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Pinto MH, Leite ACAB, Neris RR, Kusumota L. Experience of hope in older people with chronic illness: A meta-synthesis. Int J Older People Nurs 2024; 19:e12579. [PMID: 37926905 DOI: 10.1111/opn.12579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 09/19/2023] [Accepted: 09/21/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND The increase in life expectancy has contributed to an increase in the number of older people, but this population has to learn to live with at least one chronic illness. Thus, hope has become an important resource for the older adult to face the repercussions of chronic illness. OBJECTIVE To synthesise qualitative evidence on the experience of hope in older people with chronic illness. METHODS This meta-synthesis included qualitative studies which present the experiences of hope in older people diagnosed with at least one chronic illness. The searches were made from six databases, guided by the SPIDER tool. The identified articles were then independently screened by two reviewers. The results were analysed according to the thematic synthesis approach. RESULTS Eighteen articles were included, and four analytical themes were constructed. The results allow us to understand that older people live with long-term conditions and hope for an ordinary life. To react to new changes and to maintain hope, they create goals that motivate them in daily life. The treatment is initially seen as a salvation, but the information acquired with the evolution of the illness modifies this perception. In addition, the uncertainty about the success of the treatment creates conflict in their hope. In the support and care of older people in the new context of illness, meaningful relationships strengthen hope most of the time. There is still the hope of being reconciled with death, but there are times when suffering overcomes the hope of living. CONCLUSIONS This meta-synthesis highlights that the experience of hope in older people is dynamic and influenced by the context of changes related to illness, treatment, significant relationships and proximity to death. IMPLICATIONS FOR PRACTICE A better understanding of the role and characteristics of hope in older people with chronic illness may help to develop more effective interventions to promote and maintain hope.
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Affiliation(s)
| | - Ana Carolina Andrade Biaggi Leite
- Escola de Enfermagem de Ribeirão Preto da Universidade de São Paulo, São Paulo, Brazil
- Departamento de Ciencias de la Salud, Universidad Pública de Navarra, Pamplona, Spain
| | | | - Luciana Kusumota
- Escola de Enfermagem de Ribeirão Preto da Universidade de São Paulo, São Paulo, Brazil
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Chay J, Huynh VA, Cheung YB, Kanesvaran R, Lee LH, Malhotra C, Finkelstein EA. The relationship between hope, medical expenditure and survival among advanced cancer patients. Front Psychol 2023; 14:1151976. [PMID: 37287770 PMCID: PMC10242009 DOI: 10.3389/fpsyg.2023.1151976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 05/02/2023] [Indexed: 06/09/2023] Open
Abstract
Introduction Among those with advanced illness, higher levels of hope may offer physiological benefits. Yet, greater levels of hope may also encourage aggressive treatments. Therefore, higher levels of hope may lead to greater healthcare utilization, higher expenditure, and longer survival. We test these hypotheses among patients with advanced cancer. Methods A secondary data analysis from a cross-sectional survey of 195 advanced cancer patients with high mortality risk linked to subsequent healthcare utilization (outpatient, day surgeries, non-emergency admissions), health expenditures, and death records. The survey collected data on hope, measured generally by the Herth Hope Index (HHI) and more narrowly by two questions on illness-related hope. Generalized linear regression and Cox models were used to test our hypotheses. Results 142 (78%) survey participants died during the period of analysis, with close to half (46%) doing so within a year of the survey. Contrary to expectation, HHI scores did not have a significant association with healthcare utilization, expenditure or survival. Yet, illness-related hope, defined as those who expected to live at least 2 years, as opposed to the likely prognosis of 1 year or less as determined by the primary treating oncologist, had 6.6 more planned hospital encounters (95% CI 0.90 to 12.30) in the 12-months following the survey and 41% lower mortality risk (hazard ratio: 0.59, 95% CI 0.36 to 0.99) compared to those who were less optimistic. Secondary analysis among decedents showed that patients who believed that the primary intent of their treatment is curative, had higher total expenditure (S$30,712; 95% CI S$3,143 to S$58,282) in the last 12 months of life than those who did not have this belief. Conclusion We find no evidence of a relationship between a general measure of hope and healthcare utilization, expenditure, or survival among advanced cancer patients. However, greater illness-related hope is positively associated with these outcomes.
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Affiliation(s)
- Junxing Chay
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore
| | - Vinh Anh Huynh
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore
| | - Yin Bun Cheung
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
- Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore
| | | | - Lai Heng Lee
- Department of Haematology, Singapore General Hospital, Singapore, Singapore
| | - Chetna Malhotra
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore
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Khezri E, Bagheri-Saveh MI, Kalhor MM, Rahnama M, Roshani D, Salehi K. Nursing care based on the Support-Based Spiritual Care Model increases hope among women with breast cancer in Iran. Support Care Cancer 2022; 30:423-429. [PMID: 34302544 DOI: 10.1007/s00520-021-06413-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 07/04/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE Taking care of cancer patients and treating them are among major challenges in the field of health. Several studies have shown that promotion of hope is an efficient strategy for effectively treating this group of patients, reducing their symptoms, and improving the quality of their life. It seems that spiritual care can boost hope in these patients. This study aims to determine the effects of nursing care based on the Support-Based Spiritual Care Model on boosting hope among women with breast cancer. METHODS In this controlled clinical trial, 72 patients with breast cancer were selected through consecutive sampling and randomly assigned to two control and intervention groups (n = 36 in each group) based on four randomized blocks. The intervention was carried out based on the Support-Based Spiritual Care Model for the patients and their main caregivers in six sessions. Besides, the Snyder's hope scale was completed before and 1 month after the intervention by the participants in the intervention and control groups. RESULTS The results of the independent samples t-test showed no significant difference in the mean scores of hope between the intervention and control groups before the intervention (P > 0.05). However, after the intervention, the mean scores of hope for the intervention and control groups were 46.71 ± 4.61 and 40.40 ± 5.42, respectively, showing a significant intergroup difference as verified by the independent samples t-test (P < 0.05). CONCLUSION According to the results of this study, providing nursing care based on the Support-Based Spiritual Care Model can raise hope in patients with breast cancer. CLINICAL IMPLICATIONS Healthcare professionals can boost hope in cancer patients through proper planning and adequate support in providing nursing care based on the proposed model.
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Affiliation(s)
- Edris Khezri
- Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Mohammad Iraj Bagheri-Saveh
- Clinical Care Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Marya Maryam Kalhor
- Clinical Care Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Mozhgan Rahnama
- Department of Nursing, Zabol University of Medical Sciences, Zabol, Iran
| | - Daem Roshani
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Kamal Salehi
- Clinical Care Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.
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Finkelstein EA, Baid D, Cheung YB, Schweitzer ME, Malhotra C, Volpp K, Kanesvaran R, Lee LH, Dent RA, Ng Chau Hsien M, Bin Harunal Rashid MF, Somasundaram N. Hope, bias and survival expectations of advanced cancer patients: A cross-sectional study. Psychooncology 2021; 30:780-788. [PMID: 33739561 DOI: 10.1002/pon.5675] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 01/27/2021] [Accepted: 03/04/2021] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Many patients with advanced illness are unrealistically optimistic about their prognosis. We test for the presence of several cognitive biases, including optimism bias, illusion of superiority, self-deception, misattribution, and optimistic update bias, that could explain unrealistically optimistic prognostic beliefs among advanced cancer patients and quantifies the extent to which hope exacerbates these biases. METHODS A cross-sectional survey was administered to 200 advanced cancer patients with physician-estimated prognoses of one year or less. Hope was measured using the Herth Hope Index (HHI). Hypotheses were tested using linear and logistic regressions and a structural-equation model. RESULTS Results are consistent with the presence of optimism bias, illusion of superiority, self-deception, and misattribution. All of these biases are amplified by higher levels of hope. Each 1-point higher HHI is associated with a 6% (OR: 1.06; 95% CI: 1.01-1.11) greater odds of believing their illness is curable, a 0.33-year (95% CI: 0.17-0.49) longer expected survival, a 6% (OR: 1.06; 95% CI: 1.02-1.11) higher probability of believing that survival outcomes are better than the average patient, a 5% higher odds of believing primary intent of treatment is curative (OR: 1.05; 95% CI: 1.00-1.10), and a 12% (OR: 1.12; 95% CI: 1.05-1.17) higher odds of believing they are well-informed. Mediation analyses revealed that hope significantly mediates the effect of mental-well-being and loneliness on expected survival. CONCLUSIONS Results suggest advanced cancer patients succumb to several cognitive biases which are exacerbated by greater levels of hope. As a result, they are susceptible to possible over-treatment and regret.
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Affiliation(s)
- Eric A Finkelstein
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore.,Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore
| | - Drishti Baid
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
| | - Yin Bun Cheung
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore.,Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore
| | - Maurice E Schweitzer
- Wharton School of Business, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Chetna Malhotra
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore.,Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore
| | - Kevin Volpp
- Wharton School of Business, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | - Lai Heng Lee
- Department of Haematology, Singapore General Hospital, Singapore
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Abbasnezhad M, Rahmani A, Ghahramanian A, Roshangar F, Eivazi J, Azadi A, Berahmany G. Cancer Care Burden among Primary Family Caregivers of Iranian Hematologic Cancer Patients. Asian Pac J Cancer Prev 2016. [PMID: 26225701 DOI: 10.7314/apjcp.2015.16.13.5499] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Providing care for hematologic cancer patients may lead to many negative complications in different aspects of life in their family caregivers. Based on a wide review of relevant literature, there are limited data about the burden of giving care for hematologic cancer patients on their primary family caregivers in Iran or other Middle Eastern countries. Therefore, the aim of this study was to investigate the cancer care burden on primary family caregivers of hematologic cancer patients, in terms of physical, psychological, social, spiritual, and financial aspects. MATERIALS AND METHODS In this descriptive study, 151 primary family caregivers of hematologic cancer patients referred to two cancer care centers in East Azerbaijan Province in northwest of Iran participated. The Financial Distress/Financial Well-being Scale, Hospital Anxiety and Depression Scale, Vaux Social Support Questionnaire, Spiritual Well-being Scale, and SF-36 were used for data collection. Data analysis was performed with SPSS software. RESULTS The findings of this study indicated that the primary family caregivers experience a high level of financial distress and a significant percentage of them suffered from anxiety and depression. In addition, the physical quality of life in these caregivers was moderate. On the other hand, spiritual health and social support of participants was at an acceptable level. CONCLUSIONS Iranian primary family caregivers of hematologic cancer patients experience many problems in physical, psychological, and financial aspects of their life. Therefore, developing care plans for reducing these problems appears necessary.
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Affiliation(s)
- Masoomeh Abbasnezhad
- Medical and Surgical Department, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran E-mail :
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Tahory H, Mohammadian R, Rahmani A, Seyedrasooli A, Lackdezajy S, Heidarzadeh M. Viewpoints of Family Caregivers about Posttraumatic Growth in Cancer Patients. Asian Pac J Cancer Prev 2016; 17:755-8. [PMID: 26925675 DOI: 10.7314/apjcp.2016.17.2.755] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Hale Tahory
- Medical andSurgical Department, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran E-mail :
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Faghani S, Mohammadian R, Rahmani A, Mohajjel-Aghdam AR, Hassankhani H, Azadi A. Supportive Care Needs of Iranian Cancer Survivors and Relationships with Social Support. Asian Pac J Cancer Prev 2015; 16:6339-45. [DOI: 10.7314/apjcp.2015.16.15.6339] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Lee CE, Tai IS, Yang GM, Akhileswaran R, Dignadice D, Lim A, Ng WR, Sarasvathy S, Neo SH. A retrospective audit of spirituality assessment in palliative care patients in Singapore. PROGRESS IN PALLIATIVE CARE 2014. [DOI: 10.1179/1743291x14y.0000000116] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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