Relationship between hope and fatigue characteristics in newly diagnosed outpatients with cancer

Shiow Ching Shun, Fei Hsiu Hsiao, Yeur Hur Lai*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

Hope is a pivotal factor in personal adjustments for patients struggling with their cancer diagnoses, particularly those newly diagnosed and receiving active treatment (Chi, 2007; Hammer, Mogensen, & Hall, 2009; Whitney, McCullough, Frugé, McGuire, & Volk, 2008). Previous investigation has revealed hope to be a significant factor for survival and a vital factor for reducing psychological distress, increasing self-esteem, and enhancing psychosocial well-being and quality of life (Felder, 2004; Herth, 2000, 2001; Lai et al., 2003; Mattioli, Repinski, & Chappy, 2008). Hope is described as having multidimensional factors (Herth, 1992; McClement & Chochinov, 2008) and generally is defined as the desire that an individual anticipates for the future (Chi, 2007). A sense of hopelessness has been proposed as a risk factor for suicide in patients with cancer (Lin, Wu, & Lee, 2009). Therefore, identifying factors influential to patients' feelings of hope is important to better support patients by providing and maintaining their hope during the cancer treatment process. Previous studies have examined many influential factors for hope, including demographic factors (e.g., age, gender, education level, religion, marital status) and disease-related factors (e.g., diagnosis of cancer, disease stage, time since diagnosis) (Chen, 2003; Chi, 2007; Rustøen & Wiklund, 2000; Vellone, Rega, Galletti, & Cohen, 2006). Declining functional status (Lai et al., 2003; McGill & Paul, 1993) and increasing symptom distress (Chen, 2003; Lai et al., 2003; Vellone et al., 2006) have been commonly identified as significant factors affecting the level of hope in patients with cancer. Cancer-related fatigue may play a key role in influencing a patient's sense of hope because it profoundly affects the physical, psychosocial, and cognitive performance of patients (Dy et al., 2008; Lai et al., 2007; Miller, Maguire, & Kearney, 2007; Morrow, 2007). In addition, energy has emerged as an attribute of hope, whereas lack of energy is one of the negative relationship between hope and overall perceived fatigue as measured by the revised Piper Fatigue Scale in patients with breast cancer. However, the aim of the study focused on the roles of fatigue and hope on psychosocial adjustment. The relationships between hope and characteristics of fatigue (e.g., intensity, duration, interference) have not yet been explored. Because cancer-related fatigue is the most frequently reported side effect of cancer treatment and hope is a pivotal factor for survival, a better understanding of their relationship could allow healthcare providers to help patients maintain a sense of hope while managing their fatigue, thus relieving the most common issue encountered by patients with cancer. Cancer-related fatigue is a complex and multidimensional phenomenon, and fatigue intensity and its interference are two major dimensions assessed in clinical care guidelines (National Comprehensive Cancer Network [NCCN], 2007; Piper et al., 2008). However, assessing fatigue interference has been underperformed when compared with assessing fatigue intensity in the clinical screening process. For example, screening newly identified patients with advanced cancer for fatigue intensity during the clinical screening process has been suggested (NCCN, 2007), but further assessment of fatigue interference in functioning is recommended only when patients have moderate-to-severe fatigue. However, interference caused by fatigue can directly affect patients' quality of life (Armstrong, 2003) and might influence their level of hope. Therefore, the aim of the study was to examine the level of hope and fatigue in newly diagnosed patients receiving chemotherapy and further explore the association between hope and fatigue in this population.

Original languageEnglish
Pages (from-to)E81-E86
JournalOncology Nursing Forum
Volume38
Issue number2
DOIs
StatePublished - Mar 2011

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