ArticlePublisher preview availableLiterature Review

Hope therapy in cancer patients: a systematic review

June 2022
Supportive Care in Cancer 30(3)

Authors:

Aim To identify the associated factors of hope therapy during treatment in cancer patients. Background Hope is very important to cancer patients at all stages of the disease process. Several and different factors are associated with hope. Design A systematic literature review of quantitative empirical studies on hope and quality of life in cancer patients. Data Sources Search in MEDLINE, Psychinfo, and Cochrane (January 2010–December 2020). Review methods A coherent search strategy was designed where MESH terms were combined with “free text” terms: hope (e.g., hope therapy, Herth Hope Index, quality of life) and cancer (e.g. neoplasm, tumor). Two authors independently screened all the studies and assessed their quality. Results Twenty studies were included. The overall score of Herth Hope Index in cancer patients was 36.93, and the overall score of quality of life in cancer patients were 47.52. Also, the trend of quality of life and Herth Hope Index in cancer patients has been decreasing, from 2010 to 2020. Conclusions This systematic literature review of associated factors of hope in cancer patients receiving treatment shows that hope seems to be positively related mainly by intrinsic factors, such as perceived health, quality of life, and social support.

Flowchart of selections of studies

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The overall effect of Herth Hope Index in cancer patients

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Cumulative Herth Hope Index in cancer patients

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The overall effect of quality of life in cancer patients

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Cumulative quality of life in cancer patients

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https://doi.org/10.1007/s00520-022-06831-y

REVIEW ARTICLE

Hope therapy incancer patients: asystematic review

HamedSalimi1 · HaniyehBashiZadehFakhar2 · MohammadHadizadeh2 · MohammadEsmaeilAkbari2 ·

NedaIzadi3· RezaMohamadiRad4· HosnaAkbari2· RamtinHoseini5

Received: 16 October 2021 / Accepted: 11 January 2022

Abstract

Aim To identify the associated factors of hope therapy during treatment in cancer patients.

Background Hope is very important to cancer patients at all stages of the disease process. Several and diﬀerent factors are

associated with hope.

Design A systematic literature review of quantitative empirical studies on hope and quality of life in cancer patients.

Data Sources Search in MEDLINE, Psychinfo, and Cochrane (January 2010–December 2020).

Review methods A coherent search strategy was designed where MESH terms were combined with “free text” terms: hope

(e.g., hope therapy, Herth Hope Index, quality of life) and cancer (e.g. neoplasm, tumor). Two authors independently screened

all the studies and assessed their quality.

Results Twenty studies were included. The overall score of Herth Hope Index in cancer patients was 36.93, and the overall

score of quality of life in cancer patients were 47.52. Also, the trend of quality of life and Herth Hope Index in cancer patients

has been decreasing, from 2010 to 2020.

Conclusions This systematic literature review of associated factors of hope in cancer patients receiving treatment shows that

hope seems to be positively related mainly by intrinsic factors, such as perceived health, quality of life, and social support.

Keywords Hope therapy· Cancer patients· A systematic review

Introduction

Today, 43 million people live with cancer around the world

[1]. Discovering that you have cancer can be dreadful [2]

and devastating [3]. The awareness of having a malignant

life-threatening illness changes people’s understanding of

life, and they try to adjust to this condition [4]. Psychologi-

cal eﬀects of cancer diagnosis and physical side eﬀects of

treatment can negatively impact hope in these patients [5].

Hope is a very crucial factor for patients with cancer in

all stages of the disease [6]. Hope is shaped diﬀerently in the

* Haniyeh Bashi Zadeh Fakhar

Haniyehfakhar@yahoo.com

Hamed Salimi

deyarsalimi268@gmail.com

Mohammad Hadizadeh

omhadizadeh@gmail.com

MohammadEsmaeil Akbari

profmeakbari@gmail.com

Neda Izadi

neda.izady@yahoo.com

Reza MohamadiRad

rezamohammadirad1990@gmail.com

Hosna Akbari

hsn.22.psy@gmail.com

Ramtin Hoseini

ramtin.h18@gmail.com

1 Department ofDBA, Oxford University, London, UK

2 Cancer Research Centre (CRC), Shahid Beheshti University

ofMedical Sciences, Tehran, Iran

3 Cancer Research Center, Department ofEpidemiology,

School ofPublic Health andSafety, Shahid Beheshti

University ofMedical Sciences, Tehran, Iran

4 Department ofPsychology, University ofGuilan, Rasht, Iran

5 Chalous Branch, Islamic Azad University, Chalous, Iran

/ Published online: 25 January 2022

Supportive Care in Cancer (2022) 30:4675–4685

Content courtesy of Springer Nature, terms of use apply. Rights reserved.

The Meaning of Hope for Polish Male Patients Dying from Cancer Depending on Their Age: An Interdisciplinary Study with the Use of Osgood’s Semantic Differential Method

Article

Full-text available

May 2024

Background/Objectives: The subject of this article is the reflection on hope—one of the most important predictors and motivators of human actions. Hope is our response to a threat, and it is also the emotion that allows us to overcome hopelessness and to reduce suffering. Hoping is a human capacity with varying cognitive, emotional, and functional dimensions. Psychological, pedagogical (particularly in the framework of special-needs pedagogy and thanatological pedagogy), and theological reflection on hope can be helpful for dying people. The objective of this study was to characterize hope in the semantic space of individuals in the terminal stage of cancer and to verify whether age is a variable that determines this hope. Methods: To complete the study, the Osgood semantic differential method was applied, as modified by Polish psychologist Dr. Boguslaw Block (the DSN-3 test). The research technique consisted of a therapeutic conversation. Results: Research results show that, in general, those in the terminal stage have positive associations with hope. In all three aspects of the used test, namely the cognitive, emotional, and functional aspects, the highest scores assigned to the perception of hope were obtained from men up to 35 years of age. Depending on the ages of patients, one could observe certain semantic shifts, but they did not prove to be statistically significant. Conclusions: Polish males surveyed at the end of life due to cancer generally perceived hope as a supportive force. Therefore, hope can provide emotional support to patients in the terminal stage of cancer and improve their quality of life.

Esperança da Pessoa com Câncer Avançado em Cuidados Paliativos

Article

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May 2024

A esperança é um constructo multidimensional e multifacetado imbricado no processo de cuidar das pessoas com câncer, trata-se de estado emocional dinâmico, adaptativo e essencial para transcendência. O objetivo deste estudo é refletir sobre a esperança da pessoa com câncer avançado em cuidados paliativos. A esperança é multideterminada por diferentes fatores intrínsecos, funcionais, socioafetivos, psicoemocionais, terapêuticos; entre outros, ela é ancorada e potencializada pela espiritualidade, que propulsiona a transposição da adversidade imposta pela doença progressiva e busca de sentido da vida. Existe relação positiva entre a esperança e a qualidade de vida relacionada à saúde, além de ser parte de uma “engrenagem” dinâmica, intimamente associada ao bem-estar biopsicossocioespiritual. Faz-se importante a reflexão do impacto da esperança no cuidado da pessoa com câncer avançado para um planejamento holístico e fundamentado na avaliação e promoção da esperança no intuito de auxiliar na busca de equilíbrio.

Hope and its associated factors in cancer patients undergoing drug therapy: a systematic review

Article

Full-text available

Sep 2023
SUPPORT CARE CANCER

Objective This study seeks to clarify the hope of cancer patients undergoing drug therapy and related factors through a systematic review. Methods References were searched and selected in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses. Results Thirteen articles were selected. A meta-analysis found that the overall Herth Hope Index score for cancer patients undergoing drug therapy averaged 35.64 points. The hope of cancer patients was associated with anxiety/depression and quality of life (QOL). It was also associated with personal attributes such as age, family structure, economic situation, educational level, social support, internal factors such as coping, self-esteem, optimism, self-confidence, locus of control, etc., as well as disease/treatment-related factors such as the purpose of treatment, general condition, presence or absence of metastasis, symptoms, survival period, and estimated life expectancy. Conclusion Anxiety/depression, QOL, and other factors were found to be related to cancer patients’ hope. In the future, studies that clarify the overall structure of various factors related to hope and longitudinal studies will be necessary.

Esperança no cuidado de pacientes com câncer avançado

Article

Full-text available

May 2024

A esperança é um constructo multidimensional, orientado por atributos motivacionais e cognitivos do indivíduo, trata-se uma dimensão intrínseca no cuidado de pacientes com câncer nos diferentes ambientes de prática clínica. Esta análise tem como objetivo refletir sobre o constructo da esperança no paciente com câncer avançado, apoiado nas etapas do ciclo de reflexão da experiência (descrição; sentimentos; avaliação; análise; plano de ação e conclusões). Nos diferentes contextos de cuidados, somos confrontados com pacientes que desconhecem o estágio de câncer avançado e os objetivos do tratamento. Tal situação resulta em múltiplos vieses, esperança exacerbada ou de cura não realista e potencializa o sofrimento psicoemocional. A comunicação compreensível promove a sobrevida com qualidade, autotranscendência e a morte pacífica. Para (não) concluir, a compreensão da experiência humana da pessoa com câncer e a comunicação qualitativa devem ser a base para nortear o plano de cuidados na promoção da esperança para além da doença avançada, visto que a esperança é algo positivo e essencial para a salutogênese.

Kemoterapi alan hastalarda umut düzeyinin genel semptom ve yaşam kalitesine etkisi/The effect of the level of hope on the general symptoms and quality of life in patients receiving chemotherapy

Article

Full-text available

Apr 2024

Amaç: Çalışma onkoloji kliniğinde kemoterapi tedavisi alan hastalarda umut düzeyinin genel semptom ve yaşam kalitesine etkisini belirlemek amacıyla yapıldı. Yöntem: Tanımlayıcı kesitsel türdeki bu araştırmaya Türkiye'nin batı bölgesindeki bir eğitim ve araştırma hastanesinin kemoterapi ünitesine başvuran 202 hasta dahil edildi. Veriler Kişisel Bilgi Formu, Herth Umut Ölçeği, Genel Semptom Envanteri Türkçe Formu, Kanserli Hastalarda Yaşam Kalitesi Ölçeği (EORTC QLQ-C30) ve Genel Yaşam Kalitesi Ölçeği (SF-12) ile toplandı. Verilerin analizinde tanımlayıcı istatistikler, tek değişkenli analizler ve linear regresyon analizi kullanıldı. Bulgular: Hastaların yaş ortalaması 56.24±11.88 yıldır. Araştırma grubunun hastalık süresi ortalamasının 10.57±16.61 ay, %55'inin meme kanseri tanısı aldığı, %60.4'ünün hastalığı ile ilgili ameliyat olduğu ve %40.6'sının hastalık evresinin Evre II olduğu saptandı. Hastaların %21.8'inin metastazı bulunduğu ve kemoterapi kür ortalamasının 6.69±4.48 olduğu belirlendi. Katılımcıların Herth Umut Ölçeği ve Genel Semptom Envanteri düzeylerinin SF-12 fiziksel ve mental özet skor ve EORTC QLQ-C30 özet skor ve global yaşam kalitesi düzeylerini etkilediği saptandı. Sonuç: Araştırma sonucunda kemoterapi alan hastaların umut düzeylerinin ve kansere bağlı yaşam kalitelerinin orta, genel yaşam kalitelerinin düşük düzeyde olduğu ve kansere bağlı semptomları daha az yaşadıkları saptandı. Umut düzeylerinin genel semptomları ve yaşam kalitesini etkilediği belirlendi.

Relationship Between Hope and Quality of Life in Patients with Advanced Cancer in Uruguay: An Observational Analysis

Article

Full-text available

Dec 2023

Introduction: International research suggests a beneficial effect of hope on quality of life in advanced-stage cancer patients. Specific evidence for Latin America and Uruguay is limited, highlighting the need to explore this relationship for regional clinical strategies.Objective: To evaluate the correlation between hope and quality of life in Uruguayan patients with advanced cancer. Materials and Methods: This observational, analytical-descriptive, and cross-sectional study used the Herth Hope Index (HHI) and the Functional Assessment of Cancer Therapy - General (FACT-G) Quality of Life questionnaire. It included 59 patients aged 18 or older, diagnosed with advanced, non-curable cancer.

Online Cognitive Behavioral Stress Management Program for Breast Cancer Patients

Preprint

Full-text available

Apr 2023

Purpose: Breast cancer is a challenging process that affects the diagnosed people and their social environment psychologically, physiologically, socially,and economically. The main purpose of this study is to investigate the effectiveness of the Online Cognitive Behavioral Stress Management (CBSM) for Cancer program, which is prepared for people diagnosed with cancer to develop coping methods that will enable them to cope with the stress they experience in a healthy and active way. The research question is, whether attending the CBSM program is effective on psychological well- being of breast cancer patients. Material and Method: The study was completed with a total of 35 people, 17 in the experimental group and 18 in the control group. The pretest-posttest results of the experimental and control groups formed according to cancer type and stages were analyzed. The independent sample t-test was used in the comparison of the two groups of experimental and control groups. Paired sample t-test was used to compare the pretest-posttest scores. Results: There was no significant difference in the pre-test and post-test scores of the experimental and control groups in terms of mental adjustment to cancer. There was a significant difference observed between the experimental ,and control groups in the post-test measurements in terms of psychosocial adjustment to illness, assessment of coping attitudes, depression, hope, state and trait anxiety (p<.001). Conclusion: It can be stated that the Online CBSM program for breast cancer patients can enable them to cope with the stress they experience in a healthy and active way.

Beyond the Visible: The Relationship Between Social Appearance Anxiety, Hopelessness, and Depression in Women with Urinary Incontinence

Article

Jan 2025
INT UROGYNECOL J

This study aims to examine the relationship between the severity of urinary incontinence and levels of social appearance anxiety, hopelessness, and depression in women. A total of 393 women participated in this descriptive and correlational study. Data were collected using the Introductory Information Form, Incontinence Severity Index (ISI), Social Appearance Anxiety Scale (SAAS), Beck Hopelessness Scale (BHS), and Beck Depression Inventory (BDI). Of the participants, 46.3% reported moderate social appearance anxiety, while 25.2% had severe depression. The mean BHS score was 8.80 ± 5.63. No significant correlation was found between the severity of incontinence and social appearance anxiety (p > 0.05). A strong positive correlation was observed between the BDI and BHS scores (p < 0.001). A one-unit increase in age was associated with a 0.172 (B) increase in incontinence severity, and a one-unit increase in BDI score was linked to a 0.137 (B) increase in incontinence severity. The results suggest that increasing age is associated with greater severity of urinary incontinence. Higher incontinence severity is also correlated with higher levels of hopelessness and depression. The psychological impact of urinary incontinence on women’s mental health should be addressed, and referrals to psychiatric care should be considered when necessary for a comprehensive treatment approach.

Hope level and associated factors among older people living with HIV/AIDS: a cross-sectional study

Article

Full-text available

Apr 2024

Background In China, little is known about the hope level of older people living with HIV/AIDS (PLWHA).¹ This study was to examine the hope level of older PLWHA in China and identify related factors. Methods This cross-sectional study was conducted in Sichuan province in China among older PLWHA.² A standardized self-report questionnaire, the Herth Hope Index, was adopted. Multiple linear regression was used to identify factors influencing hope level. p-values <0.05 were considered statistically significant. Results There were 314 participants with an average age of 64.5 (SD ± 8.7). Most of the participants were males (72.6%), primary school and below (65.9%), rural household registration (58.6%) and married (64.3%). More than half of the older adults had pension insurance, had a monthly income of more than RMB 1,000 and considered themselves to be in good health. About 80% confirmed being diagnosed for more than a year and disclosed their HIV status to family and friends. The majority of the population had low medium social support (79%). More than 80% had moderate and severe HIV stigma. Many older PLWHA had medium and high levels of hope, with an average score of 34.31 (SD ± 4.85). Multiple linear regression showed that having pension insurance (β = 1.337, p = 0.015), longer diagnosis (β = 0.497, p = 0.031), better self-reported health (β = 1.416, p<0.001) and higher levels of social support (β = 2.222, p < 0.001) were positively associated with higher levels of hope. HIV stigma (β = −1.265, p < 0.001) was negatively correlated with hope level. Conclusion The hope level of older PLWHA is good, but there is still room for improvement, and its hope is related to multiple factors. Therefore, the AIDS-related healthcare sector should pay special attention to the hope of older PLWHA, help them to improve their health, provide financial assistance and social aid to those with financial difficulties, and take measures to reduce HIV stigma, improve family support for the older adults, and guide the older adults to adopt a positive approach to life.

Guidelines for goals of care discussions in patients with gynecologic cancer

Article

May 2023
GYNECOL ONCOL

This article represents a distillation of literature to provide guidance for goals of care discussions with patients who have gynecologic malignancies. As clinicians who provide surgical care, chemotherapy, and targeted therapeutics, gynecologic oncology clinicians are uniquely positioned to form longitudinal relationships with patients that can enable patient-centered decision making. In this review, we describe optimal timing, components, and best practices for goals of care discussions in gynecologic oncology.

Associated factors of hope in cancer patients during treatment: A systematic literature review

Article

Full-text available

Mar 2020
J ADV NURS

Aim: to identify the associated factors of hope during treatment in cancer patients. Background: Hope is very important to cancer patients at all stages of the disease process. Hope is seen as an important coping mechanism. Most research about hope in cancer patients considered the end of life or in palliative care. Several and different factors are associated with hope. It is not yet sufficiently clear which factors are associated with hope during the treatment. Design: a systematic literature review of quantitative empirical studies on hope in cancer patients during treatment. Data sources: Search in MEDLINE (PubMed interface), CINAHL (EBSCO interface), Psychinfo and Cochrane (January 2009-December 2018). Review methods: Empirical quantitative studies were included regardless of the disease stage, written in English or Dutch, measuring hope from the perspective of cancer patients. Two authors independently screened all the studies and assessed their quality. Results: Thirty three studies were included. Positive relationship has been established between hope and quality of life, social support, spiritual and existential well-being. Hope appears to be negatively associated with symptom burden, psychological distress and depression. There appears to be no relationship between hope and demographic and clinical variables. The relationship between anxiety and hope remains unclear. Conclusions: Hope primarily seems to be a process that takes place in a person's inner being rather than being determined from outside. Impact: Health professionals may want to focus on the meaning of hope for cancer patients in relation to the associated factors. A better understanding of the meaning of hope during treatment can be of great value in supporting cancer patients with regard to treatment decisions, psychosocial support, the experienced quality of life and symptom burden and any wishes they may have with regard to advanced care planning.

Predictors of Quality of Life in Patients with Breast Cancer

Article

Full-text available

Feb 2019

Introduction: Breast cancer is one of the most common cancers among women and is responsible for physical and sociomental problems. Evaluation of life quality is considered as an important issue in studying chronic diseases, especially cancer. Cancer affects the life quality of the patients in different degrees. Therefore, the effect of disease on life quality of these patients is an important consequence. Therefore, this study was conducted to determine the predictors of quality of life in patients with breasts cancer. Methods: This descriptive-analytical cross-sectional study was conducted in 2017 on 166 female under treatment for breast cancer who referred to Ghazi, Alzahra, Valiasr, and Shams hospitals in Tabriz city, Iran. Samples were selected through convenience method. Sociodemographic and quality of life questionnaires-Cancer 30 in breast cancer patients were completed through interview. Data analysis was performed using Pearson’s correlation, independent t, analysis of variance, and linear multivariate regression tests. Results: The mean ± standard deviation of total quality of life score was 59.1 ± 17.4 from the achievable range of 0 to 100. The highest mean score was obtained for cognitive performance subscale (74.9 ± 23.8), and the lowest mean score was achieved for emotional performance subscale (51.4 ± 21.1). According to the results obtained from the linear multivariate regression, variables of time of disease diagnosis, lifestyle, caregiver person, caregiver health status, and matrimonial satisfaction were among the predictors of total quality of life score. Conclusion: The results showed that quality of life in patients under treatment for breast cancer was moderate; therefore, special attention must be paid by caregivers to improve the quality of life in these patients considering its sociodemographic predictors

Rasch analysis of the Herth Hope Index in cancer patients

Article

Full-text available

Oct 2018
HEALTH QUAL LIFE OUT

Background: The concept of hope has been measured using the Herth Hope Index (HHI) in different samples, but varying factor structures comprising different items from the HHI have been reported. Therefore, further testing with regard to the dimensionality of the instrument is recommended. Rasch modeling can be used to evaluate validity evidence of an instrument's underlying structure, to identify items with poor fit to the rest of the scale, and to identify items that perform inconsistently across groups. The aim of this study was to assess the HHI's psychometric properties in a sample of cancer patients using a Rasch model. Adult oncology outpatients (n = 167) with pain from bone metastasis were included, and medical records were reviewed for disease and treatment information. Patients completed the 12-item HHI, which measures various dimensions of hope using a 4-point Likert scale that ranges from 1 (strongly disagree) to 4 (strongly agree). The internal scale validity, person response validity, unidimensionality, and uniform differential item functioning were evaluated by applying a Rasch rating scale model. Results: Five (42%) of the twelve items (#3, #4, #5, #6 and #7) did not meet the criterion set for item goodness-of-fit. After removing these 5 items, the resulting 7-item scale demonstrated acceptable item fit to the model, acceptable unidimensionality (52.6% of the variance explained), acceptable person goodness-of-fit, adequate separation, and no differential item function. Conclusion: A 7-item version of the HHI had better psychometric properties than the original 12-item version among patients with cancer-related pain. Trial registration: The protocol ID is 158,707/V10 and it was registered on ClinicalTrials.gov as NCT00760305 . Registered September 25, 2008.

Psychometric properties of Hope Scales: A systematic review

Article

Full-text available

Jun 2018

Introduction Hope is recognised as an important factor in health, illness, and well‐being. Many scales to measure hope have been developed and used in various disciplines, yet, their psychometric properties have not been systematically reviewed. Aim To systematically review the psychometric properties of hope scales. Design Systematic review. Methods Four electronic databases were searched followed by a hand search. The data were extracted and qualitatively evaluated by the COSMIN checklist, an instrument designed as a quality rating tool for systematic reviews of psychometric properties. Results From 1271 retrieved abstracts, 68 papers met the inclusion criteria. The most used scale was the Snyder Hope Scale (46%) followed by the Herth Hope Index (16%). All other scales (n = 16) were evaluated in less than 10% of the papers. Structural validity (91%), internal consistency (88%), and hypothesis testing (74%) were the most reported properties. Reliability (34%), cross‐cultural validity (34%), content validity (25%), and criterion validity (15%) were reported in less than 50% of the papers. Only two (3%) studies reported responsiveness, and none reported measurement error. Less than 35% of the validation studies achieved excellent or good quality for any of the measurement properties. Conclusion The results show that no robust and valid scale exists for measuring hope. It highlights important gaps in psychometric properties of hope scales. Despite more than 40 years of research and development of hope scales, the currently available scales do not meet the standards of psychometric evaluation. This calls for efforts to improve the quality of hope scales.

The association between hope, marital status, depression and persistent pain in men and women following cardiac surgery

Article

Full-text available

Jan 2018
BMC Wom Health

Background: Cardiac surgery is a major life event, and outcomes after surgery are associated with men's and women's ability to self-manage and cope with their cardiac condition in everyday life. Hope is suggested to impact cardiac health by having a positive effect on how adults cope with and adapt to illness and recommended lifestyle changes. Methods: We did a secondary analysis of 416 individuals (23% women) undergoing elective coronary artery bypass graft and/or valve surgery between March 2012 and September 2013 enrolled in randomized controlled trial. Hope was assessed using The Herth Hope Index (HHI) at three, six and 12 months following cardiac surgery. Linear mixed model analyses were performed to explore associations after cardiac surgery between hope, marital status, depression, persistent pain, and surgical procedure. Results: For the total sample, no statistically significant difference between global hope scores from 3 to 12 months was observed (ranging from 38.3 ± 5.1 at 3 months to 38.7 ± 5.1 at 12 months), and no differences between men and women were observed at any time points. However, 3 out of 12 individual items on the HHI were associated with significantly lower scores in women: #1) I have a positive outlook toward life, #3) I feel all alone, and #6) I feel scared about my future. Over the study period, diminished hope was associated with older age, lower education, depression prior to surgery, and persistent pain at all measurement points. Isolated valve surgery was positively associated with hope. While neither sex nor marital status, as main effects, demonstrated significant associations with hope, women who were divorced/widowed/single were significantly more likely to have lower hope scores over the study period. Conclusion: Addressing pain and depression, and promoting hope, particularly for women living alone may be important targets for interventions to improve outcomes following cardiac surgery. Trial registration: Clinical Trials gov Identifier: NCT01976403 . Date of registration: November 28, 2011.

Understanding how Coping Strategies and Quality of Life maintain Hope in Patients deliberating Phase-I Trial Participation

Article

Full-text available

Jun 2017
PSYCHO-ONCOLOGY

Objective: This study aimed to understand how hope and motivation of patients considering phase-I trial participation are affected by psychological factors such as coping strategies and locus of control (LoC), and general well-being as measured by the quality of life (QoL). Methods: An exploratory cross-sectional study was performed in patients with incurable cancer (N=135) referred to our phase-I unit for the first time. Patients were potentially eligible for phase-I trial participation and participated in our study while deliberating phase-I trial participation. We used questionnaires on hope, motivation to participate, coping, LoC, and QoL. To investigate the nature and magnitude of the relationships between the scales, a structural equation modeling (SEM) was fitted to the data. Results: Hope significantly predicted the motivation to participate in phase-I trials. Predictors of hope were a combination of flexible and tenacious goal pursuit (both p<0.01), internal LoC (p<0.01), and QoL (p<0.01). The SEM showed an exact fit to the data, using a null hypothesis significance test: chi-square (8)=9.30, p=0.32. Conclusions: Patients considering phase-I trial participation seem to use a pact of tenacious and flexible coping, and control to stay hopeful. Furthermore, hope and QoL positively affected each other. The psychological pact may promote an adaptation enabling them to adjust to difficult circumstances by unconsciously ignoring information, called dissonance reduction. This mechanism may impair their ability to provide a valid informed consent. We suggest including a systematic exploration of patients' social context and values before proposing a phase-I trial.

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

Article

Jan 2021

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.

Cochrane Handbook for Systematic Reviews of Interventions

Article

Sep 2019

The revised edition of the Handbook offers the only guide on how to conduct, report and maintain a Cochrane Review ? The second edition of The Cochrane Handbook for Systematic Reviews of Interventions contains essential guidance for preparing and maintaining Cochrane Reviews of the effects of health interventions. Designed to be an accessible resource, the Handbook will also be of interest to anyone undertaking systematic reviews of interventions outside Cochrane, and many of the principles and methods presented are appropriate for systematic reviews addressing research questions other than effects of interventions. This fully updated edition contains extensive new material on systematic review methods addressing a wide-range of topics including network meta-analysis, equity, complex interventions, narrative synthesis, and automation. Also new to this edition, integrated throughout the Handbook, is the set of standards Cochrane expects its reviews to meet. Written for review authors, editors, trainers and others with an interest in Cochrane Reviews, the second edition of The Cochrane Handbook for Systematic Reviews of Interventions continues to offer an invaluable resource for understanding the role of systematic reviews, critically appraising health research studies and conducting reviews.

Health professionals’ dealing with hope in palliative patients with cancer, an explorative qualitative research

Article

Jul 2018

Hope Herth Index (HHI): A Validation Study in Italian Patients with Solid and Hematological Malignancies on Active Cancer Treatment

Article

May 2012

Aims and background Although hope is a widely used term, the experience of hope in patients with chronic or even life-threatening diseases is often disregarded due to the scarcity of carefully designed and validated assessment tools. The aim of this study was to validate the Hope Herth Index (HHI) questionnaire in the Italian population of patients with solid or hematological malignancies during active cancer treatment. Methods After the translation procedures, the psychometric properties of the Italian version of HHI were evaluated in 266 patients with non-advanced cancer cared for in four different settings. Summative scores ranged from 12–48, with a higher score denoting greater hope. Confirmative factorial analysis was performed to assess dimensionality. The test-retest reliability was assessed by means of the Lin concordance coefficient (two weeks' interval, 80 patients). Concurrent validity was assessed through the following questionnaires: Hospital Anxiety and Depression Scale (HADS), Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp), Edmonton Symptom Assessment Scale (ESAS), and System Belief Inventory (SBI-15R). Results A total of 266 patients were enrolled. Confirmative factor analysis did not confirm the original three-factor solution, whereas a one-factor solution did perform well. Cronbach's alpha was 0.84 and the test-retest reliability was 0.64 (95% CI 0.51; 0.76). Large convergence was found with spiritual well-being as measured by the FACIT-Sp (0.69) and with anxiety-depression as measured by the HADS (inverse correlation: –0.51). Physical symptoms and religiousness were only slightly correlated, as expected. Conclusions The Italian version of HHI is a valid and reliable assessment tool – useful to initiate conversation with someone who is troubled but finds it difficult to talk – in patients with either solid or hematological malignancies on active cancer treatment during the non-advanced stages of the disease.