A Brief Hope Intervention to Increase Hope Level and Improve Well-Being in Rehabilitating Cancer Patients: A Feasibility Test

The relationship between caregiver burden and hope in leukemia patients: a cross-sectional study in selected referral hospitals in Tehran, Iran

BACKGROUND

Leukemia is a life-threatening condition that imposes significant challenges not only on patients but also on their caregivers. Caregiver burden, a multidimensional concept encompassing physical, psychological, and emotional strain, often impacts the quality of care provided to patients. Conversely, hope, a critical psychological resource, plays a pivotal role in patient well-being and coping. Understanding the relationship between caregiver burden and patient hope is essential for improving holistic cancer care.

METHODS

This descriptive correlational study was conducted at the Cancer Institute and Valiasr Hospital, affiliated with Tehran University of Medical Sciences, between May and November 2024. A total of 400 participants, including 200 leukemia patients and their 200 primary caregivers, were recruited using convenience sampling. Data were collected using the Zarit Caregiver Burden Interview (ZBI) and Snyder's Adult Hope Scale (AHS). Descriptive statistics and Pearson's correlation coefficient were used to analyze the data in SPSS version 16, with a significance level of P < 0.05.

RESULTS

The mean caregiver burden score was 37.69 ± 7.12, indicating a moderate level of burden, while the mean hope score among leukemia patients was 32.19 ± 1.88, reflecting relatively high levels of hope. A weak but statistically significant negative correlation was found between caregiver burden and overall hope scores (r= -0.164, P = 0.02). However, no significant correlations were observed between caregiver burden and the subscales of hope, namely Pathway Thinking (r=-0.127, P = 0.073) and Agency Thinking (r=-0.126, P = 0.076).

CONCLUSION

The study highlights a significant inverse relationship between caregiver burden and patient hope, underscoring the interconnected dynamics between caregiver well-being and patient psychological resilience. Interventions aimed at reducing caregiver burden and fostering hope in patients are essential for enhancing the overall quality of care in leukemia.

CLINICAL TRIAL NUMBER

Not applicable.

Psychoeducational Intervention for Pain, Psychological Distress, Hope, and Post-traumatic Growth Among Breast Cancer Patients During Chemotherapy: A Pilot Randomized Controlled Trial

BACKGROUND

Chemotherapy is associated with many side effects, including pain and psychological distress, which affect patients' physical and psychological health.

AIM

The aim of this study was to elucidate the efficacy of a pain management intervention (POLA) to promote pain, psychological distress, hope and post-traumatic growth in breast cancer patients, also, to undertake a preliminary evaluation of the intervention.

METHODS

A pilot randomized controlled trial was conducted in an Iranian hospital involving 42 breast cancer (BC) patients during chemotherapy. The intervention group received a 6-week group therapy (90 minutes per session) administered by a psychologist. Meanwhile, the comparison group received standard care. patients' Pain, psychological distress, hope and post-traumatic growth were measured at 3 time points (baseline, week 6, and 12 weeks postintervention).

RESULTS

The study design was found to be feasible, with a recruitment rate of 61.64% and an attrition rate of 6.66%. Compared to the control group, the intervention group showed a significant reduction in pain, psychological distress, depression, anxiety, and stress, as well as a notable improvement in hope and post-traumatic growth (p < .01). These differences remained significant at follow-up (p < 0.05). The study population found the intervention acceptable, as evidenced by a high attendance rate of 90% and adherence rate of 90.47%.

CONCLUSION

Psychoeducational intervention positively affects the pain, psychological distress, hope and post-traumatic growth of BC patients during chemotherapy.

Children's perspective of hope in living with leukemia: A qualitative study using drawing

PURPOSE

This study aimed to explore children's perspective of hope in living with leukemia through the utilization of drawing-based interview technique.

DESIGN AND METHODS

This qualitative study was conducted at the Children's Medical Center in Tehran with the participation of children aged 6 to 12 diagnosed with leukemia. The children were asked to prepare a drawing about hope then interviews were conducted face-to-face with each child after completing the drawing. Data analysis was conducted using the qualitative content analysis.

RESULTS

In the collection of a total of 20 drawings from school-age children with leukemia, each drawings has different metaphors symbolizing hope. Five themes emerged including positive thinking, embracing the sanctuary of maternal affection and collective caring, the ethereal glow of joy, the melody of resilient soul, and navigating the way back to home.

CONCLUSION

Hope from the child's perspective can be achieved in simple, possible and accessible ways, making it easier for the family, community and healthcare system to inspire hope in their lives with Leukemia.

PRACTICE IMPLICATION

Health providers in pediatric oncology can integrate hope-based care interventions related to the factors influencing children's perspectives.

The experience of hope in dyads living with advanced chronic illness in Portugal: a longitudinal mixed-methods study

BACKGROUND

Hope is an important resource that helps patients and families thrive during difficult times. Although several studies have highlighted the importance of hope in different contexts, its specific manifestations in the realm of advanced chronic illness need further exploration. In this study, we sought to elucidate the intricate interplay between the construct of hope and the lived experience of advanced chronic illness within patient-caregiver dyads. Our objectives were (a) to explore the dyadic experience of hope as a changing dynamic over time for patients living with advanced chronic illness and their informal caregivers and (b) to evaluate variations of hope and symptom burden across time.

METHODS

We conducted a longitudinal mixed-methods study with a convergent design between December 2020 and April 2021. Patients living with advanced chronic illness and informal caregivers participated as a dyad (n = 8). The Herth Hope Index scale was used to measure dyads' level of hope and the Edmonton Symptom Assessment System was used to measure patients' symptom burden. Descriptive statistics were undertaken. A thematic analysis as described by Braun and Clarke was conducted to analyze dyadic interview data. Dyads' experience of hope was described by using the six dimensions of hope in the Model of Hope of Dufault and Martocchio.

RESULTS

Dyadic scores of hope and patients' symptom burden were stable over time. The constructs of hope in dyads included "Living one day at the time," "Having inner force/strength," and "Maintaining good health." Changes in patterns of hope were captured for each dyad in their transition over time. Data converged for all dyads except one.

CONCLUSIONS

The findings of our study show a constant presence of hope even in the face of adversity. Healthcare professionals must find ways to promote hope in dyads of patients living with advanced chronic diseases. Nurses play a pivotal role; dyadic interviews should be promoted to create a safe space for both patients and informal caregivers in order to share experiences. More research is needed to address patients' and informal caregivers' hope in chronic illness because current hope-based interventions primarily target cancer diagnoses.

A picture of hope: From the perspective of adolescents with cancer-A phenomenological-visual qualitative study

This study aims to investigate the phenomenon of hope in adolescents diagnosed with cancer and examine adolescents' lived experiences of hope. The study was conducted between November 2022 and March 2023. The study used a phenomenological-visual qualitative research design with 20 adolescents in the pediatric oncology ward. The purposive sampling method was used in the study. Data were collected using "Descriptive Characteristic Form," "Semi-structured Interview Form," "Drawing Technique," and "Mutual Storytelling Technique". The adolescents were instructed, "Let us draw our hopes," and asked to draw pictures. Each adolescent was interviewed about the drawings and asked four semi-structured questions. Audio recordings of the interviews were made and transcribed. A hermeneutic phenomenological approach was used in the analysis of the data. Two main themes and four subthemes were identified in the study. Metaphorical and conceptual context was included in the theme of symbolizing and linking hope. Two subthemes, facilitators and barriers, were identified in the main theme of rooting hope. The study sheds light on hope experiences in adolescents receiving cancer treatment and guides healthcare professionals.

Middle-aged and older adults in Aids village: a mixed methods study on talking about death and well-being promotion based on social support theory

Introduction

Will about talking about death bring well-being? This study aims to explore the impact of talking about death on the subjective well-being of the rural middle-aged and older adults in China's "Aids village" from five dimensions: the way of talking about death, the attitude towards talking about death, the objects of talking about death with, the frequency of talking about death and the content of the death talk, and investigate whether social support played a mediating role during this process.

Methods

A field survey and in-depth interviews were conducted in Wen Lou village (a famous Chinese "Aids village"), and valid questionnaires were completed by the HIV/Aids-affected middle-aged and older adults. A series of linear regression analyses were conducted to detect whether the way of talking about death, the attitude towards talking about death, the objects of talking about death with, the frequency of talking about death and the content of the death talk predict the subjective well-being of the HIV/Aids-affected middle-aged and older adults. An empirical test for mediation effect was performed to examine whether social support played a mediating role during the process.

Results

It was found that the more frequent the middle-aged and older adults talk about death, the higher level of their subjective well-being is (ΔR2 = 0.056, 0.05 < p < 0.10), and during which process social support played a mediating role.

Discussion

The author believes that using "talking about death" as a kind of medical intervention, carrying out corresponding life education and death education, and developing a suitable hospice care model, may be a valuable way for the HIV/Aids-affected middle-aged and older adults in the rural area.

Effectiveness of an app-based intervention to improve well-being through cultivating positive thinking and positive emotions in an adult sample: study protocol for a randomized controlled trial

Introduction

Interventions to promote health and well-being based on the construction of psychological resources can positively impact the daily life of users and foster human flourishing. Nowadays, mobile health represents a safe way to support health research and implement evidence-based psychological interventions. The present study aims to evaluate the effectiveness of a mobile app-based intervention program (OneUS) designed to cultivate positive emotions and positive thinking to improve overall well-being.

Methods

The study is designed as a randomized controlled trial. Two hundred participants will be randomly assigned to either a mobile health intervention condition (OneUS App) or an active control condition. The intervention consists of a program to cultivate positive emotions and positive thoughts. The active control intervention will comprise a set of mental imagery exercises and daily routine recording. The primary outcome comprises optimal well-being assessed using the multidimensional PERMA-Profiler scale. The sample will include adult people from the general population, who will be assessed at 8 time points: baseline (t1), intervention (t2, t3, t4, t5, t6) post-intervention (t7) and 3-month follow-up (t8).

Discussion

Mobile apps seem to be promising tools to promote health and well-being. This study will evaluate the effectiveness of a mobile app (OneUS) aiming to cultivate positive emotions and positive thinking to improve well-being. The main strength of this study is the development of an evidence-based mobile health app, based on intentional mental training, to promote well-being. The limitations of this study relate to potential participant drop-out and the non-generalizability of the results to clinical populations.

Clinical trial registration

https://ensaiosclinicos.gov.br/rg/RBR-43hpwqk, Identifier RBR-43hpwqk.

Hopefulness among individuals living with schizophrenia and their caregivers in Tanzania: an actor-partner interdependence model

BACKGROUND

Hopefulness is a positive orientation or state of mind that can aid in the recovery and treatment of mental illness, as it can have significant impacts on clinical and psychosocial outcomes. As resource-constrained settings work to implement recovery-oriented care, there is a need to better understand hopefulness among people living with schizophrenia (PLWS) and caregivers in their extended family networks. This study seeks to examine the dyadic relationship of hopefulness and its associated correlates among PLWS attending outpatient psychiatric clinics and their caregivers in Tanzania.

METHODS

This study utilized baseline and immediate post-intervention data collected as part of a randomized controlled trial testing a culturally tailored model of Family Psychoeducation, KUPAA, in Tanzania. The Herth Hope Index was used to measure hopefulness among PLWS (n = 33) and their caregivers (n = 33) at baseline and immediate post-intervention. Univariable and multivariable regression models were conducted to determine correlates of hopefulness at baseline, while the Actor-Partner Interdependence Model (APIM) was employed to examine the longitudinal, dyadic relationship of hopefulness among and between PLWS and their caregivers.

RESULTS

Better family functioning was associated with higher levels of hopefulness in PLWS and their caregivers. Lower levels of stigma, lower symptom severity, and lower disability were associated with higher levels of hopefulness in PLWS. For PLWS and their caregivers, actor effects from the APIM model were less than one (PLWS, [Formula: see text]; caregivers, [Formula: see text]), indicating stability (within each person) in hopefulness over time. Regarding partner effects, a caregiver's baseline hopefulness had a positive effect on the hopefulness of their PLWS at follow-up ([Formula: see text]). This indicates that higher caregiver hope at time 0 is associated with higher levels of hope in PLWS at time 1. Baseline hopefulness levels for PLWS had a negative effect on caregivers' hopefulness at follow-up ([Formula: see text]). This suggests that higher hopefulness among PLWS at baseline is associated with lower levels of hope in caregivers at follow-up.

CONCLUSION

Hopefulness is important to consider in family or caregiver-based treatments for PLWS because caregiver hopefulness may influence improvements in hopefulness among PLWS over time. Future studies should further explore the longitudinal dyadic relationship of hopefulness for these populations, as hope is a non-pharmacological and modifiable mechanism of change that is underutilized in care and treatment plans for PLWS globally.

TRIAL REGISTRATION

Clinical Trials #NCT04013932, July 10, 2019.

The Indirect Relationship Between Spiritual Experiences and Subjective Wellbeing Through Hope? A Sample of Chilean Students

Spirituality and religiousness are important factors for adolescents wellbeing. Little is known about the mechanisms underlying the positive relationship between spirituality as well as religiousness and subjective wellbeing. This study aimed to verify, whether, in a sample of Chilean students, religiousness is indirectly related to hope through spiritual experiences, and whether spiritual experiences are indirectly related to subjective wellbeing via hope. The sample consisted of 177 Chilean students and the following measures were applied: the Daily Spiritual Experiences Scale, the Herth Hope Index, the Satisfaction With Life Scale, the Positive and Negative Affect Schedule, and one item measuring the frequencies of prayer and Mass attendance. According to obtained results religiousness was indirectly, positively related to hope through spiritual experiences. In turn spiritual experiences were indirectly, positively related to subjective wellbeing through hope. Conducted research confirmed the beneficial role of religious practices, spiritual experiences, and hope for Chilean students' subjective wellbeing and the presence of mechanisms underlying the relationships between religiousness as well as spirituality and subjective wellbeing.

Hope and well-being

The numerous benefits of hope have been supported through decades of empirical research. One of these benefits is a marked increase in one's well-being. Well-being has been theoretically explored in the realms of an individual's interpersonal relations, life satisfaction, and capacity to reach their full potential. This positive relationship between hope and well-being has continued to be supported in recent literature and has been observed in various populations and amid a worldwide pandemic. Hope predicts increases in well-being in students, children, adolescents, and adults of different ages. This effect is seen across several ethnic groups and clinical populations. In addition, hope plays a mediating role between predictive constructs and well-being outcomes. To expand existing knowledge surrounding hope and its impacts on wellness, it is crucial to continue to diversify our populations of interest when exploring these constructs.

Promoting hope in minoritized and economically disadvantaged students

Minoritized and economically disadvantaged (MED) students encounter a host of detrimental factors within the academic setting (e.g., racism, classism, low expectations). In order for them to be successful, ways must be found to help them achieve academically despite their disadvantageous academic environments. Recent research indicates that hope theory might provide a pathway for MED students to have a higher chance at success. In this review, how hope has the potential to take on a special significance for MED students as well as how it can be leveraged to increase their odd of academic and life success is discussed. In addition, recent research centered around promoting hope in MED students, both formally and informally, is reviewed. Altogether, this review has implications for cultivating hope in schools.

Hope and cancer

Two models of hope have predominated in the literature pertaining to cancer-Snyder's "Hope Theory" and Herth's hope model-both of which have produced brief self-report measures. Growing evidence demonstrates that hope, as operationalized in these models, is associated with a number of psychological variables in individuals with cancer, including depression, distress, coping, symptom burden, and posttraumatic growth. Emerging evidence also suggests that hope may predict probability of survival in advanced cancer. Surveys show that patients and families generally prefer healthcare communication that authentically conveys prognosis; such communication is not associated with decreased hope, but may actually foster hope. Finally, several interventions have been developed to enhance hope in people with cancer, which generally demonstrate medium effects.

Hope-Based Program for Portuguese Outpatients with Advanced Chronic Illness in a Community Setting: A Randomized Control Trial

Background: Hope is widely considered a subjective phenomenon able to bring beneficial consequences to human health and existence. Maintaining hope amid a life-threatening disease and during palliative care is critical. The study aims to examine the effectiveness of a psychosocial supportive Hope Promotion Program (HPP) in enhancing hope, comfort, and quality of life in Portuguese adult outpatients with advanced and progressive chronic illness. Method: Using a parallel Randomized Control Trial (RCT) with pre-post design, 56 cancer outpatients from two day hospitals. Participants were randomly assigned to either a control group (n = 28) or an intervention group (n = 28). The primary outcome measure was hope. Secondary measures included comfort and quality of life. Participants were assessed at baseline, day 15, and day 30 of follow-up. Results: Baseline characteristics were similar between the two groups. In the intervention group, there was a significant increase in the total hope scores after the HPP (day 15). Significant differences were still present after one month (p < 0.05). There was also a significant increase in comfort and quality of life scores in the intervention group one month after HPP (p = 0.018). Conclusions: The HPP may be an effective intervention to increase hope and improve comfort and quality of life among palliative patients. Future studies should increase sample size, diversify settings, and include longer and more detailed follow-ups.

Effectiveness and content components of nursing counselling interventions on self‐ and symptom management of patients in oncology rehabilitation—A systematic review

AIM

To synthesize the evidence on the effectiveness and content components of nurse-led counselling interventions on the self-and symptom management of patients in oncology rehabilitation.

DESIGN

A systematic review METHODS: The electronic databases MEDLINE, CINAHL, Cochrane Library and Grey Literature were searched for randomized controlled trials or quasi-experimental trials. Following data extraction, a quality assessment was performed using the Joanna Briggs Institute checklist and the Cochrane risk-of-bias tool. The findings were synthesized in narrative and tabular formats.

RESULTS

Seven studies were included in the analysis. Two RCTs measured a statistically significant increase in self-efficacy compared to the control group, and one quasi-experimental study showed a statistically significant increase compared to the pre-intervention period. Symptom anxiety was statistically significantly reduced in two RCTs and one quasi-experimental trial. Self-management similarities in the components of the interventions were seen as identifying patients' concerns, setting goals, developing action plans and evaluating the goals and giving patient-tailored information.

A Descriptive and Phenomenological Exploration of the Spiritual Needs of Chinese Children Hospitalized with Cancer

Spiritual well-being is the fourth dimension of health, as equally important as physical, mental, and social well-being. The shadow of death associated with cancer triggers children to explore their personal values, meanings, and life goals throughout the illness trajectory, enabling them to identify their unique spiritual needs. Chinese children are generally non-religious, unlike Western children, which affects their spiritual needs. To address the literature gaps, we applied a qualitative, descriptive, phenomenological approach for exploring the spiritual needs of Chinese children hospitalized with cancer. Purposive sampling was conducted in two public hospitals with special wards for pediatric oncology patients in Hunan Province, China. Consequently, 22 children, hospitalized with cancer, were recruited and individually interviewed using a semi-structured interview format. We conducted a thematic analysis of the interview transcripts. Four important themes were identified: the need for self-exploration, inner needs, need for a connection with others, and need for a connection with gods, supernatural powers, and fictional characters. We found that culture significantly influenced the spiritual needs of Chinese children with cancer. Hope was a key factor motivating the children to continue cancer treatment. To address their unique spiritual needs, culturally specific interventions should be developed and incorporated into their care to enhance their spiritual well-being.

Psychosocial factors associated with dispositional hope, agency thinking, and pathways thinking in a homeless adult population

Adults facing homelessness often perceive themselves to be at the bottom of society, which has implications for their current and future well-being. Snyder's hope theory, which posits that agency thinking and pathways thinking are necessary for achieving a hopeful outlook on life, may be helpful for understanding drivers of well-being among individuals experiencing homelessness. In this study, we examined dispositional hope, perceived goal attainment, social support, and perceived standing in society among 123 adults experiencing homelessness who were attending a support group at a daytime drop-in center in the United States. Participants completed self-report measures related to the aforementioned variables of interest. We discovered that higher levels of self-reported goal attainment, independent of the type of goal identified, were significantly associated with total hope and both its subscales, that social support was significantly associated with total hope and pathways thinking, and that perceived standing in society was significantly associated with total hope and agency thinking.

Analysis of hope level and its influencing factors in patients with decompensated cirrhosis

AIM

The aim of this study was to examine hope level and its influencing factors in patients with decompensated liver cirrhosis.

DESIGN

A prospective observational study.

METHODS

We selected 93 patients with decompensated liver cirrhosis from a Chinese university hospital based on the inclusion and exclusion criteria. A general information questionnaire and Herth Hope Index were used, and multiple linear regression identified factors associated with the patients' hope level.

RESULTS

The participants' average hope level was 32.01 ± 6.14 (moderate). The hope score's highest and lowest dimensions were "interconnectedness" (11.29 ± 2.17) and "temporality and future" (10.12 ± 2.28), respectively. Multiple linear regression showed that education level and monthly per capita income were independent influencing factors (p < .05). These variables explained 38.3% of the variation in hope.

CONCLUSION

The participants' hope level was not optimal. Thus, medical staff should pay special attention to patients with low education level and poor economic status, and guide them to adopt a positive attitude.

Effectiveness of a brief hope intervention for chronic kidney disease patients on the decisional conflict and quality of life: a pilot randomized controlled trial

Background

Stage 5 chronic kidney disease (CKD) patients often experience decisional conflict when faced with the selection between the initiation of dialysis and conservative care. The study examined the effects of a brief hope intervention (BHI) on the levels of hope, decisional conflict and the quality of life for stage 5 CKD patients.

Methods

This is a single-blinded, randomized controlled trial (ClinicalTrials.gov identifier: NCT03378700). Eligible patients were recruited from the outpatient department renal clinic of a regional hospital. They were randomly assigned to either the intervention or the control group (intervention: n = 35; control: n = 37). All participants underwent a customized pre-dialysis education class, while the intervention group received also BHI. Data were collected prior to the intervention, immediately afterwards, and one month following the intervention. The Generalized Estimating Equation was used to measure the effects in the level of hope, decisional conflict scores (DCS) and Kidney Disease Quality of life (KDQOL-36) scores. Estimated marginal means and standard errors with 95% confidence intervals of these scores were also reported to examine the within group and between group changes.

Results

An increase of the hope score was found from time 1 (29.7, 1.64) to time 3 (34.4, 1.27) in the intervention group. The intervention had a significant effect on the KDQOL-36 sub-scores Mental Component Summary (MCS) (Wald χ² = 6.763, P = 0.009) and effects of kidney disease (Wald χ² = 3.617, P = 0.004). There was a reduction in decisional conflict in both arms on the DCS total score (Wald χ² = 7.885, P = 0.005), but the reduction was significantly greater in the control group (effect size 0.64).

Conclusions

The BHI appeared to increase the level of hope within the intervention arm. Nonetheless, differences across the intervention and control arms were not significant. The KDQOL-36 sub-scores on MCS and Effects of kidney disease were found to have increased and be higher in the intervention group. The DCS total score also showed that hope was associated with reducing decisional conflict.

Trial Registration

ClinicalTrials.gov Protocol Registration, NCT03378700. Registered July 12 2017.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12882-022-02830-7.

Digital Life Coaching During Stem Cell Transplantation: Development and Usability Study

BACKGROUND

For patients with multiple myeloma receiving high-dose chemotherapy followed by autologous stem cell transplantation (SCT), acute life disruptions and symptom burden may lead to worsened quality of life (QOL) and increased emotional distress. Digital life coaching (DLC), whereby trained coaches deliver personalized well-being-related support via phone calls and SMS text messaging, has been shown to improve QOL among SCT survivors. However, DLC has not been investigated during the acute peri-SCT period, which is generally characterized by symptomatic exacerbations and 2-week hospitalizations.

OBJECTIVE

We launched a single-arm pilot study to investigate the feasibility of patient engagement with DLC during this intensive period.

METHODS

We approached English-speaking adult patients with multiple myeloma undergoing autologous SCT at our center. Enrolled patients received 16 weeks of virtual access to a life coach beginning on day -5 before SCT. Coaches used structured frameworks to help patients identify and overcome personal barriers to well-being. Patients chose the coaching topics and preferred communication styles. Our primary endpoint was ongoing DLC engagement, defined as bidirectional conversations occurring at least once every 4 weeks during the study period. Secondary endpoints were electronic patient-reported outcome assessments of QOL, distress, and sleep disturbances.

RESULTS

Of the 20 patients who were screened, 17 (85%) chose to enroll and 15 (75%) underwent SCT as planned. Of these 15 patients (median age 65 years, range 50-81 years), 11 (73%) demonstrated ongoing DLC engagement. The median frequency of bidirectional conversations during the 3-month study period was once every 6.2 days (range 3.9-28 days). During index hospitalizations with median lengths of stay of 16 days (range 14-31 days), the median frequency of conversations was once every 5.3 days (range 2.7-15 days). Electronic patient-reported outcome assessments (94% adherence) demonstrated an expected QOL nadir during the second week after SCT. The prevalence of elevated distress was highest immediately before and after SCT, with 69% of patients exhibiting elevated distress on day -5 and on day +2.

CONCLUSIONS

DLC may be feasible for older patients during intensive hospital-based cancer treatments such as autologous SCT for multiple myeloma. The limitations of our study include small sample size, selection bias among enrolled patients, and heterogeneity in DLC use. Based on the positive results of this pilot study, a larger phase 2 randomized study of DLC during SCT is underway to investigate the efficacy of DLC with regard to patient well-being.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04432818; https://clinicaltrials.gov/ct2/show/NCT04432818.

Effects of Psychotherapy on Hope/Hopelessness in Adults with Cancer: a Systematic Review and Meta-analysis

BACKGROUND

Although psychotherapy is a common treatment for hopelessness and hope, the effectiveness remains controversial. The purpose of this study was to quantitatively synthesize available evidence related to the effect of a broad range of psychotherapy interventions on hope/hopelessness in cancer patients.

METHOD

Eight electronic databases were searched for studies with adult cancer patients (mean age ≥ 18 years) receiving psychotherapy interventions with hope/hopelessness measured as outcomes and written in English. We used the random-effects model to compute effect size using Hedges' g and conducted moderator analyses.

RESULTS

We found 27 primary studies which included 1,998 participants who were 57.6 ± 8.0 years old across studies. The psychotherapy effect size ranged from - 0.86 to 2.92. Researchers who conducted psychotherapy at hospital/health centers showed higher effects, that is, improved hope scores (g = 0.63), than those who conducted psychotherapy in the community (g = 0.05). When researchers enrolled participants alone, psychotherapy resulted in higher effects (g = 0.62) than when partners/caregivers were involved (g = - 0.04). Researchers who included group discussion showed lower effects (g = 0.36) than without group discussion (g = 1.10). Researchers who examined fidelity found lower effects (g = 0.16) than researchers who did not examine fidelity (g = 0.66). Interestingly, researchers who studied people with breast cancer showed higher effects (g = 0.96) than those who studied people with other types of cancer (g = 0.26). Researchers who included higher percentages of women showed greater effects (slope = 0.008, Q_model = 3.99, p = 0.046). Finally, the greater the time span between psychotherapy and the measurement of hope, the lower the psychotherapy effects (slope = - 0.002, Q_model = 4.25, p = 0.039).

CONCLUSION

Psychotherapy had a solid moderate effect on reducing hopelessness and improving hope in cancer patients compared to controls.

Hope and Fear of Threats as Predictors of Coping with Two Major Adversities, the COVID-19 Pandemic and an Armed Conflict

Coping with adversities has been explained by two major theories: the fear appeal theory and the hope theory. The predictability of hope with that of fear of threats as variables explaining coping with two major adversities, the COVID-19 pandemic and an armed conflict, was compared. Participants were approached via an internet panel company in two different times: (1) January 2021 (N = 699; age range: 18–82; 330 women), during the third wave of the COVID-19 pandemic in Israel and (2) May 2021 (N = 647; age range: 19–83; 297 women), during an armed conflict between Israel and Hamas. Participants self-reported on hope, four perceived threats (health, economics, security, and political), well-being, individual resilience, societal resilience, and distress symptoms (anxiety and depression symptoms) were collected. Hope was found as a more consistent and stronger predictor of the following expressions of coping: well-being, individual and societal resilience, depression, and anxiety. It can be concluded that hope is a better and more consistent predictor of coping, as well as coping suppressing expressions, compared with fear of threats, in the face of the current adversities. The innovative nature of these findings, the importance of hope as a coping supporter, and the need for replicating these innovative results are discussed and elaborated.

Symbols of Hope on Pediatric Oncology Ward: Children's Perspective Using Photovoice

Background Hope nurtures confidence and enhances positivity. It is known to be a critical factor in illness, recovery and healing. This study aimed to identify the views of hospitalized children with cancer about the circumstances and factors that create hope for them in the oncology ward. Methods: This qualitative study explored children's experiences using Photovoice, which is an arts-based approach. Twenty children aged 6-12 years diagnosed with various cancers at a Pediatric Hospital in Tehran, Iran, participated in this study. Participants were requested to take photographs of objects, circumstances, or anything that gave them hope or represented a sign of hope in the oncology ward. The photographs were then used to facilitate face-to-face interviews with these children. Data were analyzed using thematic analysis. Results: Data analysis revealed six main themes: emotional connectedness with nursing staff; the playroom as a means to soften the hospital space; the presence of a parent; symbols of recovery; a touch of nature in the hospital setting; and escaping the hospital cage. Discussion: Hopefulness among children can emanate from diverse events and circumstances within the hospital environment. Nurses and physicians need an understanding of children's perspectives to design interventions to improve hopefulness among hospitalized children with cancer.

Depression, hope and social support among older people with cancer: a comparison of Muslim Palestinian and Jewish Israeli cancer patients

OBJECTIVES

Studies of depression in older Muslim Palestinians diagnosed with cancer are scarce. To gain insight into the psychological response and coping ability of this very large, globally distributed population, we collected data from older Muslim Palestinian people diagnosed with cancer concerning depression hope and perceived social support. Both hope and social support were selected because they can be manipulated through intervention and education, as shown in the geriatric literature. Data were compared to data collected from older Jewish Israeli people diagnosed with cancer.

DESIGN

The study sample comprised 143 Muslim Palestinian and 110 Jewish Israeli people diagnosed with cancer, aged ≥ 65. All participants were either in treatment for active disease or within 6 months of such treatment. Self-administered measures included depression (the Five-Item Geriatric Depression Scale), perceived social support (Cancer Perceived Agents of Social Support Questionnaire) and hope (Snyder's Adult Hope Scale).

RESULTS

Hope and depression were both found to be significantly higher among the Muslim Palestinian patients than in the Jewish Israeli participants. In both samples, higher levels of hope were associated with lower levels of depression, with this correlation stronger in the Jewish Israeli group.

CONCLUSION

To improve the psychological wellbeing of patients, healthcare providers must exercise cultural sensitivity in their interactions, respecting the perspectives of both the patients and their families. Incorporating the concept of hope into the therapeutic dialogue and language may improve psychological wellbeing and synchronize the needs and expectations of patients, caregivers, and healthcare professionals, resulting in more equitable, effective and value-oriented care.

Developing pathways, a hope-enhancing intervention for metastatic lung cancer patients receiving cancer treatment

OBJECTIVE

Between 40% and 65% of lung cancer patients report concern about maintaining valued activities and roles, yet few interventions address this concern. Hope, a patient's perceived ability to generate goals and identify ways to pursue them, may be a promising intervention target to support function among lung cancer patients. The goal of this study was to assess metastatic non-small cell lung cancer (mNSCLC) patient interest and preferences for a hope-enhancing intervention.

METHODS

We conducted a sequential mixed-methods (survey followed by semi-structured interviews) study with patients with mNSCLC. Surveys assessed patient interest in, perceived helpfulness of, and preferences for a hope intervention. A subset of 12 patients (and caregivers, when present) completed semi-structured interviews to elicit feedback on proposed intervention content and procedures.

RESULTS

Survey data from 60 patients (40% male; Mean age = 62.5; SD = 9.3) suggested high perceived importance of pursuing personal goals during cancer treatment, moderate perceived helpfulness in discussing personal goals, and preference for a nurse-led intervention. Based on these data, a 5-session, nurse-led intervention protocol was drafted and reviewed with 12 patients. Interviewed patients and caregivers agreed working towards goals was beneficial, liked the intervention concept, and thought prompts and rating scales on handouts would facilitate discussion. The majority preferred nurse delivery during infusions.

CONCLUSIONS

A nurse-led hope-enhancing intervention delivered primarily during infusions may be acceptable to mNSCLC patients. Future work should test feasibility and identify ways to incorporate caregivers and oncology providers into hope interventions.

The effects of a brief hope intervention on decision-making in chronic kidney disease patients: A study protocol for a randomized controlled trial

AIMS

This study describes the study protocol of a manualized brief hope intervention that is based on the theoretical proposition - hope theory.

BACKGROUND

Patients with stage 5 chronic kidney disease often had decisional regret when facing the tension of treatment alternatives between dialysis initiation and palliative care. Hope has been found to account for therapeutic changes in clients with depressive symptoms, heightens positive expectations, and striving to accomplish chosen goals. Nevertheless, little is known about the effect of hope on decisional conflict and its influences to the quality of life in these chronic kidney disease patients.

DESIGN

This study is a single-blinded, randomized controlled trial.

METHODS

Participants will be recruited from a regional hospital (approved in April 2018). They will be randomly assigned in equal numbers to either the brief hope intervention or the control arm on completion of the baseline assessment on the possible need of dialysis initiation. Participants in the intervention group will receive the pre-dialysis education and a 4-week Brief Hope Intervention [consisting of four sessions at weekly intervals (two face-to-face sessions and two telephone follow-up sessions in between)], while those allocated to the control arm will receive the renal education and social chats. Outcome measures will be carried out prior to the intervention (baseline), immediately, and 1 month after the intervention. These consist of the hope level, decisional conflict, and quality of life. Healthcare resources use data will be reported.

IMPACT

The study results have the potential to add scientific evidence to the research-tested programme when developing renal services integral to multimodal care management to optimize decision-making and attain better health outcomes.