Hostname: page-component-76fb5796d-zzh7m Total loading time: 0 Render date: 2024-04-25T20:40:55.078Z Has data issue: false hasContentIssue false
  • English
  • Français

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

Published online by Cambridge University Press:  12 January 2021

Andrea Bovero Open the ORCID record for Andrea Bovero [Opens in a new window] ,
Marta Opezzo ,
Rossana Botto ,
Francesco Gottardo  and
Riccardo Torta
Andrea Bovero*
Affiliation:
Clinical Psychology and Psycho-Oncology Unit, Department of Neuroscience, University of Turin, Azienda Ospedaliera Universitaria (A.O.U.) “Città della Salute e della Scienza” Hospital, Turin, Italy
Marta Opezzo
Affiliation:
Clinical Psychology and Psycho-Oncology Unit, Department of Neuroscience, University of Turin, Azienda Ospedaliera Universitaria (A.O.U.) “Città della Salute e della Scienza” Hospital, Turin, Italy
Rossana Botto
Affiliation:
Clinical Psychology and Psycho-Oncology Unit, Department of Neuroscience, University of Turin, Azienda Ospedaliera Universitaria (A.O.U.) “Città della Salute e della Scienza” Hospital, Turin, Italy
Francesco Gottardo
Affiliation:
Clinical Psychology and Psycho-Oncology Unit, Department of Neuroscience, University of Turin, Azienda Ospedaliera Universitaria (A.O.U.) “Città della Salute e della Scienza” Hospital, Turin, Italy
Riccardo Torta
Affiliation:
Clinical Psychology and Psycho-Oncology Unit, Department of Neuroscience, University of Turin, Azienda Ospedaliera Universitaria (A.O.U.) “Città della Salute e della Scienza” Hospital, Turin, Italy
*
Author for correspondence: Andrea Bovero, Clinical Psychology and Psycho-Oncology Unit, A.O.U. “Città della Salute e della Scienza” Hospital, Corso Bramante, n.88, 10126 Turin, Italy. E-mail: abovero@cittadellasalute.to.it
Get access Rights & Permissions [Opens in a new window]

Abstract

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.

Keywords

CancerEnd of lifeHopeMeaningPalliative care
Type
Original Article
Information
Palliative & Supportive Care , Volume 19 , Issue 5 , October 2021 , pp. 563 - 569
Check for updates
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abdullah-zadeh, F, Agahosseini, S, Asvadi-Kermani, I, et al. (2011) Hope in Iranian cancer patients. Iranian Journal of Nursing and Midwifery Research 16(4), 288–291.Google ScholarPubMed
Balsanelli, ACS, Grossi, SAA and Herth, KA (2010) Cultural adaptation and validation of the Herth Hope Index for Portuguese language: Study in patients with chronic illness. Texto & Contexto Enfermagem 19(4), 754–761.10.1590/S0104-07072010000400019CrossRefGoogle Scholar
Benzein, E, Norberg, A and Saveman, BI (2001) The meaning of the lived experience of hope in patients with cancer in palliative home care. Palliative Medicine 15(2), 117–126.CrossRefGoogle ScholarPubMed
Berendes, D, Keefe, FJ, Somers, TJ, et al. (2010) Hope in the context of lung cancer: Relationships of hope to symptoms and psychological distress. Journal of Pain and Symptom Management 40(2), 174–182.CrossRefGoogle Scholar
Bjelland, I, Dahl, AA, Haug, TT, et al. (2002) The validity of the hospital anxiety and depression scale: An updated literature review. Journal of Psychosomatic Research 52(2), 69–77.10.1016/S0022-3999(01)00296-3CrossRefGoogle Scholar
Bovero, A, Sedghi, NA, Botto, R, et al. (2018) Dignity in cancer patients with a life expectancy of a few weeks. Implementation of the factor structure of the patient dignity inventory and dignity assessment for a patient-centered clinical intervention: A cross-sectional study. Palliative & Supportive Care 16(6), 648–655.CrossRefGoogle ScholarPubMed
Bovero, A, Botto, R, Adriano, B, et al. (2019a) Exploring demoralization in end-of-life cancer patients: Prevalence, latent dimensions, and associations with other psychosocial variables. Palliative & Supportive Care 14, 1–8.Google Scholar
Bovero, A, Tosi, C, Botto, R, et al. (2019b). The spirituality in end-of-life cancer patients, in relation to anxiety, depression, coping strategies and the daily spiritual experiences: A cross- sectional study. Journal of Religion and Health 58(6), 2144–2160.10.1007/s10943-019-00849-zCrossRefGoogle Scholar
Breitbart, W, Rosenfeld, B, Pessin, H, et al. (2015) Meaning-centered group psychotherapy: An effective intervention for improving psychological well-being in patients with advanced cancer. Journal of Clinical Oncology 33(7), 749.CrossRefGoogle ScholarPubMed
Breitbart, W, Pessin, H, Rosenfeld, B, et al. (2018) Individual meaning-centered psychotherapy for the treatment of psychological and existential distress: A randomized controlled trial in patients with advanced cancer. Cancer 124(15), 3231–3239.CrossRefGoogle ScholarPubMed
Butt, CM (2011) Hope in adults with cancer: State of the science. Oncology Nursing Forum 38(5), E341–E350.CrossRefGoogle ScholarPubMed
Castelli, L, Binaschi, L, Caldera, P, et al. (2011) Fast screening of depression in cancer patients: The effectiveness of the HADS. European Journal of Cancer Care 20(4), 528–533.CrossRefGoogle ScholarPubMed
Chen, ML (2003) Pain and hope in patients with cancer: A role for cognition. Cancer Nursing 26(1), 61–67.CrossRefGoogle ScholarPubMed
Chi, GC (2007) The role of hope in patients with cancer. Oncology Nursing Forum 34(2), 415–424.CrossRefGoogle ScholarPubMed
Chochinov, HM (2002) Dignity-conserving care — A new model for palliative care: Helping the patient feel valued. JAMA 287(17), 2253–2260.CrossRefGoogle Scholar
Costantini, M, Musso, M, Viterbori, P, et al. (1999) Detecting psychological distress in cancer patients: Validity of the Italian version of the hospital anxiety and depression scale. Supportive Care in Cancer 7(3), 121–127.CrossRefGoogle ScholarPubMed
Costantini, A, Picardi, A, Brunetti, S, et al. (2013) La versione italiana della Demoralization scale: Uno studio di validazione. Rivista di Psichiatria 48(3), 234–239.Google Scholar
Crothers, MK, Tomter, HD and Garske, JP (2006) The relationships between satisfaction with social support, affect balance, and hope in cancer patients. Journal of Psychosocial Oncology 23(4), 103–118.CrossRefGoogle Scholar
Daneault, S, Lussier, V, Mongeau, S, et al. (2016) Ultimate journey of the terminally ill: Ways and pathways of hope. Canadian Family Physician 62(8), 648–656.Google Scholar
Delgado-Guay, MO (2014) Spirituality and religiosity in supportive and palliative care. Current Opinion in Supportive and Palliative Care 8(3), 308–313.CrossRefGoogle ScholarPubMed
Dufault, K and Martocchio, BC (1985) Symposium on compassionate care and the dying experience. Hope: Its spheres and dimensions. Nursing Clinics of North America 20(2), 379–391.Google ScholarPubMed
Duggleby, W and Wright, K (2004) Elderly palliative care cancer patients’ descriptions of hope-fostering strategies. International Journal of Palliative Nursing 10(7), 352–359.CrossRefGoogle ScholarPubMed
Ebright, PR and Lyon, B (2002) Understanding hope and factors that enhance hope in women with breast cancer. Oncology Nursing Forum 29, 561–568.CrossRefGoogle ScholarPubMed
Folstein, MF, Folstein, SE and McHugh, PR (1975) "Mini-mental state”: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research 12(3), 189–198.CrossRefGoogle ScholarPubMed
Garssen, B, Visser, A and de Jager Meezenbroek, E (2016) Examining whether spirituality predicts subjective well-being: How to avoid tautology. Psychology of Religion and Spirituality 8(2), 141–148.10.1037/rel0000025CrossRefGoogle Scholar
Geiser, F, Zajackowski, K, Conrad, R, et al. (2015) The German version of the Herth Hope Index (HHI-D): Development and psychometric properties. Oncology Research and Treatment 38(7–8), 356–360.CrossRefGoogle ScholarPubMed
Herth, K (1992) Abbreviated instrument to measure hope: Development and psychometric evaluation. Journal of Advanced Nursing 17(10), 1251–1259.10.1111/j.1365-2648.1992.tb01843.xCrossRefGoogle ScholarPubMed
Karnofsky, DA (1949) The clinical evaluation of chemotherapeutic agents in cancer. In MacLeod, CM (ed.), Evaluation of Chemotherapeutic Agents. New York, NY: Columbia University Press. pp. 191–205.Google Scholar
Kylmä, J, Duggleby, W, Cooper, D, et al. (2009) Hope in palliative care: An integrative review. Palliative and Supportive Care 7(3), 365–377.10.1017/S1478951509990307CrossRefGoogle ScholarPubMed
Lee, EH (2001) Fatigue and hope: Relationships to psychosocial adjustment in Korean women with breast cancer. Applied Nursing Research 14(2), 87–93.CrossRefGoogle ScholarPubMed
Lin, CC, Tsai, HF, Chiou, JF, et al. (2003) Changes in levels of hope after diagnostic disclosure among Taiwanese patients with cancer. Cancer Nursing 26, 155–160.CrossRefGoogle ScholarPubMed
Maltoni, M, Nanni, O, Pirovano, M, et al. (1999) Successful validation of the palliative prognostic score in terminally ill cancer patients. Journal of Pain and Symptom Management 17(4), 240–247.CrossRefGoogle ScholarPubMed
McClain, CS, Rosenfeld, B and Breitbart, W (2003) Effect of spiritual well-being on end-of-life despair in terminally-ill cancer patients. Lancet 361(9369), 1603–1607.CrossRefGoogle ScholarPubMed
Miller, JF (2007) Hope: A construct central to nursing. Nursing Forum 42(1), 12–19.CrossRefGoogle Scholar
Moss, AH, Lunney, JR, Culp, S, et al. (2010) Prognostic significance of the “surprise” question in cancer patients. Journal of Palliative Medicine 13(7), 837–840.CrossRefGoogle ScholarPubMed
Peterman, AH, Fitchett, G, Brady, MJ, et al. (2002) Measuring spiritual well-being in people with cancer: The functional assessment of chronic illness therapy-spiritual well-being scale (FACIT-Sp). Annals of Behavioral Medicine 24(1), 49–58.CrossRefGoogle Scholar
Puchalski, CM (2012) Spirituality in the cancer trajectory. Annals of Oncology 23(suppl_3), 49–55.CrossRefGoogle ScholarPubMed
Rawdin, B, Evans, C and Rabow, MW (2013) The relationships among hope, pain, psychological distress, and spiritual well-being in oncology outpatients. Journal of Palliative Medicine 16(2), 167–172.CrossRefGoogle ScholarPubMed
Reb, AM (2007) Transforming the death sentence: Elements of hope in women with advanced ovarian cancer. Oncology Nursing Forum 34(6), E70–E81.CrossRefGoogle ScholarPubMed
Ripamonti, CI, Buonaccorso, L, Maruelli, A, et al. (2012a) Hope Herth Index (HHI): A validation study in Italian patients with solid and hematological malignancies on active cancer treatment. Tumori 98(3), 385–392.CrossRefGoogle Scholar
Ripamonti, CI, Buonaccorso, L, Maruelli, A, et al. (2012b) Patient dignity inventory (PDI) questionnaire: The validation study in Italian patients with solid and hematological cancers on active oncological treatments. Tumori 98(4), 491–500.CrossRefGoogle Scholar
Robinson, S, Kissane, DW, Brooker, J, et al. (2016) A review of the construct of demoralization: History, definitions, and future directions for palliative care. American Journal of Hospice and Palliative Medicine 33(1), 93–101.CrossRefGoogle ScholarPubMed
Schjolberg, TK, Dodd, M, Henriksen, N, et al. (2011) Factors affecting hope in a sample of fatigued breast cancer outpatients. Palliative and Supportive Care 9(1), 63–72.CrossRefGoogle Scholar
Scott, J and Huskisson, EC (1976) Graphic representation of pain. Pain 2, 175–184.10.1016/0304-3959(76)90113-5CrossRefGoogle ScholarPubMed
Smith, TJ, Dow, L, Viraho, E, et al. (2011) A pilot trial of decision aids to give truthful prognostic and treatment information to chemotherapy patients with advanced cancer. The Journal of Supportive Oncology 9(2), 79–86.10.1016/j.suponc.2010.12.005CrossRefGoogle ScholarPubMed
Vellone, E, Rega, ML, Galletti, C, et al. (2006) Hope and related variables in Italian cancer patients. Cancer Nursing 29(5), 356–366.CrossRefGoogle ScholarPubMed
Young-Brockopp, D (1982) Cancer patients’ perception of five psychosocial needs. Oncology Nursing Forum 9(4), 31–35.Google ScholarPubMed