Hope and illness expectations: A cross-sectional study in patients with advanced cancer
Background: The fear of taking away hope hinders clinicians’ willingness to share serious news with patients with advanced disease. Unrealistic illness expectations, on the other hand, can complicate decision making and end-of-life care outcomes. Exploration of the association between hope and illne...
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| Veröffentlicht in: | Palliative medicine 2024-01, Vol.38 (1), p.131-139 |
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| creator | Loučka, Martin Althouse, Andrew D Arnold, Robert M Smith, Thomas J Smith, Kenneth J White, Douglas B Rosenzweig, Margaret Q Schenker, Yael |
| description | Background:
The fear of taking away hope hinders clinicians’ willingness to share serious news with patients with advanced disease. Unrealistic illness expectations, on the other hand, can complicate decision making and end-of-life care outcomes. Exploration of the association between hope and illness expectations can support clinicians in better communication with their patients.
Aim:
The aim of this study was to explore whether realistic illness expectations are associated with reduced hope in people with advanced cancer.
Design:
This is a cross-sectional secondary analysis of baseline data from a primary palliative care cluster-randomized trial CONNECT (data collected from July 2016 to October 2020). Hope was measured by Herth Hope Index. Illness expectations were measured by assessing patients’ understanding of their treatment goals, life expectancy, and terminal illness acknowledgement. Multivariable regression was performed, adjusting for demographical and clinical confounders.
Setting/participants:
Adult patients with advanced solid cancers recruited across 17 oncology clinics.
Results:
Data from 672 patients were included in the study, with mean age of 69.3 years (±10.2), 53.6% were female. Proportion of patients indicating realistic expectations varied based on which question was asked from 10% to 46%. Median level of hope was 39 (IQR = 36–43). Multivariate non-inferiority regression did not find any significant differences in hope between patients with more and less realistic illness expectations.
Conclusions:
Our results suggest that hope can be sustained while holding both realistic and unrealistic illness expectations. Communication about serious news should focus on clarifying the expectations as well as supporting people’s hopes. |
| doi_str_mv | 10.1177/02692163231214422 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_miscellaneous_2902942382</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_02692163231214422</sage_id><sourcerecordid>2916634707</sourcerecordid><originalsourceid>FETCH-LOGICAL-c376t-fb1a52bebb08e8464d77aab11b7c85aabcc99e799019f020ab424b04902b6eee3</originalsourceid><addsrcrecordid>eNp1kcGO0zAQhi20iJbCA3BBlvbCJYvHduyEy6qqgCKtxAUEN8t2Jm2qNMnGSZe-PQ5dCsuK01gz3_wznp-QV8CuALR-y7jKOSjBBXCQkvMnZA5S64QJ9v2CzKd6MgEz8jyEHWMgmJLPyExkLNOZgDn5tm47pLYpaFXXDYZA8UeHfrBD1TbhHV1S37chJCHmYsbWNAxjcaRVQ7vIYDMEelcNW2qLg208FtRPoX9Bnpa2DvjyPi7I1w_vv6zWyc3nj59Wy5vEC62GpHRgU-7QOZZhJpUstLbWATjtszS-vM9z1HnOIC8ZZ9ZJLh2TOeNOIaJYkOuTbje6PRY-LtTb2nR9tbf90bS2Mg8rTbU1m_ZgANKUqzSLCm_uFfr2dsQwmH0VPNa1bbAdg-FxVi65yHhEL_9Bd-3Yx6NMFCglpGY6UnCifl2ux_K8DTAz-WYe-RZ7Xv_9jXPHb6MicHUCgt3gn7H_V_wJQB6hEA</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2916634707</pqid></control><display><type>article</type><title>Hope and illness expectations: A cross-sectional study in patients with advanced cancer</title><source>MEDLINE</source><source>Applied Social Sciences Index & Abstracts (ASSIA)</source><source>SAGE Complete A-Z List</source><creator>Loučka, Martin ; Althouse, Andrew D ; Arnold, Robert M ; Smith, Thomas J ; Smith, Kenneth J ; White, Douglas B ; Rosenzweig, Margaret Q ; Schenker, Yael</creator><creatorcontrib>Loučka, Martin ; Althouse, Andrew D ; Arnold, Robert M ; Smith, Thomas J ; Smith, Kenneth J ; White, Douglas B ; Rosenzweig, Margaret Q ; Schenker, Yael</creatorcontrib><description>Background:
The fear of taking away hope hinders clinicians’ willingness to share serious news with patients with advanced disease. Unrealistic illness expectations, on the other hand, can complicate decision making and end-of-life care outcomes. Exploration of the association between hope and illness expectations can support clinicians in better communication with their patients.
Aim:
The aim of this study was to explore whether realistic illness expectations are associated with reduced hope in people with advanced cancer.
Design:
This is a cross-sectional secondary analysis of baseline data from a primary palliative care cluster-randomized trial CONNECT (data collected from July 2016 to October 2020). Hope was measured by Herth Hope Index. Illness expectations were measured by assessing patients’ understanding of their treatment goals, life expectancy, and terminal illness acknowledgement. Multivariable regression was performed, adjusting for demographical and clinical confounders.
Setting/participants:
Adult patients with advanced solid cancers recruited across 17 oncology clinics.
Results:
Data from 672 patients were included in the study, with mean age of 69.3 years (±10.2), 53.6% were female. Proportion of patients indicating realistic expectations varied based on which question was asked from 10% to 46%. Median level of hope was 39 (IQR = 36–43). Multivariate non-inferiority regression did not find any significant differences in hope between patients with more and less realistic illness expectations.
Conclusions:
Our results suggest that hope can be sustained while holding both realistic and unrealistic illness expectations. Communication about serious news should focus on clarifying the expectations as well as supporting people’s hopes.</description><identifier>ISSN: 0269-2163</identifier><identifier>ISSN: 1477-030X</identifier><identifier>EISSN: 1477-030X</identifier><identifier>DOI: 10.1177/02692163231214422</identifier><identifier>PMID: 38087831</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Adult ; Advance directives ; Aged ; Cancer ; Communication ; Cross-Sectional Studies ; Decision making ; End of life decisions ; Female ; Health psychology ; Hope ; Hospice care ; Humans ; Inferiority ; Life expectancy ; Life goals ; Male ; Middle Aged ; Motivation ; Neoplasms - therapy ; News ; Oncology ; Palliative care ; Palliative Care - methods ; Randomized Controlled Trials as Topic ; Spirituality ; Terminal Care ; Terminal illnesses</subject><ispartof>Palliative medicine, 2024-01, Vol.38 (1), p.131-139</ispartof><rights>The Author(s) 2023</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c376t-fb1a52bebb08e8464d77aab11b7c85aabcc99e799019f020ab424b04902b6eee3</cites><orcidid>0000-0002-9875-7997</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/02692163231214422$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/02692163231214422$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>230,314,780,784,885,21819,27924,27925,30999,43621,43622</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38087831$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Loučka, Martin</creatorcontrib><creatorcontrib>Althouse, Andrew D</creatorcontrib><creatorcontrib>Arnold, Robert M</creatorcontrib><creatorcontrib>Smith, Thomas J</creatorcontrib><creatorcontrib>Smith, Kenneth J</creatorcontrib><creatorcontrib>White, Douglas B</creatorcontrib><creatorcontrib>Rosenzweig, Margaret Q</creatorcontrib><creatorcontrib>Schenker, Yael</creatorcontrib><title>Hope and illness expectations: A cross-sectional study in patients with advanced cancer</title><title>Palliative medicine</title><addtitle>Palliat Med</addtitle><description>Background:
The fear of taking away hope hinders clinicians’ willingness to share serious news with patients with advanced disease. Unrealistic illness expectations, on the other hand, can complicate decision making and end-of-life care outcomes. Exploration of the association between hope and illness expectations can support clinicians in better communication with their patients.
Aim:
The aim of this study was to explore whether realistic illness expectations are associated with reduced hope in people with advanced cancer.
Design:
This is a cross-sectional secondary analysis of baseline data from a primary palliative care cluster-randomized trial CONNECT (data collected from July 2016 to October 2020). Hope was measured by Herth Hope Index. Illness expectations were measured by assessing patients’ understanding of their treatment goals, life expectancy, and terminal illness acknowledgement. Multivariable regression was performed, adjusting for demographical and clinical confounders.
Setting/participants:
Adult patients with advanced solid cancers recruited across 17 oncology clinics.
Results:
Data from 672 patients were included in the study, with mean age of 69.3 years (±10.2), 53.6% were female. Proportion of patients indicating realistic expectations varied based on which question was asked from 10% to 46%. Median level of hope was 39 (IQR = 36–43). Multivariate non-inferiority regression did not find any significant differences in hope between patients with more and less realistic illness expectations.
Conclusions:
Our results suggest that hope can be sustained while holding both realistic and unrealistic illness expectations. Communication about serious news should focus on clarifying the expectations as well as supporting people’s hopes.</description><subject>Adult</subject><subject>Advance directives</subject><subject>Aged</subject><subject>Cancer</subject><subject>Communication</subject><subject>Cross-Sectional Studies</subject><subject>Decision making</subject><subject>End of life decisions</subject><subject>Female</subject><subject>Health psychology</subject><subject>Hope</subject><subject>Hospice care</subject><subject>Humans</subject><subject>Inferiority</subject><subject>Life expectancy</subject><subject>Life goals</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Motivation</subject><subject>Neoplasms - therapy</subject><subject>News</subject><subject>Oncology</subject><subject>Palliative care</subject><subject>Palliative Care - methods</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Spirituality</subject><subject>Terminal Care</subject><subject>Terminal illnesses</subject><issn>0269-2163</issn><issn>1477-030X</issn><issn>1477-030X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><recordid>eNp1kcGO0zAQhi20iJbCA3BBlvbCJYvHduyEy6qqgCKtxAUEN8t2Jm2qNMnGSZe-PQ5dCsuK01gz3_wznp-QV8CuALR-y7jKOSjBBXCQkvMnZA5S64QJ9v2CzKd6MgEz8jyEHWMgmJLPyExkLNOZgDn5tm47pLYpaFXXDYZA8UeHfrBD1TbhHV1S37chJCHmYsbWNAxjcaRVQ7vIYDMEelcNW2qLg208FtRPoX9Bnpa2DvjyPi7I1w_vv6zWyc3nj59Wy5vEC62GpHRgU-7QOZZhJpUstLbWATjtszS-vM9z1HnOIC8ZZ9ZJLh2TOeNOIaJYkOuTbje6PRY-LtTb2nR9tbf90bS2Mg8rTbU1m_ZgANKUqzSLCm_uFfr2dsQwmH0VPNa1bbAdg-FxVi65yHhEL_9Bd-3Yx6NMFCglpGY6UnCifl2ux_K8DTAz-WYe-RZ7Xv_9jXPHb6MicHUCgt3gn7H_V_wJQB6hEA</recordid><startdate>20240101</startdate><enddate>20240101</enddate><creator>Loučka, Martin</creator><creator>Althouse, Andrew D</creator><creator>Arnold, Robert M</creator><creator>Smith, Thomas J</creator><creator>Smith, Kenneth J</creator><creator>White, Douglas B</creator><creator>Rosenzweig, Margaret Q</creator><creator>Schenker, Yael</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-9875-7997</orcidid></search><sort><creationdate>20240101</creationdate><title>Hope and illness expectations: A cross-sectional study in patients with advanced cancer</title><author>Loučka, Martin ; Althouse, Andrew D ; Arnold, Robert M ; Smith, Thomas J ; Smith, Kenneth J ; White, Douglas B ; Rosenzweig, Margaret Q ; Schenker, Yael</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c376t-fb1a52bebb08e8464d77aab11b7c85aabcc99e799019f020ab424b04902b6eee3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adult</topic><topic>Advance directives</topic><topic>Aged</topic><topic>Cancer</topic><topic>Communication</topic><topic>Cross-Sectional Studies</topic><topic>Decision making</topic><topic>End of life decisions</topic><topic>Female</topic><topic>Health psychology</topic><topic>Hope</topic><topic>Hospice care</topic><topic>Humans</topic><topic>Inferiority</topic><topic>Life expectancy</topic><topic>Life goals</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Motivation</topic><topic>Neoplasms - therapy</topic><topic>News</topic><topic>Oncology</topic><topic>Palliative care</topic><topic>Palliative Care - methods</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Spirituality</topic><topic>Terminal Care</topic><topic>Terminal illnesses</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Loučka, Martin</creatorcontrib><creatorcontrib>Althouse, Andrew D</creatorcontrib><creatorcontrib>Arnold, Robert M</creatorcontrib><creatorcontrib>Smith, Thomas J</creatorcontrib><creatorcontrib>Smith, Kenneth J</creatorcontrib><creatorcontrib>White, Douglas B</creatorcontrib><creatorcontrib>Rosenzweig, Margaret Q</creatorcontrib><creatorcontrib>Schenker, Yael</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Palliative medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Loučka, Martin</au><au>Althouse, Andrew D</au><au>Arnold, Robert M</au><au>Smith, Thomas J</au><au>Smith, Kenneth J</au><au>White, Douglas B</au><au>Rosenzweig, Margaret Q</au><au>Schenker, Yael</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hope and illness expectations: A cross-sectional study in patients with advanced cancer</atitle><jtitle>Palliative medicine</jtitle><addtitle>Palliat Med</addtitle><date>2024-01-01</date><risdate>2024</risdate><volume>38</volume><issue>1</issue><spage>131</spage><epage>139</epage><pages>131-139</pages><issn>0269-2163</issn><issn>1477-030X</issn><eissn>1477-030X</eissn><abstract>Background:
The fear of taking away hope hinders clinicians’ willingness to share serious news with patients with advanced disease. Unrealistic illness expectations, on the other hand, can complicate decision making and end-of-life care outcomes. Exploration of the association between hope and illness expectations can support clinicians in better communication with their patients.
Aim:
The aim of this study was to explore whether realistic illness expectations are associated with reduced hope in people with advanced cancer.
Design:
This is a cross-sectional secondary analysis of baseline data from a primary palliative care cluster-randomized trial CONNECT (data collected from July 2016 to October 2020). Hope was measured by Herth Hope Index. Illness expectations were measured by assessing patients’ understanding of their treatment goals, life expectancy, and terminal illness acknowledgement. Multivariable regression was performed, adjusting for demographical and clinical confounders.
Setting/participants:
Adult patients with advanced solid cancers recruited across 17 oncology clinics.
Results:
Data from 672 patients were included in the study, with mean age of 69.3 years (±10.2), 53.6% were female. Proportion of patients indicating realistic expectations varied based on which question was asked from 10% to 46%. Median level of hope was 39 (IQR = 36–43). Multivariate non-inferiority regression did not find any significant differences in hope between patients with more and less realistic illness expectations.
Conclusions:
Our results suggest that hope can be sustained while holding both realistic and unrealistic illness expectations. Communication about serious news should focus on clarifying the expectations as well as supporting people’s hopes.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>38087831</pmid><doi>10.1177/02692163231214422</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-9875-7997</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0269-2163 |
| ispartof | Palliative medicine, 2024-01, Vol.38 (1), p.131-139 |
| issn | 0269-2163 1477-030X 1477-030X |
| language | eng |
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| source | MEDLINE; Applied Social Sciences Index & Abstracts (ASSIA); SAGE Complete A-Z List |
| subjects | Adult Advance directives Aged Cancer Communication Cross-Sectional Studies Decision making End of life decisions Female Health psychology Hope Hospice care Humans Inferiority Life expectancy Life goals Male Middle Aged Motivation Neoplasms - therapy News Oncology Palliative care Palliative Care - methods Randomized Controlled Trials as Topic Spirituality Terminal Care Terminal illnesses |
| title | Hope and illness expectations: A cross-sectional study in patients with advanced cancer |
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