Background Maintaining hope has been referred to as a way to endure suffering among people living with a life-limiting disease. Reports about comfort and well-being in palliative care have indicated that hope is an indicator of the quality of life (QoL)and the quality of dying. This study aimed to characterise hope, comfort and QoL of palliative patients, and correlate these variables to the place of care.

Methods A cross-sectional observational study was conducted to test the hypothesis that hope is positively correlated to comfort and QoL and that patients in palliative care units had higher levels of hope, comfort, and QoL than other settings. Participants were recruited from daycare hospital, palliative care units and communitary palliative care in Portugal. Patients answered the Portuguese versions of Herth Hope Index, McGill Quality of Life Questionnaire and Hospice Comfort Questionnaire, a VAS for pain, two-item screening for depression and socio-demographic information. All ethical procedures were considered according to the Helsinki declaration.

Results A total of 205 palliative patients participated in the study (mean age 64.5, range 28–89). Most patients were diagnosed with metastatic cancer (85.4%). Palliative care patients in the sample experienced good level of hope, comfort and QoL. A strong correlation was noted between hope and QoL (0.65; p<0.001) and hope and comfort (0.58; p<0.001). QoL of patients attending daycare unit were higher compared to other settings (p<0.05). Patients experienced higher comfort at home (p<0.05). There were no differences in hope regarding the place of care.

Conclusions Palliative patients reported good levels of hope, comfort and QoL. As hope is dynamic and correlated to comfort and QoL, hope fostering interventions should be implemented in palliative care settings to increase the QoL and quality of death. Further research should address the causative relations among these variables.