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Nursing issues
Hope is a crucial factor for patients facing cancer treatment
  1. Ana C M Dos Santos1,
  2. Karol F de Farias2
  1. 1 Nursing, Faculdade Regional da Bahia, Salvador, Brazil
  2. 2 Nursing, Universidade Federal de Alagoas - Campus Arapiraca, Arapiraca, Alagoas, Brazil
  1. Correspondence to Dr Ana C M Dos Santos, Faculdade Regional da Bahia, Salvador, Brazil; anacaroline12305{at}

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Commentary on: Nierop-van Baalen C, Grypdonck M, Van Hecke A, et al. Associated factors of hope in cancer patients during treatment: a systematic literature review. J Adv Nurs 2020; 00:1–18.

Implications for practice and research

  • In clinical practice, nurses need to focus on factors related to the management of hope levels in patients undergoing cancer treatment.

  • Cohort studies and clinical trials considering the implications of clinical characteristics and levels of hope, in advanced cancer as well as studies with children, are necessary.


Hope is a multidimensional and dynamic mental process; it consists of the relationship between motivational energy and strategies, visions, plans to achieve long-term goals. All of these components are necessary for the normal functioning of hope. One of the factors that should be considered in assisting patients who are undergoing cancer treatment involves emotional and spiritual aspects, among which hope stands out as a vital component.1


Nierop-van Baalen and colleagues2 conducted a systematic review that investigated linked factors of hope during the treatment of patients with cancer. The research was performed in MEDLINE, CINAHL, Psychinfo and Cochrane databases. The search strategy was defined with MESH terms: hope, cancer and anticancer therapy. The authors determined the following inclusion criteria: quantitative studies on hope in patients with cancer who were 18 years or older and receiving treatment, which were written in English or Dutch and published over the past decade. Exclusion criteria included studies with patients with cancer who did not or no longer received treatment. Papers were screened by two reviewers. The Quality Assessment Tool was used to determine the quality of the studies.3 Meta-analysis was not possible due to the methodological heterogeneity of the studies. Information about authors and publication year, aim, hope instrument, design, percentage participants under treatment and variables related to hope was extracted by researchers.


From 1271 retrieved abstracts, 33 papers met the inclusion criteria. The most (n=17) used scale was the Herth Hope Index to assess hope; studies focused either on patients receiving curative or palliative treatment. The findings of the review suggested that there was no relationship between hope and demographic or clinical variables (including the type of cancer). Quality of life, social support, spiritual and existential well-being were correlated positively with hope, whereas symptom burden, psychological distress and depression had no relationship with hope.


This review focused on the identification of studies that addressed potential factors related to hope in patients undergoing cancer treatment. Hope is a fundamental feeling when facing cancer and from the nursing perspective, it is one of the most important aspects in promoting holistic care in which the nurses deal with maintaining positive health and management in complex and difficult situations.4

This study is important because it provides an evidence base for nursing care, identifying several factors that influence levels of hope, allowing nursing interventions to be modulated accordingly. Factors known to influence levels of hope in patients with cancer are religious and spiritual beliefs associated; nurses, therefore, need to assess these in order to provide assistance and care that is individualised.5 Families hold a crucial role, in which the consolidation of a bond allows the promotion of humanistic and ideal values that transcend the physical aspect, in order to direct an integral look towards the patient undergoing cancer treatment.

The findings of this study2 highlighted the emerging need for the development of clinical trial studies in order to identify consolidated ways of nursing interventions that include the family in the planning and delivery of care. In addition, conducting cohort studies to verify the association of spiritual support and the outcomes considering the clinical parameters of patients with cancer undergoing treatment are necessary to assist management in clinical practice. Besides proposing studies with patients who are undergoing treatment, the investigation needs to include factors related to hope with patients with advanced cancer and studies with children.6



  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.

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