Does Hope Matter? Associations Among Self-Reported Hope, Anxiety, and Health-Related Quality of Life in Children and Adolescents with Cancer

Abstract

This study aimed to examine the direct and indirect effects of hope on health-related quality of life (HRQoL) via anxiety of children/adolescents with cancer. We proposed to test if the mediation model was moderated by the child/adolescent's treatment status. The participants were 211 children/adolescents diagnosed with cancer, divided into two clinical groups according to treatment status: 97 patients on-treatment and 114 off-treatment. Self-reported questionnaires measured the youths' hope, anxiety, and HRQoL perceptions. The results revealed that children/adolescents on- and off-treatment only differed in levels of HRQoL, with a more compromised HRQoL found for the on-treatment group. Hope was positively associated with HRQoL, directly and indirectly via anxiety reduction. Moreover, only the association between anxiety and HRQoL was moderated by clinical group, revealing stronger associations for on-treatment patients. Findings highlight the importance of hope as a decisive resource in pediatric cancer adaptation, which may be strategically targeted in psycho-oncological interventions.

The Association between Hope and Quality of Life among Adolescents with Chronic Diseases: A Systematic Review

“…The number of participants in the studies ranged from 37 to 224, and most used convenience sampling. Hope was measured using the Children's Hope Scale [13][14][15] Index [16]. The PedsQLTM 4.0 Generic Core Scale, PedsQL 3.0 Cancer Module, Miami Pediatric Quality of Life Questionnaire, and the short version of the DISABKIDS Chronic Generic Measure self-report questionnaire were used to measure quality of life.…”

“…All five studies reported a positive correlation between hope and quality of life, meaning that people with higher levels of hope had a better quality of life. One study reported that hope had significant direct and indirect effects on quality of life [16], while another study reported that anxiety mediated the relationship between hope and quality of life [13]. One study also reported that hope was a mediator in the relationship between quality of life and adaptive behavior [15].…”

“…was linked to better health-related quality of life (and viceversa for lower adaptive behavior). In contrast, Martins et al [13] explored the difference between pediatric cancer patients on and off treatment and revealed that children and adolescents on treatment had higher quality of life compared to those who were off treatment. Hope was positively associated with quality of life, both directly and indirectly via anxiety reduction.…”

Nursing student perceptions of hope in children: A qualitative descriptive study

“…On the other hand, success during treatments and interventions should build hope in children. Decreasing anxiety (Martins et al, 2018) before treatments and procedures can help with success in treatments and procedures. This can be done in a multitude of ways including use of pharmacologic and nonpharmacologic agents (Nunns et al, 2018).…”

“…Sposito et al (2015) found that keeping alive the hope of cure was an essential coping mechanism in their exploration of persons undergoing chemotherapy for cancer. Hope has been related to better health outcomes in several chronic diseases such as asthma (Berg, Rapoff, Snyder, & Belmont, 2007), irritable bowel disease (Nicholas et al, 2007), cancer (Herth, 2000;Hinds et al, 1999;Martins et al, 2018;Sposito et al, 2015), renal and liver transplant (Maikranz, Steele, Dreyer, Stratman, & Bovaird, 2007), sickle cell disease (Lewis & Kliewer, 1996), and juvenile rheumatoid arthritis (Connelly, 2005;Sällfors, Fasth, & Hallberg, 2002). Specifically, it has been documented in previous studies that children with higher hope with chronic illnesses, have better treatment adherence including inhalers with asthma (Berg et al, 2007), renal and liver transplant medications (Maikranz et al, 2007), and irritable bowel disease treatment (Nicholas et al, 2007).…”