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Level and direction of hope in cancer patients: an exploratory longitudinal study

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Abstract

Goals

Hope is an important factor to consider when caring for cancer patients as a key component of coping with adversity. The aim of our study was to address the following questions: Is there a difference in level of hope between those patients being curatively and those palliatively treated, and how does this change over time? What are patients’ most important hopes? Better understanding of patients’ hopes may promote more effective patient-centered care.

Materials and methods

Outpatients referred to medical oncology or pain and symptom clinics at the London Regional Cancer Program were surveyed before consultation. The Herth Hope Index (HHI) questionnaire was administered to assess level of hope, and the patients were asked to indicate their highest priority hopes. Qualitative thematic analysis was performed on the responses, and comparison was made between patients treated with curative vs those treated with palliative intent. This survey was repeated 4 months after initial assessment.

Results

Fifty patients were surveyed (29 curative-intent; 21 palliative). Highest priority initial hopes were categorized as follows: cure, other positive health outcomes, emotional well-being, life achievements/return to normalcy, interpersonal goals, other. There was no association noted between treatment intent and choice of highest-priority hope. Follow-up assessments after 4 months revealed no significant differences in the distribution pattern of hopes. There was a statistically significant increase in the HHI over time in curatively treated patients, but none in the combined analysis.

Discussion and conclusion

Our study indicates that patients receiving palliative therapy have a HHI score not significantly different from patients being treated for cure. The hope deemed most important is also similar between groups. Over time, overall hope was maintained or increased even in the presence of a trend towards fewer patients hoping for a cure. These results remind oncologists to explore the experience of hope with all patients to ensure that the subjective needs and goals of the patients are met by the proposed therapies.

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Acknowledgments

We would like to acknowledge the contribution of Frances Whiston in preparing and maintaining our database. Many thanks also to Elenor Dilullo for the help with the data collection and telephone calls.

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Authors and Affiliations

  1. London Regional Cancer Program, London Health Sciences Centre, 790 Commissioners Road East, London, ON, N6A 4L6, Canada

    Michael Sanatani

  2. Department of Family Medicine and Palliative Care, London Health Sciences Centre, Room C6-008, 800 Commissioners Road East, London, ON, N6A 4L6, Canada

    Gil Schreier

  3. Department of Clinical Epidemiology and Biostatistics, University of Western Ontario, London, ON, N6A 4L6, Canada

    Larry Stitt

Authors
  1. Michael Sanatani
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  2. Gil Schreier
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  3. Larry Stitt
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Correspondence to Michael Sanatani.

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Sanatani, M., Schreier, G. & Stitt, L. Level and direction of hope in cancer patients: an exploratory longitudinal study. Support Care Cancer 16, 493–499 (2008). https://doi.org/10.1007/s00520-007-0336-6

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  • DOI: https://doi.org/10.1007/s00520-007-0336-6

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