title: Determinants of a hopeful attitude among family caregivers in a palliative care setting.
abstract: OBJECTIVE
  This study investigated the determinants of a hopeful attitude among family caregivers involved with palliative care.
  
  
  METHODS
  We investigated a broad range of factors for the patient-family dyad in a palliative care setting using a cross-sectional design. The patients' sociodemographic, clinical and psychological factors were evaluated, as well as caregiver-related sociodemographic and psychological factors, including depressive symptoms, burden, coping style and religiosity. Caregivers were divided into two groups based on a hopeful or nonhopeful attitude and assessed using the abbreviated version of the seven-item Beck Hopelessness Scale (BHS-7).
  
  
  RESULTS
  Of 304 analyzed dyads, 210 (69.1%) caregivers showed a hopeful attitude, with a BHS-7 score of 0. The adjusted logistic regression analyses showed that caregivers' hopeful attitude was determined by only their psychological status: less depressive symptoms [odds ratio (OR), 0.86; 95% confidence interval (CI), 0.83-0.90], active coping strategy (OR, 1.12; 95% CI, 1.07-1.18) and lower burden (OR, 0.93; 95% CI, 0.88-0.99). In a subpopulation analysis (n=200), higher religiosity was a significantly associated factor.
  
  
  CONCLUSIONS
  Healthcare providers need to pay attention to the psychological vulnerability of caregivers to encourage a hopeful attitude. Additional studies of longitudinal design for hopeful attitude throughout the trajectory of palliative care are necessary.
authors.affiliation: Mental Health Clinic, Chonnam National University Hwasun Hospital, Hwasun 519-763, Korea; Departments of Psychiatry, Chonnam National University Medical School, and Depression Clinical Research Center, Chonnam National University Hospital, Gwangju 501-757, Korea.
authors.forename: Seon-Young
authors.initials: SY
authors.lastname: Kim
authors.affiliation: Departments of Psychiatry, Chonnam National University Medical School, and Depression Clinical Research Center, Chonnam National University Hospital, Gwangju 501-757, Korea. Electronic address: jmkim@chonnam.ac.kr.
authors.forename: Jae-Min
authors.initials: JM
authors.lastname: Kim
authors.affiliation: Departments of Psychiatry, Chonnam National University Medical School, and Depression Clinical Research Center, Chonnam National University Hospital, Gwangju 501-757, Korea.
authors.forename: Sung-Wan
authors.initials: SW
authors.lastname: Kim
authors.affiliation: Departments of Psychiatry, Chonnam National University Medical School, and Depression Clinical Research Center, Chonnam National University Hospital, Gwangju 501-757, Korea.
authors.forename: Hee-Ju
authors.initials: HJ
authors.lastname: Kang
authors.affiliation: Departments of Psychiatry, Chonnam National University Medical School, and Depression Clinical Research Center, Chonnam National University Hospital, Gwangju 501-757, Korea.
authors.forename: Il-Seon
authors.initials: IS
authors.lastname: Shin
authors.affiliation: Department of Hemato-Oncology, Chonnam National University Medical School, Gwangju 501-757, Korea.
authors.forename: Hyun-Jeong
authors.initials: HJ
authors.lastname: Shim
authors.affiliation: Department of Hemato-Oncology, Chonnam National University Medical School, Gwangju 501-757, Korea.
authors.forename: Sang-Hee
authors.initials: SH
authors.lastname: Cho
authors.affiliation: Department of Hemato-Oncology, Chonnam National University Medical School, Gwangju 501-757, Korea.
authors.forename: Ik-Joo
authors.initials: IJ
authors.lastname: Chung
authors.affiliation: Departments of Psychiatry, Chonnam National University Medical School, and Depression Clinical Research Center, Chonnam National University Hospital, Gwangju 501-757, Korea.
authors.forename: Jin-Sang
authors.initials: JS
authors.lastname: Yoon
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D001290:Attitude; D017028:Caregivers / Q000523:psychology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology*; D005260:Female; D065026:Hope; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000451:nursing*; D010166:Palliative Care / Q000523:psychology*
keywords: Cancer; Caregiver; Coping strategy; Depression; Hope