Predictors of hope among women with breast cancer during chemotherapy

Abstract

Objective:Identifying the predictors of hope in patients with breast cancer during chemotherapy treatment. Method: A prospective longitudinal study. The sample was composed of 122 women who responded to the instruments of hope, anxiety and depression, coping, fatigue, religiosity and self-esteem in the first and last cycle of chemotherapy. These variables were used in adjusting the logistic regression model that characterized multivariate statistics, allowing identification of predictor variables. Result: The increase of hope at the end of chemotherapy treatment was statistically significant (p = 0.012). The delay in undergoing treatment from the onset of breast cancer symptoms, Karnofsky Performance Status, depression, self-esteem and pain were characterized as factors being associated to hope by univariate analysis. Among the variables analyzed, pain was the only predicting factor of hope. Conclusion: Pain was the predicting factor in this sample. Hope increased during treatment and revealed the following associated factors: Karnofsky Performance Status, delay in starting the treatment, depression, selfesteem and pain. This study brought forth a multidisciplinary contribution, allowing for understanding the factors that can influence hope and presenting support to nursing care. The data evidenced conditions of improvement or worsening of hope, which requires interdisciplinary attention in Oncology. DESCRIPTORS INTRODUCTIONThe diagnosis of cancer arouses innumerable feelings and emotions, among them, hope. This feeling can be seen as a resource that helps patients in coping with psychological suffering associated to the disease (1)(2)(3) . In the medical field, all definitions of hope involve something that is desired in the future, and when it is associated to the present it can have a positive influence on well-being or, at least, reflect in a positive state (2) . Having hope is essential after a cancer diagnosis is disclosed, since the news can cause suffering and is usually received as a threat. The patient often believes that the diagnosis of cancer is a death sentence, probably resulting in a profound loss of hope, leading to deleterious consequences to their prognosis (4) . Maintaining hope enables incurable cancer patients to accept treatment or clinical research, even if there are few benefits (2) . The study of this construct has aroused interest, as it seems to be directly related to the success of cancer treatments and management of signs and symptoms (5)(6) . Hope presents some strategies that facilitate the daily practice of nursing. It is made feasible by human principles which are the basis of care, by the use of knowledge put into practice, by interpersonal relationships, and how health professionals handle the environment and care organization (7) . Nurses are an important source of hope for people who are vulnerable and ill, as they are in constant contact with those who are suffering (7) . This is particularly true for oncologic patients who, due to their long stay in the hospital ...

<p>Psychosocial, Spiritual, and Biomedical Predictors of Hope in Hemodialysis Patients</p>

“…18 On the other hand, pain, depression, self-esteem, and functional status were found to be the predictors of hope in cancer patients. 19 Another study demonstrated that anxiety, depression, effects and symptoms of renal disease, and mental health dimension of quality of life were the predictors of hope in hemodialysis patients. 20 As maintained above, some studies have evaluated the predictors of hope in chronic diseases.…”

Esperança De Mulheres Em Tratamento Quimioterápico Para O Câncer De Mama

“…Foi possível observar que os dados sociodemográficos não influenciaram diretamente na esperança das pacientes avaliadas, embora haja estudos que tenham encontrado associação significativa com a renda (7) .…”

“…Não foi observada variação da esperança ao longo do tempo de tratamento. No entanto, em estudo realizado com mulheres da cidade de São Paulo em tratamento para o câncer de mama, a esperança foi observada de forma dependente durante todo o processo de tratamento, apresentando-se de forma positiva quando a paciente se encontrava em um bom estado clínico e proximidade da cura, e negativa diante do início do tratamento, atraso no diagnóstico, com alterações psicológicas e aparecimento dos efeitos adversos do tratamento (7) .…”

“…Nesse sentindo, vale ressaltar que a esperança é uma emoção positiva vivenciada no enfrentamento da doença, ou seja, a esperança é uma crença emocional na possibilidade de resultados positivos relacionados com eventos e circunstâncias da vida pessoal de forma a amenizar os efeitos negativos no momento do diagnóstico, tanto na dimensão psíquica quanto espiritual. A possibilidade da morte pode trazer prejuízo à esperança, dificultando a aceitação da doença e enfrentamento (7) .…”

“…Os profissionais da enfermagem são essenciais durante o processo de tratamento da pessoa com doença oncológica, visto que permanecem mais tempo em contato com o paciente, uma vez que o profissional realiza uma assistência que envolve atividades educativas até atividades mais complexas. Neste sentindo, o enfermeiro é uma pessoa que pode resgatar a esperança, decorrente da alta permanência do paciente no ambiente hospitalar em virtude dos retornos e protocolos de tratamento, e por este motivo a enfermagem consegue estabelecer vínculos e relações empáticas, visto o processo de enfermagem ter caráter contínuo (7) . Sendo assim, é necessário compreender o fenômeno da esperança e o seu papel no bem-estar das pacientes no enfrentamento do câncer de mama em tratamento quimioterápico ambulatorial e verificar até que ponto a compreensão deste fenômeno é relevante para a assistência à saúde da pessoa com câncer.…”