Abstract

PURPOSE/OBJECTIVE(S): Hope is important in serious illnesses including cancer, as it has been linked to patient well-being and quality of life. We assessed hope among patients seen in radiation oncology and aimed to determine associated socioeconomic and disease factors. We hypothesized that patients who may have less resources to cope with their illness would have lower hope scores.MATERIALS/METHODS: The Adult Dispositional Hope Scale (AHS) is a questionnaire that aims to measures an individual's determination to accomplish goals and planning strategies to accomplish goals. We prospectively collected AHS survey scores from patients with benign or malignant disease seen in 2 radiation oncology clinics at our institution from 10/2022 to 1/2023. The AHS survey contains 12 items to measure hope through two qualities: agency (goal-directed energy) and pathways (plan to meet goals). Each item is answered using an 8-point scale. There are 4 items each for the Agency and Pathway subscales with 4 filler items for total scores ranging from 8 to 64, with higher scores reflecting higher agency and pathways thinking. Kruskal-Wallis H test and Kendall's Tau Rank Correlation were used to determine differences between categorical and continuous variables on AHS scores, respectively.RESULTS: We included 228 patients with a median age of 62 years (range 16.9-92.6). Half were male (51%), 56% were white, and 77% had malignant disease. The primary disease subsite was CNS, GI and other in 76 (34%), 70 (31%), and 81 (36%) patients, respectively. Of patients with known occupation and insurance information, 32 (14%), 67 (29%), and 49 (22%) were not employed, employed, and retired, respectively, and 115 (50%), 85 (37%), and 20 (9%) had private insurance, Medicare, and Medical, respectively. Median agency, pathway, and total hope scores were 27 (interquartile range [IQR] 24-29), 28 (IQR 24-30), and 55 (IQR 48-58), respectively. Higher total hope scores were associated with being employed (p?=?0.02), having private insurance (p<0.02), and higher ECOG scores (p<0.01). After excluding those who are not employed because they are retired (n?=?99), lack of employment was significantly associated with hope (p<0.01). Characteristics such as race/ethnicity, gender, marital status, pain, symptoms from disease, malignant or benign disease, stage of disease, and treatment modalities were not associated with AHS scores.CONCLUSION: In our study, patients with non-private insurance and being currently unemployed had lower AHS scores. The lower hope scores suggest that these patients may have fewer resources to cope with their treatments and diagnoses and may benefit from further inquiry about the need to mitigate cancer-related financial burden to improve hope levels. Further studies are needed to evaluate whether financial toxicity, which has been shown to negatively impact patient outcomes, is correlated to coping and hope.

View details for DOI 10.1016/j.ijrobp.2023.06.1161

View details for PubMedID 37784941