Article2016

Hope, Symptoms, and Palliative Care

Mellar P. Davis · Ruth L. Lagman · Armida Parala‐Metz · Chirag Amrutlal Patel · Tanya M Sanford · Flannery Fielding +4 more

44 citations0/0 files storedAmerican Journal of Hospice and Palliative Medicine®

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Optimism, Hope, and Well-being Cancer survivorship and care Palliative and Oncologic Care

Abstract

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.

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References

1992Abbreviated instrument to measure hope: development and psychometric evaluation 1985Hope: Its Spheres and Dimensions 1985Symposium on compassionate care and the dying experience. Hope: its spheres and dimensions.1990Fostering hope in terminally‐ill people 2000Enhancing hope in people with a first recurrence of cancer 2007Living with Hope: Initial Evaluation of a Psychosocial Hope Intervention for Older Palliative Home Care Patients 2010Metasynthesis of the Hope Experience of Family Caregivers of Persons With Chronic Illness 2010Hope in the Context of Lung Cancer: Relationships of Hope to Symptoms and Psychological Distress

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