loneliness in shaping health outcomes for Mexican-origin adults, our findings underscore the significance of fostering supportive environments that not only enhance well-being but also cultivate robust community bonds within the US-Mexico border region.

Couples' skills training intervention in young breast cancer patients with fear of cancer recurrence: A randomized controlled trial

PURPOSE

This study adapted the Chinese version of the Couple Skills Training intervention program to couples of young breast cancer patients in China and investigated its effects on fear of cancer recurrence (FCR), cancer-related communication, and level of hope among the couples.

METHODS

Ninety young breast cancer patients and their spouses were recruited and randomly assigned to the intervention group (45 couples) and the control group (45 couples). Couples in the intervention group received skills training and were assessed at baseline, post-intervention, and 3 months post-intervention to measure outcomes. Differences in scores between the two groups were analyzed using two-sample t-tests and generalized estimating equations (GEE) controlling for demographic and health-related variables.

RESULTS

Couples' skills training intervention effectively reduced FCR and improved cancer-related communication in young breast cancer patients compared to the control group (both p < 0.001). Spouses' expectations significantly increased (p < 0.001). At 3 months post-intervention, couples in the intervention group showed significant improvements in FCR, cancer-related communication, and hope (all p < 0.001).

CONCLUSION

Couples' skills training interventions are beneficial for helping young breast cancer patients cope with FCR. Couples-based interventions play a crucial role in addressing FCR in these patients and their spouses. Future research should consider larger samples and longer follow-up periods to enhance intervention effectiveness.

CLINICAL TRIAL CENTER REGISTRATION NUMBER

This study has also been registered with the Chinese Clinical Trial Registry (No: ChiCTR2200063327).

The influence of socio-demographics and clinical characteristics on coping strategies in cancer patients: a systematic review

OBJECTIVES

Cancer is a frequent illness and a traumatic experience for both patients and their families. This systematic review aims to analyse studies that examine socio-demographic and clinical characteristics that predict the coping strategies in cancer patients.

METHODS

From January 2000 to March 2021, the database searches were conducted in 7 different databases, using relevant keywords. According to PRISMA Statements, full-text, peer-reviewed articles in English which used socio-demographics as independent variables and coping as dependent variables were included.

RESULTS

Of 1101 abstracts and titles, 30 full-text papers were included. Overall results showed a great influence of socio-demographic characteristics (such as women, younger, in a relationship, with high educational level, with active work status, and high income) on positive coping strategies adopted by cancer patients. Regarding clinical characteristics, no-metastatic patients who have recently been diagnosed, especially in the early stage of cancer, and who know the characteristics of their illness and treatments, more frequently used adaptive coping strategies.

CONCLUSIONS

Both socio-demographics and clinical characteristics showed considerable influence on the coping strategies adopted by patients in most of the investigations. These results supported the assessment of basic patients' information (sociodemographic and clinical characteristics) as fundamental to quickly outline an efficient, supportive, and holistic taking-over, before all the essential and in-depth considerations.

TRIAL REGISTRATION

This systematic review was recorded in PROSPERO with the registration number: CRD42021254776.

The Effect of Spiritual Counseling on Hope in Patients with Multiple Sclerosis: A Randomized Clinical Trial

Background:

Spiritual practices have recently emerged as beneficial to both mental and physical health. The present study was conducted to determine the effect of spiritual counseling on hope among patients with Multiple Sclerosis (MS).

Methods:

This single blind randomized controlled clinical trial was conducted on the patients with MS in April-June 2020, Kashan, Iran. 50 patients were randomly assigned to two 25-member groups. The patients in the intervention group participated in eight 60-minute spiritual counseling program. They were asked to fill out the demographic information questionnaire before the intervention and Herth Hope Index (HHI) before, immediately (in the 4th week of the study) and a month after the intervention (in the 8th week of the study). Data were analyzed using Chi-square, independent samples t-test and repeated measures ANOVA in SPSS version 16. The significance level was considered P<0.05.

Results:

The results showed that the differences between the two groups before the intervention were not statistically significant in terms of demographic variables (P>0.05) and the mean score of hope (P=0.61). However, the total mean score of HHI in the intervention group was significantly different from the control group immediately and a month after the intervention (44.95±1.42 VS. 31.66±2.45 and 43.25±1.84 VS. 30.58±2.24), respectively (P<0.001). According to the results of the repeated measures ANOVA, the level of hope and its dimensions significantly changed in the intervention group over time (P<0.001).

Conclusion:

The results of the present study showed that spiritual counseling promoted the hope score in patients with MS. It is recommended that spiritual counseling should be use as a complementary therapy along with other counseling treatments to increase hope in patients with MS.

Trial Registration Number:

IRCT20190819044567N

The Effect of Religious Coping on Hope Level of Cancer Patients Receiving Chemotherapy

Religious coping and hope are among factors that affect the disease, treatment compliance, psychological health and quality of life of cancer patients. The aim of this study was to determine the level of hope and religious coping styles of cancer patients, and to determine the relationship between religious coping and hope. The study was carried out descriptively and cross-sectionally with 133 patients receiving chemotherapy in an oncology center. In the study, the level of hope and positive religious coping of the patients were high and their level of negative religious coping was low. It was determined that there was a positive relationship between positive religious coping style and hope levels of patients, and positive religious coping style was a significant predictor of hope level. While patients are dealing with cancer diagnosis and treatment, it is recommended that health care professionals primarily focus on providing these patients a service with a holistic care approach and developing their hope with practices that will strengthen their positive religious coping styles.

Delirium and depression in cardiac surgery: A comprehensive review of risk factors, pathophysiology, and management

BACKGROUND

Mental health and wellbeing continue to gain more attention as they are inextricably associated with clinical outcomes, particularly quality of life. Many medical ailments and major surgeries affect patients' mental health, including depression and delirium.

AIMS

The objective of this manuscript was to comprehensively review and critically examine the literature pertaining to cardiac surgery, depression, and delirium.

METHODS

This is a narrative review article. We performed our search analysis by using the following key words: "Cardiac Surgery", "Depression", "Delirium", "Clinical outcomes", and "Mental Health". Search analysis was done on MedLine PubMed, accessing indexed peer-reviewed publications.

RESULTS

Cardiac Surgery is a life-altering intervention indicated to improve morbidity and mortality in patients with cardiovascular diseases. Psychiatric conditions before and after cardiac surgery worsen patient prognosis and increase mortality rate. Specifically, preoperative depression increases postoperative depression and is associated with impaired functional status, slow physical recovery, and an increased readmission rate.

DISCUSSION

Although the exact pathophysiology between depression and cardiovascular disease (CVD) is unknown, several pathways have been implicated. Unmanaged depression can also lead to other psychological conditions such as delirium. Like depression, the exact association between delirium and CVD is not well understood, but believed to be multifactorial.

CONCLUSION

Herein, we provide a comprehensive review of the links between depression, delirium, and cardiovascular surgery. We critically examine the current data that pertains to the pathophysiology of these debilitating mental health issues in the context of cardiac surgery. Finally, we summarize the various treatment options available for managing depression and delirium in the cardiac surgery patient population.

Hope and Distress Are Not Associated With the Brain Tumor Stage

Objective

Hopelessness and depression are strongly associated with suicidality. Given that physical and psychological outcomes can be altered with hope, hope is a therapeutic goal of increasing importance in the treatment of brain tumor patients. Moreover, it is not yet understood which factors affect the perception of hope in brain tumor patients. In addition, it remains uncertain whether lower-grade brain tumor patients suffer less from psycho-oncological distress than higher-grade brain tumor patients.

Methods

Neuro-oncological patients were examined perioperatively with the Distress Thermometer (DT) and the Herth Hope Index (HHI). In addition, psychological comorbidities (anxiety GAD-2, depression PHQ-2) and an assessment of general psycho-oncological distress were recorded.

Results

Sixty-six brain tumor patients were included (median age 53 years, 35% higher-grade brain tumors, i.e., WHO grade III/IV). No differences between higher- and lower-grade brain tumor patients were observed for general psycho-oncological distress and hope. However, higher-grade brain tumor patients showed a significantly higher level of depression (p ≤ 0.001) and more negative expectations regarding therapeutic success (H = 4.873, p ≤ 0.050). The extent of depression correlated negatively with hope.

Conclusion

Unexpectedly, higher-grade brain tumor patients remained as hopeful as lower-grade brain tumor patients despite the devastating diagnosis, higher levels of depression, and a worse expectation of therapeutic success. Conversely, lower-grade brain tumor patients experience as much psycho-oncological distress as patients with a higher-grade brain tumor, underpinning the imperative need for comprehensive psycho-oncological screening. For all brain tumor patients, considering hope is important to avoid suicides resulting from hopelessness and depression.

Beyond basic psychological needs: The hope construct during adjuvant treatment in colorectal cancer patients

This study explored basic psychological needs (BPN) experiences, motivation to continue living, and psychological well-being in colorectal cancer (CRC) patients during adjuvant treatment. Qualitative data from 30 participants (ten CRC patients, ten relatives and ten healthcare professionals) were collected by performing two sets of semi-structured interviews. Three categories were identified: (a) BPN frustration, (b) hope as a source of motivation, and (c) sources of hope. This last category included several subcategories: positive attitude, religious faith, positive medical feedback, knowing that they were going to receive a short-term chemotherapy, and being aware that other patients were in a worse condition. CRC patients felt their basic psychological needs were thwarted during adjuvant treatment. However, hopeful thoughts were reported as relevant sources of motivation to live, which positively impacted on patients’ psychological well-being. Future research could explore the construct of hope as a hypothetical moderator between BPN and CRC patients’ well-being during treatment.

Hope in end-of-life cancer patients: A cross-sectional analysis

Objective

Hope promotes oncology patients’ adaptability to their illness, regardless of the stage of cancer. This study aimed to determine the prevalence of hope in a sample of end-of-life patients and to investigate the possible relationships between hope and a set of clinical and psychosocial measures.

Method

Three hundred and fifty end-of-life oncology patients, with a presumed life expectancy of 4 months or less and a Karnofsky Performance Status (KPS) of 50 or lower, were administered the Italian validated versions of a set of rating scales during their first consultation with a psychologist. This included the Herth Hope Index (HHI), Patient Dignity Inventory (PDI), Demoralization Scale (DS), Hospital Anxiety and Depression Scale (HADS), Functional Assessment of Chronic Illness Therapy (FACIT-Sp), and the Visual Analogue Scale for pain (VAS).

Results

On average, the sample scored between moderate and high on the HHI and the average level of spirituality was high. However, most patients had clinically relevant anxious and depressive symptomatology and high levels of demoralization. Other than the pain scale, the total HHI score significantly correlated with the total scores of all rating scales and their subscales, as well as with the measure of personal religious practice. The “Meaning” FACIT-Sp subscale was found to be the main predictor of hope.

Significance of results

Since hope represents a core need and a tool for patients dealing with their illness, it is essential to implement stage-specific and realistic hope-facilitating interventions and support patients in their search for meaning, which promotes spiritual well-being and appears relevant in fostering hope.

The Effect of a Spiritual Care on Hope in Patients Undergoing Hemodialysis: A Randomized Controlled Trial

Background:

The most common psychological problem in hemodialysis patients is low hope. Hope is an important source of adaptation for the survival of the patients with a chronic disease.

Objective:

This study aimed to evaluate the effect of spiritual care on hope in patients undergoing hemodialysis.

Methods:

In this randomized controlled trial conducted in Iran in 2017, 60 hemodialysis patients with ending-stage of renal disease under hemodialysis treatment were randomly assigned into two experimental (n=30) and control (n=30) groups. The spiritual care program consisting of protectionist care, supporting the patient's rituals and using support systems was administered in four sessions of 60 minutes individually, twice a week, morning or evening in hemodialysis ward. Snyder’s Hope Questionnaire was completed before and after the intervention in both groups. Data were analyzed in SPSS software version 16.

Results:

Prior to the intervention, there was no significant difference between the experimental and control groups (p=0.262); however, following the intervention, the difference was statistically significant with regard to the mean scores of hope in the experimental (36.43 ± 3.37) and control (35.20 ± 7.00) groups (p=0.04).

Conclusion:

According to the findings of the present study, spiritual care promotes hope in Muslim patients undergoing hemodialysis; therefore, nurses can adopt the spiritual care to this end.

Hope and perspective on death in patients with cancer

This study was conducted to determine the relationship between various attitudes and hope levels of cancer patients. The study was conducted in an observational and cross-sectional design with 106 cancer patients who were followed in the oncology clinic of a hospital. In the study, it was found that women had lower hope levels than men, and as age decreased, hope levels increased and as educational level increased, hope levels increased. It was found that the patients who said "I have fear/worry/anxiety and think about my family as they will be left behind" had lower total scores and subscale scores of hope. The results of the study showed that individuals with cancer had relatively higher hope levels. It was determined that the patients' thoughts about death affected their hope both directly and indirectly.

Determination of Hopelessness and Quality of Life in Patients with Heart Disease: An Example from Eastern Turkey

This descriptive study was undertaken in order to determine hopelessness and quality of life among the patients with heart disease. No sampling was made, and 200 patients who were voluntary and were able to communicate were included in the study. The data of the study were collected using a personal information form that involved questions about patients' descriptive information and their diseases, Beck Hopelessness Scale and SF-36 Quality of Life Scale with a face-to-face interview technique. For the analyses of the data, percentages, means, t test, Kruskal-Wallis and Pearson's correlation analyses were used. It was identified 54% of them was male patients. It was seen that there were significant between income status and general health perceptions, hopelessness; and between health perceptions and vitality, general health perceptions, global quality of life, hopelessness (p < .05). It was also explored that there was a negative correlation between hopelessness levels of the cardiac patients and functioning status, general health perceptions and global quality of life. It was determined that the desperation levels of the patients were above the middle level, and the quality of life was low.

Relationship Between Spiritual Well-Being and Hope in Patients with Cardiovascular Disease

Spirituality and hope have been identified as important constructs in health research, since both are thought to enhance a person's ability to cope with the consequences of serious illness. The aim of this study was to examine the relationship between spiritual well-being and hope in patients with cardiovascular disease. Using descriptive, correlational methodology, the investigator gathered data on a convenience sample of 500 patients with cardiovascular disease who were hospitalized in a medical institution in Iran. The study was conducted over a four-month period. Participants completed a demographic questionnaire, the Spiritual Well-Being Scale (SWBS) and the Herth Hope Index (HHI). The mean score on the SWBS and HHI was 86.21 (SD 12.46) and 34.80 (SD 5.05), respectively. Multivariate predictors for spiritual well-being were female gender (p = 0.047), religiosity (p = 0.018), and hope (p < 0.001). Significant predictors of hope were marital status (p < 0.001), educational status (p < 0.001), economic status (p < 0.001), and spiritual well-being (p < 0.001). Findings suggest that multiple factors may impact spiritual well-being and hope. Therefore, this study has implications for those providing care to patients with cardiovascular disease.

Relieving in-patient boredom in general hospitals: the evidence for intervention and practical ideas

Boredom is highly prevalent among general hospital in-patients. Self-help strategies suit some patients, but for others hospitals need to stimulate opportunities for them to experience meaningful relationships and roles and a sense of control. In-patients' well-being and levels of boredom may be affected by no-smoking policies, hospital design, access to natural light, nature scenes and indoor or outdoor gardens. Alleviating boredom in elderly patients with reduced cognitive function may be particularly challenging. Healthcare professionals may face the wider challenge of fully engaging with patients' psychosocial needs, given the biomedical model that privileges the ‘traditional medical history’ over the more holistic communication model. Engaging with patients' psychosocial needs is consistent with managing their experience of 'sickness' rather than focusing on the narrower concept of ‘disease’.

Effects of Intrinsic and Extrinsic Factors on the Level of Hope and Psychological Health Status of Patients with Cervical Cancer During Radiotherapy

Background

This study aimed to explore the factors affecting the level of hope and psychological health status of patients with cervical cancer (CC) during radiotherapy.

Material/Methods

A total of 480 CC patients were recruited. Psychological distress scale, Herth hope index, functional assessment cancer therapy-cervix, and Jolowiec coping scale were used to conduct surveys on psychological distress, level of hope, quality of life (QOL), and coping style to analyze the factors affecting the level of hope and psychological health status of CC patients.

Results

The morbidity of significant psychological distress in 480 CC patients during radiotherapy was 68%, and the main factors causing psychological distress were emotional problems and physical problems. During radiotherapy, most patients had middle and high levels of hope, and the psychological distress index of patients was negatively correlated with the level of hope. The QOL of CC patients during radiotherapy were at middle and high levels, and the QOL was positively correlated with confrontment, optimism, appeasement, and self-reliance, but it was negatively correlated with predestination and emotional expression.

Conclusions

For CC patients during radiotherapy, the morbidity of psychological distress was high, but they were at middle and high levels of hope.

Patients With Hepatocellular Carcinoma Near the End of Life: A Longitudinal Qualitative Study of Their Illness Experiences

BACKGROUND

In the United States, the incidence of hepatocellular carcinoma (HCC) is rising. For those diagnosed with terminal HCC, there is no curative treatment and duration of survival is typically 1 to 2 years. Research on illness and treatment experiences toward the end of life for patients with terminal HCC is limited.

OBJECTIVE

The aim of this study was to explore the illness experiences of patients with terminal HCC as they approached the end of life.

METHODS

This study used a prospective, longitudinal descriptive design. Interview data were collected from 14 patients once a month for up to 6 months, for a total of 45 interviews. Data were analyzed using conventional content analysis.

RESULTS

Three major themes (illness perceptions, decision to start treatment, and navigating treatment over time) and 10 subthemes were identified that were reflected across time in all patient experiences. Patients faced challenges with symptom experiences, treatment decisions, and unmet information needs affecting their quality of life.

CONCLUSIONS

Gaining knowledge about the challenges facing patients with HCC is crucial for designing interventions that optimize their quality of life.

IMPLICATIONS FOR PRACTICE

Healthcare professionals may improve the quality of life of patients with terminal HCC by eliciting patients' perceptions of their illness and treatment decisions, symptom experiences, and information needs as the disease progresses and providing symptom management and offering information tailored to their needs. Care for patients with HCC who are approaching the end of life should be multidisciplinary and include timely referral to palliative care.

Hope, Symptoms, and Palliative Care

BACKGROUND

Hope is important to patients with cancer. Identifying factors that influence hope is important. Anxiety, depression, fatigue, and pain are reported to impair hope. The objective of this study was to determine whether age, gender, marital status, duration of cancer, symptoms, or symptom burden measured by the sum of severity scores on the Edmonton Symptom Assessment Scale (ESAS) correlated with hope measured by the Herth Hope Index (HHI).

METHODS

Patients with advanced cancer in a palliative care unit participated. Demographics including age, gender, marital status, cancer site, and duration of cancer were collected. Individuals completed the ESAS and HHI. Spearman correlation and linear regression were used to assess associations adjusting for gender (male vs female), age (< 65 vs ≥ 65 years), marital status (married or living with a partner vs other), and duration of cancer (≤ 12 vs > 12 months).

RESULTS

One hundred and ninety-seven were participated in the study, of which 55% were female with a mean age of 61 years (standard deviation 11). Hope was not associated with gender, age, marital status, or duration of cancer. In univariable analysis, hope inversely correlated with ESAS score (-0.28), lack of appetite (-0.22), shortness of breath (-0.17), depression (-0.39), anxiety (-0.32), and lack of well-being (-0.33); only depression was clinically relevant. In multivariable analysis, total symptom burden weakly correlated with hope; only depression remained clinically significant.

DISCUSSION

This study found correlation between symptom burden and hope was not clinically relevant but was so for depression.

CONCLUSION

Among 9 ESAS symptoms, only depression had a clinically relevant correlation with hope.

The Relationship between Hope and Self-Esteem in Patients with Leukemia

INTRODUCTION

Patients with hematologic malignancies often experience many emotional reactions which are different based on patient's culture. Indeed culture determines the different ways that patients understand cancer. Accordingly, the aim of this study was to determine the relationship of self-esteem and hope among Iranian cancer patients.

METHODS

This descriptive-correlational study was undertaken among 85 leukemic patients admitted to Shahid Ghazi hospital in East-Azerbaijan province, Iran. They were selected using consecutive sampling method. Persian form of Hearth Hope Index and Coppersmith Self-Esteem Inventory were used to identify patients' hope and self-esteem. The data were analyzed using SPSS version 13.0.

RESULTS

The overall scores of hope and self-esteem were 33.05 (5.24) and 94.61 (11.51), respectively. There was a positive correlation between hope and self-esteem (rs = 0.73, n = 85, P < 0.001).

CONCLUSION

Although culture determines the different ways that patients understand cancer, but it seems that the self-esteem and hope relationship could be similar in different cultures. The findings of this study indicate that nurses could be helpful through designing and implementing appropriate educational programs in order to enhance hope and self-esteem of leukemia patients.

The nature of hope among Iranian cancer patients

BACKGROUND

Hope is an important coping resource for cancer patients. Types and sources of hope and hope- inspiring strategies are not well investigated among Iranian cancer patients. The aims of present study were therefore to investigate the nature of hope and some demographic predictors of hope among Iranian cancer patients.

MATERIALS AND METHODS

This descriptive-correlational study was undertaken among 200 cancer patients admitted to an educational center affiliated to Ardabil University of Medical Sciences, Iran. Participants were selected using a convenience sampling method. The Herth Hope Index and other validated questionnaires were used to investigate level of hope and types and sources of hope, as well as hope-inspiring strategies. Data were analyzed using SPSS statistical software.

RESULTS

The overall score for hope was 31 from total scores ranging between 12 and 48. Some 94% of patients mentioned 'return to normal life' and 'complete healing of disease by drugs and physicians' as their main hopes. The most important sources of hope reported by patients include spiritual resources, family members, healthcare workers, and medicines and treatments available for the disease. Relationship with God, praying/blessing, controlling the signs and symptoms of the disease, and family/health care workers' support were the main hope-inspiring strategies. Patients who had a history of metastasis, or who were older, illiterate, divorced/widowed and lived with their children reported lower levels of hope. On the other hand, employed patients and those with good support from their families had higher levels of hope.

CONCLUSIONS

The study findings showed moderate to high levels of hope among Iranian cancer patients. Accordingly, the role of spiritual/religion, family members and health care workers should be considered in developing care plans for these patients.

The perception of trauma patients from social support in adjustment to lower-limb amputation: a qualitative study

INTRODUCTION

The effect of amputation on an individual's psychological condition as well as family and social relationships is undeniable because physical disability not just affects the psycho-social adjustment, but also the mental health. When compared to normal people, such people are mostly experiencing social isolation. On the other hand, social support is known as the most powerful force to cope with stressful situations and it allows patients to withstand problems. The present study aims to explain understanding the trauma of patients and the experience of support sources during the process of adaptation to a lower limb amputation.

MATERIALS AND METHODS

The present study was conducted using qualitative content analysis. Participants included 20 patients with lower limb amputation due to trauma. Sampling was purposive initially and continued until data saturation. Unstructured interviews were used as the main method of data collection. Collected data were analyzed using qualitative content analysis and constant comparison methods.

RESULTS

The main theme extracted from the data was support sources. The classes include "supportive family", "gaining friends' support", "gaining morale from peers", and "assurance and satisfaction with the workplace."

CONCLUSION

Given the high number of physical, mental and social problems in trauma patients, identifying and strengthening support sources can be effective in their adaptation with the disease and improvement of the quality of their life.

Hopelessness and complementary therapy use in patients with ovarian cancer

BACKGROUND

Hopelessness negatively affects ovarian cancer patients' quality of life (QOL). Research validating the effects of complementary and alternative medicine (CAM) use on QOL and hope is scarce, even though QOL and hope are reasons that patients cite for using CAM therapy. Clinicians need effective, evidence-based interventions to improve QOL and reduce hopelessness.

OBJECTIVE

The objectives of this study were to examine factors influencing hopelessness in patients with newly diagnosed disease, long-term survivors, and patients experiencing ovarian cancer recurrence and to examine the effects of CAM on hopelessness in the same population.

METHODS

Surveys of ovarian cancer patients (N = 219) undergoing treatment at a comprehensive cancer center in the United States were analyzed. Descriptive, correlation, and multivariate analyses described variables and demonstrated the effects of sociodemographics, disease state, psychological distress, QOL, CAM use, and faith on hopelessness.

RESULTS

Patients ages 65 years or older (-0.95, P = .03), with strong faith (-0.28, P = .00), and good QOL (0.11, P = .00) directly reduced hopelessness scores (mean, 3.37). Massage therapy substantially reduced hopelessness scores (-1.07, P = .02); holding age constant, employed patients were twice as likely to use massage (odds ratio, 2.09; P = .04). Patients who had newly diagnosed and recurrent ovarian cancer were more hopeless because of greater distress from symptoms and adverse effects of treatment.

CONCLUSION

Patients who used massage therapy were significantly less hopeless, as were those with strong faith and well-controlled disease symptoms and treatment for adverse effects.

IMPLICATIONS FOR PRACTICE

Support of spiritual needs and symptom management are important interventions to prevent and/or reduce hopelessness, especially for patients with newly diagnosed and recurrent ovarian cancer. Further research testing the positive effect of massage interventions on hopelessness is needed.

Hope in newly diagnosed cancer patients

CONTEXT

Hope is important to cancer patients as it helps them deal with their diagnosis. Little is known about hope in newly diagnosed cancer patients.

OBJECTIVES

Based on the Transcending Possibilities conceptual model of hope, the purpose of this study was to examine the relationship of hope with pain, energy, and psychological and demographic characteristics in newly diagnosed adult oncology outpatients.

METHODS

Data from 310 New Patient Assessment Forms from cancer outpatients' health records were collected. Health records from the first six months of 2009 were reviewed and data were collected on hope, energy, pain, depression, anxiety, feeling overwhelmed, and demographic variables. A generalized linear modeling approach was used to study the relationship of hope scores with these variables. Hypothesized variables and variables that were significant at the P = 0.01 level from the univariate analysis were entered into the multivariate model, with hope scores as the dependent variable.

RESULTS

Hope scores were significantly negatively related to age (P = 0.02). More specifically, oncology patients who were 65 years of age or older had significantly less hope than those under the age of 65 years (P = 0.01). Gender (P = 0.009) also was a significant factor, with men having higher hope scores than women. No other variables were significant.

CONCLUSION

Older adults comprise the majority of persons in Canada with cancer. The lower hope scores found in this age group compared with their younger counterparts underscore the importance of further research. This study provides a foundation for future research in this important area for oncology patients.

Do spiritual patients want spiritual interventions?: A qualitative exploration of underserved cancer patients' perspectives on religion and spirituality

OBJECTIVE

This study examines religion and spirituality among advanced cancer patients from an underserved, ethnically-diverse population by exploring patient conceptualizations of religion and spirituality, the role of religion and spirituality in coping with cancer, and patient interest in spiritual support.

METHOD

Qualitative semi-structured interviews were conducted with patients who had participated in a study of a "mind-body" support group for patients with all cancer types. Analysis based on grounded theory was utilized to identify themes and theoretical constructs.

RESULTS

With regard to patient conceptualizations of religion and spirituality, three categories emerged: (1) Spirituality is intertwined with organized religion; (2) Religion is one manifestation of the broader construct of spirituality; (3) Religion and spirituality are completely independent, with spirituality being desirable and religion not. Religion and spirituality played a central role in patients' coping with cancer, providing comfort, hope, and meaning. Patients diverged when it came to spiritual support, with some enthusiastic about interventions incorporating their spiritual values and others stating that they already get this support through religious communities.

SIGNIFICANCE OF RESULTS

Spirituality plays a central role in the cancer experience of this underserved ethnically-diverse population. While spirituality seems to be a universal concern in advanced cancer patients, the meaning of spirituality differs across individuals, with some equating it with organized religion and others taking a more individualized approach. It is important that psychosocial interventions are developed to address this concern. Future research is needed to further explore the different ways that patients conceptualize spirituality and to develop spiritually-based treatments that are not "one size fits all."

Hope in people with cancer: a multivariate analysis from Turkey

AIM

The study was planned to determine the hope levels of people with cancer and the variables affecting hope.

BACKGROUND

Hope is essential for patient well-being and positively correlated with improved coping skill.

DESIGN

A descriptive and exploratory design.

METHODS

The study sample included 240 consecutive patients treated with chemotherapy and attending the Day Chemotherapy Unit of a University Hospital in Turkey. The study was conducted between December 2009-January 2010. Personal Information Form and Herth Hope Scale were used for data collection. The determinants and subscales of hope were evaluated with univariate and multivariate regression analyses.

RESULTS

These mean scores showed high levels of hope among the patients included in the study. It was found that net family income, knowledge level about the disease, feeling of improvement, perception of satisfactory family support by the patient, mouth ulcers, feeling anxious or worried and presence of fear were independently related with the total hope score.

CONCLUSIONS

The study results showed high levels of hope among the participating patients. It is concluded that physical, financial and psychological well-being and information and support needs are directly and independently related with hope in people with cancer. These findings support the need for clinicians to continue to practise and implement hope fostering/hindering interventions among their patients.

Obesity, hope, and health: findings from the HOPE Works community survey

According to hope theory, hope is defined as goal-directed thinking in which people perceive that they can find routes to desired goals and the motivation to use those routes. The purpose of this study was to explore relationships between hope and body mass index and hope and self-rated health among women completing a community survey conducted in four rural counties in eastern North Carolina. The survey was administered as part of Hope Works, a participatory, community-led intervention program to improve weight, health and hope among low-income women in rural North Carolina. Survey data from 434 women were analyzed. In multivariate models adjusting for age, race, education and income, higher hope was positively related to self-reported health (OR:0.92; 95% CI: 0.89-0.95) and negatively related to BMI (P < 0.01). These results indicated that women who reported better self-rated health also had higher hope scores and women who were heavier had lower hope scores. While these findings are exploratory, they suggest directions for further research. State-based hope is considered to be a characteristic that is malleable and open to development. Future interventions should examine the importance of hope as a construct to examine in weight loss studies. For example, programs could be designed to increase hope by focusing on goal setting and providing support, information and resources to help women work toward their goals.

Hope in adults with cancer: state of the science

PURPOSE/OBJECTIVES

To synthesize the literature regarding research on hope in adults with cancer.

DATA SOURCES

CINAHL Plus® and PsycINFO databases.

DATA SYNTHESIS

Sixteen articles published from 2005-2009 met the criteria for review. The literature was organized according to Oncology Nursing Society levels of evidence. Research studies on hope in adults with cancer were analyzed, critiqued, and synthesized.

CONCLUSIONS

Research evidence continues to grow regarding descriptions of hope and hope attributes in adults with cancer. Although nursing intervention programs have demonstrated positive effects on hope in adults newly diagnosed with cancer, those with a first cancer recurrence, the terminally ill, and survivors of childhood cancer, current studies are small and additional research is indicated.

IMPLICATIONS FOR NURSING

Opportunities exist to explain the dynamic process of hope, develop hope interventions that are tailored to meet the developmental needs of adults with cancer, and study existing nursing programs that support hope using larger samples in randomized, controlled trials.

Coping, quality of life, depression, and hopelessness in cancer patients in a curative and palliative, end-of-life care setting

BACKGROUND

Coping strategies may be important factors influencing quality of life (QOL), depression, and hopelessness. However, most studies on this issue were performed in patients still undergoing anticancer treatment. Unknown is which coping strategies are of importance for palliative-cancer patients who no longer receive treatment.

OBJECTIVE

The objectives of this study were to assess coping strategies in curatively treated and palliative-cancer patients no longer receiving anticancer treatment and to examine the relation of these coping strategies with QOL, depression, and hopelessness.

METHODS

A descriptive research design was used. Ninety-two curative and 59 palliative patients filled out the COPE-Easy abbreviated version, the European Organisation for Research-and-Treatment of Cancer QOL-Questionnaire version 2.0, Beck Depression Inventory for Primary Care, and Beck Hopelessness Scale.

RESULTS

In both curative and palliative patients, active coping strategies and acceptance were beneficial in terms of QOL, depression, and hopelessness, unlike avoidant coping strategies and venting of emotions. Palliative patients scored higher on the coping strategy, seeking moral support. For the outcome variable, emotional functioning, significant interactions were observed between the variable, curative/palliative care setting, and the coping strategy, seeking moral support. For the outcome variable, role functioning, significant interactions were observed between the variable, curative/palliative care setting, and the coping strategy, waiting.

CONCLUSIONS

Coping strategies were significantly correlated to QOL, depression, and hopelessness. However, this correlation differed in the curative and palliative, end-of-life care setting.

IMPLICATIONS FOR PRACTICE

The observed relations between coping strategies, QOL, depression, and hopelessness give room to cognitive-behavioral nursing interventions. Specific attention is needed for differences in coping strategies between curative and palliative patients.

Relationship between hope and fatigue characteristics in newly diagnosed outpatients with cancer

PURPOSE/OBJECTIVES

To examine the relationship between hope and fatigue (intensity, duration, and interference) in newly diagnosed patients with cancer receiving chemotherapy.

DESIGN

Cross-sectional and correlational.

SETTING

Oncology outpatient clinics of two medical centers in northern Taiwan.

SAMPLE

182 patients diagnosed with various types of solid tumors in the previous six months and receiving chemotherapy treatment.

METHODS

Questionnaires were used to assess patients' fatigue intensity, duration, and interference, as well as level of hope and related background information before drug administration at a chemotherapy visit. The relationship between fatigue characteristics and level of hope was verified using Pearson's correlation analysis.

MAIN RESEARCH VARIABLES

Hope, fatigue intensity, duration, and interference.

FINDINGS

Compared to fatigue intensity, interference and its duration have a stronger association with level of hope. Further analysis of the seven individual items of fatigue interference found that interference with mood status and relations with others is significantly associated with level of hope in newly diagnosed patients.

CONCLUSIONS

Fatigue duration and interference caused by fatigue, particularly in mood status and relations with others, are associated with the perception of hope in newly diagnosed patients.

IMPLICATIONS FOR NURSING

Clinical nurses should assess intensity of fatigue as well as its interference and duration to better support patients' perception of hope by reducing interference caused by fatigue.

Depression following open-heart surgery: a path model involving interleukin-6, spiritual struggle, and hope under preoperative distress

Faith factors (i.e., factors pertaining to religion/spirituality) have been linked with well-being and adequate coping. Few studies have investigated negative aspects of religious coping, such as spiritual struggle. Based on the multidisciplinary literature and on previous findings, the study's analysis estimated parallel psychophysiological pathways from preoperative distress to postoperative depression in patients undergoing open heart surgery. Plasma samples for interleukin(IL)-6 were obtained before surgery. The results showed that a link between spiritual struggle and IL-6 mediated the indirect effects of preoperative anxiety on postoperative depression. Avoidant coping also mediated the influence of anxiety on postoperative maladjustment. Further, hope played a protective mediating role to moderate the undesirable influences of the spiritual struggle-IL-6 link and maladaptive coping on postoperative mental health attributes.

Avaliação da esperança em pacientes com doença crônica e em familiares ou cuidadores

OBJETIVOS: Avaliar o escore de esperança entre os três diferentes grupos e suas variáveis sociodemográficas e clínicas e correlacionar esperança com essas variáveis. MÉTODOS: Estudo descritivo com amostra constituída por 131 indivíduos - 47 pacientes oncológicos, 40 pacientes diabéticos e 44 acompanhantes/ familiares/cuidadores - que responderam às Escalas de Esperança de Herth e de Autoestima de Rosenberg, o Inventário de Depressão de Beck, e um instrumento com dados pessoais. RESULTADOS: Não houve diferença nos escores de esperança entre os grupos. A esperança correlacionou-se positivamente com autoestima e negativamente com a depressão. Para pacientes oncológicos, o escore de esperança não se relacionou a nenhuma variável clínica. Para os pacientes diabéticos, as diferentes formas de tratamento e outras comorbidades não influenciaram na esperança. CONCLUSÃO: Os pacientes com doença crônica e seus familiares apresentaram escores altos de esperança. A mensuração da esperança pode melhorar o cuidado de enfermagem.

The importance of hope as a mediator of psychological distress and life satisfaction in a community sample of cancer patients

BACKGROUND

Although hope is an important resource for cancer patients, few studies include it as an independent or dependent variable in quality-of-life research.

OBJECTIVE

The purposes of this study, in a community-based sample of cancer patients, were to evaluate the relationships between demographic and clinical characteristics, health status, hope, psychological distress, and life satisfaction and evaluate whether hope mediated the relationship between psychological distress and life satisfaction.

METHODS

Participants (n = 194) completed a demographic and clinical questionnaire, a single item of self-assessed health, the Herth Hope Index, Impact of Event Scale, and a single-item rating of satisfaction with life. Structural regression models were examined to evaluate the interrelationships among these variables, with life satisfaction as the primary outcome.

RESULTS

Participants were primarily women with breast cancer. In the final structural regression model that explained 60% of the variance in life satisfaction, poorer health status, lower hope, and higher psychological distress were significantly related to lower satisfaction with life. Hope was found to mediate the relationship between psychological distress and health status, such that the direct association between distress and health status was no longer significant with hope in the model. Finally, hope partially mediated the association between psychological distress and life satisfaction.

CONCLUSIONS

These data suggest that hope is an important resource for oncology patients that impacts their quality of life.

IMPLICATIONS FOR PRACTICE

Hope may be an important coping mechanism that clinicians need to consider when they try to help patients reduce the psychological distress associated with cancer and its treatment.

Hope in the context of lung cancer: relationships of hope to symptoms and psychological distress

CONTEXT

Hope may be important in explaining the variability in how patients adjust to lung cancer.

OBJECTIVES

The aim of this study was to examine how hope, as conceptualized by Snyder et al., is associated with multiple indices of adjustment to lung cancer. This theoretical model of hope suggests that people with high levels of hope are able to think about the pathways to goals (pathways) and feel confident that they can pursue those pathways to reach their goals (agency).

METHODS

We hypothesized that higher levels of hope, as measured by Snyder et al.'s hope scale, would be related to lower levels of pain and other lung cancer symptoms (i.e., fatigue and cough) and lower psychological distress (i.e., depression). Participants in this study included patients with a diagnosis of lung cancer (n=51). All participants provided demographic and medical information and completed measures of hope, lung cancer symptoms, and psychological distress.

RESULTS

Data analyses found that hope was inversely associated with major symptoms of cancer (i.e., pain, fatigue, and cough) and psychological distress (i.e., depression), even after accounting for important demographic and medical variables (i.e., age and cancer stage).

CONCLUSION

The findings of this cross-sectional study highlight the potential importance of hope in understanding adjustment to lung cancer. Future longitudinal research could help reveal how hope and adjustment interact over the course of cancer survivorship.

The relationships between mood disturbances and pain, hope, and quality of life in hospitalized cancer patients with pain on regularly scheduled opioid analgesic

OBJECTIVE

The study purposes were to describe the percentage of patients in one of four mood groups (i.e., neither anxiety nor depression [NEITHER], only anxiety [ANX], only depression [DEP], both anxiety and depression [BOTH]) and to evaluate how differences in mood states are related to pain, hope, and quality of life (QOL).

METHODS

Oncology inpatients (n = 225) completed Brief Pain Inventory, Herth Hope Index (HHI), and the European Organization for Research and Treatment of Cancer Core QOL Questionnaire-C30. Research nurses completed Symptom Severity Checklist, Karnofsky Performance Status score, and medical record reviews. Data were analyzed using chi(2), Kruskal-Wallis, one-way analyses of variance (ANOVAs), and analyses of covariance (ANCOVA).

RESULTS

Thirty-two percent of patients were categorized in the NEITHER group, 12% in the ANX group, 12% in the DEP group, and 44% in the BOTH group. Younger patients and women were more likely to be in the BOTH group. While only minimal differences were found among the mood groups on pain intensity scores, patients in the NEITHER group in general, reported lower pain interference scores than those in the other three groups. Significant differences were found in HHI scores between the patients in the NEITHER group and the BOTH group. In addition, patients with both mood disorders reported significantly poorer QOL scores.

CONCLUSIONS

Because 44% of the patients had both anxiety and depression, clinicians need to evaluate patients for the co-occurrence of these two symptoms, evaluate its impact on pain management, hope, and QOL, and develop appropriate interventions to manage these symptoms.

A systematic review of therapeutic alliance, group cohesion, empathy, and goal consensus/collaboration in psychotherapeutic interventions in cancer: Uncommon factors?

The effects of four empirically supported therapeutic relationship factors (therapeutic alliance, empathy, goal consensus/collaboration, and group cohesion) on the outcome of psychotherapeutic interventions conducted with individuals living with cancer were systematically reviewed. PubMed, PsycINFO, and CINAHL were searched from their inception through November 13, 2008. Studies of psychotherapeutic interventions targeted to individuals living with cancer, which also empirically assessed the association between any of these therapeutic relationship factors and psychotherapy outcome were included in the review (8 of 742 papers initially reviewed). Information on study methodology and results were abstracted independently by the authors using a standardized form. Results indicated that therapist-rated rapport and group cohesion were significantly related to positive psychotherapeutic outcomes. No studies examined empathy. The literature on collaboration was mixed, but showed some support for increased collaboration being related to positive therapeutic outcomes. Overall the current literature on the role of therapeutic relationship factors in the context of individuals living with cancer is scant, and much more research is needed to determine the overall contribution of these four relationship elements to the outcomes of psychotherapeutic interventions for individuals living with cancer. Results of such studies could have important clinical and research implications.

Hope in palliative care: An integrative review

Objective: The objective of this review is to describe the current status of research on hope in palliative care.

Methods: Integrative review was conducted to determine current knowledge on the topic. CINAHL and PubMed MEDLINE databases were used to find the articles relevant to this review. The data consisted of 34 articles on hope and palliative care published in peer-reviewed journals. A qualitative approach utilizing content analysis was used in this review.

Results: There are at least two overarching themes of patients' hope in the palliative context: “living with hope” and “hoping for something” which however are not separate contents. Several instruments for measuring hope in a palliative context have been produced. However, future research is needed to gather further validity evidence for these instruments. Factors related to patients, other people (e. g. significant others), illness, care and context contribute to or threaten patient hope. Hope of the significant other was defined as an inner force. However, the main concern for caregivers was “hanging on to hope” in spite of eroding effects on hope caused by different factors, for example in the health care system. Also significant others' hope in a palliative care context has been measured, but the results of the studies appear inconsistent. Nurses' reflection in action, affirmation of the patient's worth, working with the patient, considering the patient in a holistic sense were the main hope-engendering interventions generated from this review.

Significance of the research: Hope is important in both living and dying. The majority of the hope research in a palliative context focuses on patient hope and factors influencing patient hope. Research on hope in significant others and nurses in palliative care is scant. More research is needed about the factors threatening patient hope, hope in significant others, and interventions to engender hope in palliative and their outcomes.