The importance of hope as a mediator of psychological distress and life satisfaction in a community sample of cancer patients

Cancer Nurs. 2010 Jul-Aug;33(4):258-67. doi: 10.1097/NCC.0b013e3181d6fb61.


Background: Although hope is an important resource for cancer patients, few studies include it as an independent or dependent variable in quality-of-life research.

Objective: The purposes of this study, in a community-based sample of cancer patients, were to evaluate the relationships between demographic and clinical characteristics, health status, hope, psychological distress, and life satisfaction and evaluate whether hope mediated the relationship between psychological distress and life satisfaction.

Methods: Participants (n = 194) completed a demographic and clinical questionnaire, a single item of self-assessed health, the Herth Hope Index, Impact of Event Scale, and a single-item rating of satisfaction with life. Structural regression models were examined to evaluate the interrelationships among these variables, with life satisfaction as the primary outcome.

Results: Participants were primarily women with breast cancer. In the final structural regression model that explained 60% of the variance in life satisfaction, poorer health status, lower hope, and higher psychological distress were significantly related to lower satisfaction with life. Hope was found to mediate the relationship between psychological distress and health status, such that the direct association between distress and health status was no longer significant with hope in the model. Finally, hope partially mediated the association between psychological distress and life satisfaction.

Conclusions: These data suggest that hope is an important resource for oncology patients that impacts their quality of life.

Implications for practice: Hope may be an important coping mechanism that clinicians need to consider when they try to help patients reduce the psychological distress associated with cancer and its treatment.

MeSH terms

  • Adaptation, Psychological*
  • Adult
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Attitude to Health*
  • Chi-Square Distribution
  • Female
  • Humans
  • Life Change Events
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Models, Psychological
  • Morale*
  • Neoplasms / complications
  • Neoplasms / psychology*
  • Norway
  • Nursing Methodology Research
  • Personal Satisfaction*
  • Regression Analysis
  • Stress, Psychological / diagnosis
  • Stress, Psychological / etiology
  • Stress, Psychological / prevention & control*
  • Stress, Psychological / psychology
  • Surveys and Questionnaires