Factors influencing hopelessness and complementary therapy use in patients with ovarian cancer.

摘要

Objective: To examine factors influencing hopelessness, complementary therapy and alternative medicine use (CAM) in patients with ovarian cancer in three phases of disease: new diagnosis, recurrence and long term survivorship.;Background: Hopelessness is a significant factor affecting cancer patients' overall quality of life (QOL). Despite millions of dollars spent annually on CAM, there is little research demonstrating beneficial effects on overall QOL and hope, despite the fact these are reasons patients cite for using CAM. Oncology nurses need effective, evidence-based interventions to treat disease symptoms and treatment side effects in their cancer patients. The Conceptual Model for Nursing and Health Policy guided this study.;Methods: Descriptive statistics summarized patient characteristics. Correlation analyses described associations between independent variables of socio-demographics, disease state, psychological distress, physical QOL, and faith as causal variables influencing hopelessness and CAM use. Multivariate analyses quantified the hypothesized direct and indirect effects of independent variables on the outcome variables.;Data Sources: A dataset (N=219) was concatenated from primary data in 3 QOL studies of patients with ovarian cancer in treatment at three hospitals within the Dana- Farber Harvard Cancer Center.;Results: Several factors directly reduced Beck hopelessness scores (mean = 3.37): age ≥65 (-0.95, P=0.03), strong faith (-0.28, P=0.00) and well controlled disease symptoms and treatment side effects, or lower QOL scores (0.11, P=0.00). Unexpectedly, massage therapy substantially reduced hopelessness (-1.07, P=0.02) and, holding age constant, employed patients were twice as likely to use massage (OR 2.09; P=0.04). Long term survivors were less hopeless due to better physical QOL. Use of different types of CAM was most frequent amongst patients 65 years old, more educated, with strong faith and well controlled disease symptoms and treatment side effects.;Conclusion: The least hopeless patients were long-term survivors, ≥65 years old, employed and using massage, with strong faith and well controlled disease symptoms and treatment side effects. Future research should test massage interventions in a randomized controlled trial, to reduce hopelessness in an expanded cancer patient population. A longitudinal, multi-site study, with an expanded cancer patient population, would increase diversity, providing new knowledge of study variables' changing effects on hopelessness.