Supportive Care in Cancer

, Volume 28, Issue 2, pp 827–835 | Cite as

Hope-related goal cognitions and daily experiences of fatigue, pain, and functional concern among lung cancer patients

  • Laurie E. SteffenEmail author
  • Jennifer S. Cheavens
  • Kevin E. Vowles
  • Jennifer Gabbard
  • Huynh Nguyen
  • Gregory N. Gan
  • Martin J. Edelman
  • Bruce W. Smith
Original Article



Cross-sectional research suggests that thinking about multiple ways to reach goals (hope pathways) and the belief that one can reach them (hope agency) may be adaptive for lung cancer patients. We examined the between-person and within-person associations among aspects of hope agency and pathways thinking, daily fatigue, pain, and functional concerns (e.g., sense of independence, usefulness) among lung cancer patients during active treatment.


Data from a daily diary study were used to examine relations among hope agency, hope pathways, fatigue, pain, and functional concern in 50 patients with advanced lung cancer. Participants were accrued from one outpatient cancer center and completed the study between 2014 and 2015.


Adjusting for covariates and the previous day’s symptoms or concern, patients who engaged in higher pathways thinking reported lower daily symptoms, whereas those who engaged in higher agency thinking reported less functional concern. Within-person increases in pathways thinking were associated with less daily fatigue, pain, and functional concern; within-person increases in agency thinking were associated with less daily fatigue and pain. Models examining symptoms and concerns as predictors of hope suggested within-person increases in functional concern and fatigue and pain were related to lower agency and pathways thinking the same day. Patients with higher fatigue and pain did not report lower agency or pathways thinking, but patients with more functional concern did.


Increases in hope pathways thinking may be associated with lower symptoms and better functioning in lung cancer patients. This suggests that it is important to determine the efficacy of interventions that emphasize the pathways the component of hope.


Hope Goal setting Lung cancer Fatigue Pain Palliative 


Funding information

Laurie Steffen was supported by R25CA122061 (PI: Nancy Avis, Ph.D).

Compliance with ethical standards

Conflict of interest

The authors declare they have no competing interests. Dr. Vowles discloses grant funding from Pfizer Pharmaceuticals, outside the submitted work.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Dr. Steffen has full control of the primary data and agrees to allow the journal to review upon request.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Social Sciences & Health Policy – PHS, Wake Forest School of MedicineMedical Center BoulevardWinston-SalemUSA
  2. 2.Department of PsychologyThe Ohio State UniversityColumbusUSA
  3. 3.Department of PsychologyUniversity of New MexicoAlbuquerqueUSA
  4. 4.Department of Internal Medicine, Section on Gerontology and Geriatric MedicineWake Forest School of MedicineWinston-SalemUSA
  5. 5.School of MedicineUniversity of New MexicoAlbuquerqueUSA
  6. 6.Department of Radiation OncologyUniversity of Kansas School of MedicineKansasUSA
  7. 7.Department of Hematology/OncologyFox Chase Cancer CenterPhiladelphiaUSA

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