Understanding Hope and Factors That Enhance Hope in Women With Breast Cancer

Purposes/Objectives: To examine the extent to which antecedent variables and appraisals differentiate levels of hope in women during treatment for breast cancer.

Design: Descriptive, correlational.

Setting: Two large midwestern urban areas.

Sample: 73 Caucasian women between the ages of 20-73 with first-time diagnosis of breast cancer; recruited through five physician offices; within three months after surgical intervention with planned chemotherapy, radiation therapy, or tamoxifen; and able to read English.

Methods: Identical surveys mailed to participants 3 and 12 months after surgery. Instruments included Lazarus' Appraisal Components and Themes Scales, Herth Hope Index, Rosenberg's Self-Esteem Scale, Personal Resource Questionnaire 85-Part 2, Helpfulness of Religious Beliefs Scale, and demographics questionnaire.

Main Research Variables: Appraisal, hope, self-esteem, social support, and helpfulness of religious beliefs.

Findings: Variables influencing appraisals during breast cancer treatment on both surveys were self-esteem and helpfulness of religious beliefs. Potential for coping appraisals and self-esteem contributed to variation in hope at both time points. Social support was a significant contributor to hope in the 12-month survey. Appraisal themes reflected challenge but not fear.

Conclusions: Self-esteem and helpfulness of religious beliefs influence women's appraisals regarding the potential for coping; appraisals and antecedent variables relevant for differentiating hope are beliefs about the potential for coping, self-esteem, and social support.

Implications for Nursing: Care of women with breast cancer during the first year of treatment should include assessment of beliefs regarding the potential for coping. Results suggest that support for interventions related to self-esteem, social support, and helpfulness of religious beliefs increase confidence in coping abilities and hope.