Palliative Oncology Treatments and Hopelessness: An Analysis of Associated Clinical and Psychosocial Factors.

ABSTRACT

One of the psychological symptoms of major concern in palliative care is hopelessness because it is a risk factor for poor treatment adherence, suicidal ideation, suicide, and the desire for a premature death. Objectives: To identify the psychosocial and clinical factors associated with hopelessness after beginning palliative oncology treatment. Methods: 66 patients with advanced cancer were evaluated using the following instruments a) Beck Hopelessness Scale, b) Quality of Life Questionnaire - EORTC-QLQ-C30, c) Hospital Anxiety and Depression Scale, d) Coping Strategies Inventory, at two times at the first consultation in the palliative care outpatient clinic and at the first medical return visit. Results: The relative absence of information about palliative care treatment was associated with hopelessness after the beginning the palliative treatment (p=0.043). With regard to coping strategies, the use of social support mechanisms (p=0.033), problem resolution (p=0.033), and positive reevaluation (p=0.037) were associated with decreases in hopelessness, which indicates that these strategies have a protective character. Social support (p=0.007) and constipation (p=0.038) significantly predicted hopelessness at the first medical return visit according to the multiple linear regression analysis. The experiences of hope among the patients at the beginning of the palliative treatment did not decrease. Few correlations were found between the different clinical and psychological variables studied, and few parameters predicted hopelessness. Conclusion: The offer of information and the promotion of therapeutic interventions favoring use of coping strategies less focused on emotion thereby allowing more active coping with the situation were found to be.