Between Utter Despair and Essential Hope

Renz, Monika; Koeberle, Dieter; Cerny, Thomas; Strasser, Florian

doi:10.1200/jco.2008.19.2203

Cited by 17 publications

(10 citation statements)

References 13 publications

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“…We previously found that antiemotionality predicted shorter survival in breast cancer [6] and hopelessness in melanoma [7]. Hope at cancer diagnosis is essential [59] and it may predict survival [1, 11]. Hopelessness has been found to affect cancer mortality at the population level [60], especially in older populations [61], to which most prostate cancer patients belong.…”

Section: Discussionmentioning

confidence: 99%

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Early quality-of-life and psychological predictors of disease-free time and survival in localized prostate cancer

et al. 2018

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Purpose The constructs evaluated in investigating association between psychosocial factors and cancer survival has varied between studies, and factors related to quality of life (QOL) have shown contradictory results. We investigated the effect of socioeconomic and early QOL and psychological factors on disease-free time and survival in localized prostate cancer. Methods A consecutive sample of patients with localized prostate cancer (T1–3, N0, M0) treated with external beam radiotherapy completed validated questionnaires on coping with cancer (the Ways of Coping Questionnaire WOC-CA), anger expression (the Anger Expression Scale), life events (the Life Experience Survey), and various aspects of QOL (the Rotterdam Symptom Checklist, the Depression Scale DEPS, the EORTC QLQ-C30, the LENT-SOMA outcome measure) approximately 4.5 months after diagnosis. Cox regression analyses were used to determine the predictors of the disease-free and overall survival times measured from the date of diagnosis to the date of a PSA-relapse and date of death. Results After controlling for biological prognostic factors, age, and adjuvant hormonal therapies, moderate and high socioeconomic status and an increased level of pain predicted longer survival, whereas an increased level of prostate-area symptoms and fatigue and, especially, reports of no/few physical symptoms were predictors of a shorter survival time. A longer PSA-relapse-free time was predicted by Cognitive Avoidance/Denial coping, whereas problems in social functioning, hopelessness, and an excellent self-reported QOL predicted a shorter PSA-relapse-free time. Conclusions Higher socioeconomic status was prognostic for longer survival, as previously reported. Patients with a seemingly good QOL (few physical complaints, excellent self-reported QOL) had poorer prognoses. This association may due to the survival decreasing effect of emotional non-expression; patients with high emotional non-expression may over-report their wellbeing in simple measures, and thus actually be in need of extra attention and care.

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Section: Discussionmentioning

confidence: 99%

“…This concept refers, according to definition of coping, the patients’ efforts to manage demands caused by the cancer by minimizing impact of the disease, not the consequent negative affect. However, denying/minimizing may at a later point of time have a different effect [59].…”

Section: Discussionmentioning

confidence: 99%

Early quality-of-life and psychological predictors of disease-free time and survival in localized prostate cancer

et al. 2018

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“…False hope is viewed as maladaptive; taking energy that should be placed elsewhere, compromising decision making, and setting the stage for negative emotional responses such as depression (Links & Kramer, 1994;Clayton et al, 2005). The concept of false hope creates worry and anxiety for healthcare providers, as there is a moral imperative within the end-of-life literature to support only adaptive or "genuine" hope that is aligned with what the healthcare provider believes is realistic (Clayton et al, 2005(Clayton et al, , 2008Ngo -Metzger et al, 2008;Renz et al, 2009). The concept of false hope creates worry and anxiety for healthcare providers, as there is a moral imperative within the end-of-life literature to support only adaptive or "genuine" hope that is aligned with what the healthcare provider believes is realistic (Clayton et al, 2005(Clayton et al, , 2008Ngo -Metzger et al, 2008;Renz et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

“…However, especially in the context of palliative care, clinicians may view hope negatively if it does not agree with medical reality (Whitney et al, 2008). This hope has been called “false,” “unrealistic,” “an illusion,” or “inappropriate” (Sanatani et al, 2008; Renz et al, 2009). False hope is viewed as maladaptive; taking energy that should be placed elsewhere, compromising decision making, and setting the stage for negative emotional responses such as depression (Links & Kramer, 1994; Clayton et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

“Our best hope is a cure.” Hope in the context of advance care planning

Robinson

2012

Pall Supp Care

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AbstractObjective:Advance care planning (ACP) has the potential to enhance end-of-life care, yet often fails to live up to that potential. This qualitative interpretive study was designed to explore the process and outcomes of ACP using the patient-centered Advance Care Planning Interview (PC-ACP) developed by the Respecting Choices®program in Wisconsin.Method:Patients diagnosed with advanced lung cancer and close family members were recruited. Nine family dyads participated in the PC-ACP interview, which was audio-recorded. Follow-up interviews took place 3 and 6 months after the PC-ACP interview and were also recorded. Thematic analysis was conducted on transcribed interviews using constant comparison.Results:Analysis showed that hope was a significant theme in the ACP process and this article reports on that theme. Hope for a cure was one of many hopes that supported quality of life for the participant dyads. Three themes were identified: hope is multifaceted, hope for a cure is well considered, and hope is resilient and persistent. The seeming paradox of hoping for a cure of an incurable cancer did not interfere with the process of ACP. The dyads engaged in explicit discussions of end-of-life scenarios and preferences for care. ACP did not interfere with hope and hope for a cure did not interfere with ACP.Significance of results:Concerns about false hope are called into question. The principle of honoring hope is not necessarily in conflict with the principle of truthful communication. This is clinically significant, as the findings suggest we need not disrupt hope that we think of as “unrealistic” as long as it supports the family to live well. Further, ACP can be successful even in the context of hoping for a cure.

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“…At various moments in time, that shared hopefulness suggests protection, nurturance, guidance, and an expectation of realistic recovery (Penson et al 2007;Renz et al 2009). There may come a time-perhaps while listening to a patient's story, hearing a review of systems, examining an abdomen, or prescribing a medication-when physicians might even suggest that the power to become and live healthier comes from within, that the patient is the true healer (Glasser 1976).…”

Section: Fostering Resiliencymentioning

confidence: 98%

Beyond Religion and Spirituality: Faith in the Study and Practice of Medicine

Ventres¹,

Dharamsi²

2013

pbm

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Discussions about faith in medicine traditionally have been linked to religion and spirituality. Faith, however, is also that sense of trust or confidence one has in someone or something. As such, it is a concept integral to medical education and practice. This essay explores several dimensions of faith that play significant roles in medicine. It reviews why developing an awareness of faith is important for medical students and practitioners alike, and concludes by suggesting it is by seeking such faith in the profession that medical students and physicians can nurture their personal and professional growth.

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Between Utter Despair and Essential Hope

Cited by 17 publications

References 13 publications

Early quality-of-life and psychological predictors of disease-free time and survival in localized prostate cancer

Early quality-of-life and psychological predictors of disease-free time and survival in localized prostate cancer

“Our best hope is a cure.” Hope in the context of advance care planning

Beyond Religion and Spirituality: Faith in the Study and Practice of Medicine

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