title: Hope, Symptoms, and Palliative Care.
abstract: BACKGROUND
  Hope is important to patients with cancer. Identifying factors that influence hope is important. Anxiety, depression, fatigue, and pain are reported to impair hope. The objective of this study was to determine whether age, gender, marital status, duration of cancer, symptoms, or symptom burden measured by the sum of severity scores on the Edmonton Symptom Assessment Scale (ESAS) correlated with hope measured by the Herth Hope Index (HHI).
  
  
  METHODS
  Patients with advanced cancer in a palliative care unit participated. Demographics including age, gender, marital status, cancer site, and duration of cancer were collected. Individuals completed the ESAS and HHI. Spearman correlation and linear regression were used to assess associations adjusting for gender (male vs female), age (< 65 vs ≥ 65 years), marital status (married or living with a partner vs other), and duration of cancer (≤ 12 vs > 12 months).
  
  
  RESULTS
  One hundred and ninety-seven were participated in the study, of which 55% were female with a mean age of 61 years (standard deviation 11). Hope was not associated with gender, age, marital status, or duration of cancer. In univariable analysis, hope inversely correlated with ESAS score (-0.28), lack of appetite (-0.22), shortness of breath (-0.17), depression (-0.39), anxiety (-0.32), and lack of well-being (-0.33); only depression was clinically relevant. In multivariable analysis, total symptom burden weakly correlated with hope; only depression remained clinically significant.
  
  
  CONCLUSIONS
  This study found correlation between symptom burden and hope was not clinically relevant but was so for depression.
  
  
  CONCLUSIONS
  Among 9 ESAS symptoms, only depression had a clinically relevant correlation with hope.
authors.affiliation: 1 Harry R Horvitz Center for Palliative Medicine, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Mellar P
authors.initials: MP
authors.lastname: Davis
authors.affiliation: 1 Harry R Horvitz Center for Palliative Medicine, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Ruth
authors.initials: R
authors.lastname: Lagman
authors.affiliation: 1 Harry R Horvitz Center for Palliative Medicine, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Armida
authors.initials: A
authors.lastname: Parala
authors.affiliation: 1 Harry R Horvitz Center for Palliative Medicine, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Chirag
authors.initials: C
authors.lastname: Patel
authors.affiliation: 1 Harry R Horvitz Center for Palliative Medicine, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Tanya
authors.initials: T
authors.lastname: Sanford
authors.affiliation: 1 Harry R Horvitz Center for Palliative Medicine, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Flannery
authors.initials: F
authors.lastname: Fielding
authors.affiliation: 1 Harry R Horvitz Center for Palliative Medicine, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Anita
authors.initials: A
authors.lastname: Brumbaugh
authors.affiliation: 1 Harry R Horvitz Center for Palliative Medicine, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: James
authors.initials: J
authors.lastname: Gross
authors.affiliation: 1 Harry R Horvitz Center for Palliative Medicine, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Archana
authors.initials: A
authors.lastname: Rao
authors.affiliation: 1 Harry R Horvitz Center for Palliative Medicine, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Sumreen
authors.initials: S
authors.lastname: Majeed
authors.affiliation: 1 Harry R Horvitz Center for Palliative Medicine, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Shivani
authors.initials: S
authors.lastname: Shinde
authors.affiliation: 1 Harry R Horvitz Center for Palliative Medicine, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Rybicki
mesh_terms: D000367:Age Factors; D000368:Aged; D001066:Appetite; D003430:Cross-Sectional Studies; D005260:Female; D065026:Hope; D006801:Humans; D008297:Male; D017533:Marital Status; D008603:Mental Health; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D010166:Palliative Care / Q000523:psychology*; D011788:Quality of Life; D012720:Severity of Illness Index; D012737:Sex Factors
keywords: burden; depression; hope; symptom