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Hope in Iranian mothers of children with cancer: a descriptive correlational study

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Abstract

Purpose

This study aims to examine the relationship between the level of hope in mothers who have a child with cancer and its related factors in Iran.

Method

A cross-sectional and descriptive correlational design was used in this study. A demographic questionnaire and the Herth Hope Index (HHI) were administered to a sample of 240 mothers who have a child with cancer to assess level of hope. Mothers were also asked to indicate their highest priority hopes such as view of their supportive resources including financial support, psychosocial support, religiosity and spirituality. Data was analysed using descriptive statistics, Spearman’s rho, independent sample t test and one-way ANOVA.

Results

The mean HHI score was 35.44 (n = 237). There was a positive correlation between HHI total score and spirituality (r = 0.267, P < 0.001), and psychosocial support (r = 0.281, P < 0.001). No significant differences were found between HHI total score and respondents who saw themselves as a religious person and the family financial support. There was a significant difference in HHI total scores for a mother who has a disabled child (M = 32.92, SD = 2.75; t (235) = 2.00, P = 0.046) and mothers of a child who do not have any disability besides their cancer (M = 35.59, SD = 4.91). No significant differences were found in the HHI total score and different group of the child’s diagnoses and the mother’s age or/and child’s age.

Conclusion

Mothers who have a child with cancer with better psychosocial and spiritual support showed a higher level of hope. A thorough knowledge of factors associated with hope in mothers caring for children suffering from cancer could provide a means to further advance the support delivered and the available resources given to the parents, especially the mothers.

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Data availability

Data associated with the paper is available from Ensieh Fathollah Zadeh with the permission of Dr. Yvonne Parry upon reasonable request.

References

  1. Bally JM et al (2014) Keeping hope possible: a grounded theory study of the hope experience of parental caregivers who have children in treatment for cancer. Cancer Nurs 37(5):363–372

    PubMed  Google Scholar 

  2. Tackett AP, Cushing CC, Suorsa KI, Mullins AJ, Gamwell KL, Mayes S, McNall-Knapp R, Chaney JM, Mullins LL (2015) Illness uncertainty, global psychological distress, and posttraumatic stress in pediatric cancer: a preliminary examination using a path analysis approach. J Pediatr Psychol 41(3):309–318

    PubMed  Google Scholar 

  3. Al Qadire M et al (2020) Burden among parents of children with cancer in Jordan: Prevalence and predictors. Cancer Nurs 43(5):396–401

    PubMed  Google Scholar 

  4. Khanna AK, Prabhakaran A, Patel P, Ganjiwale JD, Nimbalkar SM (2015) Social, psychological and financial burden on caregivers of children with chronic illness: a cross-sectional study. Indian J Pediatr 82(11):1006–1011

    PubMed  Google Scholar 

  5. Sabzevari S, Nematollahi M, Mirzaei T, Ravari A (2016) The burden of care: mothers’ experiences of children with congenital heart disease. Int J Community Based Nurs Midwifery 4(4):374–385

    PubMed  Google Scholar 

  6. Shamsi A, Azizzadeh Forouzi M, Iranmanesh S (2016) Psychosocial risks among parents of children with cancer. J Pediatr Nurs 2(3):44–55

    Google Scholar 

  7. Santos S, Crespo C, Canavarro MC, Alderfer MA, Kazak AE (2016) Family rituals, financial burden, and mothers’ adjustment in pediatric cancer. J Fam Psychol 30(8):1008–1013

    PubMed  Google Scholar 

  8. El-Solh CF, Mabro J (2020) Muslim women’s choices: religious belief and social reality. Berg Publishers, Providence, pp 1–32 

  9. Blankinship LA (2018) Providing culturally sensitive care for Islamic patients and families. J Christ Nurs 35(2):94–99

    PubMed  Google Scholar 

  10. Reisi-Dehkordi N, Baratian H, Zargham-Boroujeni A (2014) Challenges of children with cancer and their mothers: a qualitative research. Iran J Nurs Midwifery Res 19(4):334–339

    PubMed  PubMed Central  Google Scholar 

  11. Chivukula U, Kota S, Nandinee D (2018) Burden experience of caregivers of acute lymphoblastic leukemia: impact of coping and spirituality. Indian J Palliat Care 24(2):189–195

    PubMed  PubMed Central  Google Scholar 

  12. Kostak MA, Avci G (2013) Hopelessness and depression levels of parents of children with cancer. Asian Pac J Cancer Prev 14(11):6833–6838

    PubMed  Google Scholar 

  13. Conway MF, Pantaleao A, Popp JM (2017) Parents’ experience of hope when their child has cancer: perceived meaning and the influence of health care professionals. J Pediatr Oncol Nurs 34(6):427–434

    PubMed  Google Scholar 

  14. Kim MA, Yi J, Sang J, Kim SH, Heo IY (2017) Experiences of Korean mothers of children with cancer: a photovoice study. J Psychosoc Oncol 35(2):128–147

    PubMed  Google Scholar 

  15. Rand KL (2018) Hope, self-efficacy, and optimism: conceptual and empirical differences, in The Oxford Handbook of Hope. Oxford University Press, New York, pp 45–58

    Google Scholar 

  16. Kelberer LJA, Kraines MA, Wells TT (2018) Optimism, hope, and attention for emotional stimuli. Personal Individ Differ 124:84–90

    Google Scholar 

  17. Wang J, Shen N, Zhang X, Shen M, Xie A, Howell D, Yuan C (2017) Care burden and its predictive factors in parents of newly diagnosed children with acute lymphoblastic leukemia in academic hospitals in China. Support Care Cancer 25(12):3703–3713

    PubMed  Google Scholar 

  18. Granek L, Barrera M, Shaheed J, Nicholas D, Beaune L, D'Agostino N, Bouffet E, Antle B (2013) Trajectory of parental hope when a child has difficult-to-treat cancer: a prospective qualitative study. Psychooncology 22(11):2436–2444

    CAS  PubMed  Google Scholar 

  19. Haugland T, Wahl AK, Hofoss D, DeVon HA (2016) Association between general self-efficacy, social support, cancer-related stress and physical health-related quality of life: a path model study in patients with neuroendocrine tumors. Health Qual Life Outcomes 14(1):11

    PubMed  PubMed Central  Google Scholar 

  20. Harper FWK, Albrecht TL, Trentacosta CJ, Taub JW, Phipps S, Penner LA (2019) Understanding differences in the long-term psychosocial adjustment of pediatric cancer patients and their parents: an individual differences resources model. Transl Behav Med 9(3):514–522

    PubMed  PubMed Central  Google Scholar 

  21. Surucu S et al (2017) Identification of the level of perceived social support and hope of cancer patients and their families. World Cancer Res J 4:1e11

    Google Scholar 

  22. Litzelman K, Blanch-Hartigan D, Lin CC, Han X (2017) Correlates of the positive psychological byproducts of cancer: role of family caregivers and informational support. Palliat Support Care 15(6):693–703

    PubMed  Google Scholar 

  23. Wiener L, Kazak AE, Noll RB, Patenaude AF, Kupst MJ (2015) Standards for the psychosocial care of children with cancer and their families: an introduction to the special issue. Pediatr Blood Cancer 62(S5):S419–S424

    PubMed  PubMed Central  Google Scholar 

  24. Barrera M, Granek L, Shaheed J, Nicholas D, Beaune L, D’Agostino NM, Bouffet E, Antle B (2013) The tenacity and tenuousness of hope: parental experiences of hope when their child has a poor cancer prognosis. Cancer Nurs 36(5):408–416

    PubMed  Google Scholar 

  25. Timmins F, Caldeira S (2017) Understanding spirituality and spiritual care in nursing. Nurs Stand 31(22):50–57

    PubMed  Google Scholar 

  26. Ebadi A, Lehto RH, Peyrovi H (2015) The experience of death anxiety in Iranian war veterans: a phenomenology study AU - Sharif Nia, Hamid. Death Stud 39(5):281–287

    PubMed  Google Scholar 

  27. Nejat N, Whitehead L, Crowe M (2016) Exploratory psychometric properties of the Farsi and English versions of the spiritual needs questionnaire (SpNQ). Religions 7(7):84

    Google Scholar 

  28. Ghorbani N, Watson PJ, Kashanaki H, Chen ZJ (2017) Diversity and complexity of religion and spirituality in Iran: relationships with self-compassion and self-forgiveness. Int J Psychol Relig 27(4):157–171

    Google Scholar 

  29. Roser K, Erdmann F, Michel G, Winther JF, Mader L (2019) The impact of childhood cancer on parents’ socio-economic situation—a systematic review. Psycho-Oncology 28(6):1207–1226

    PubMed  Google Scholar 

  30. Bradley CJ (2019) Economic burden associated with cancer caregiving. Semin Oncol Nurs 35(4):333–336

    PubMed  PubMed Central  Google Scholar 

  31. Carrera PM, Kantarjian HM, Blinder VS (2018) The financial burden and distress of patients with cancer: understanding and stepping-up action on the financial toxicity of cancer treatment. Cancer J Clin 68(2):153–165

    Google Scholar 

  32. Mofid Children’s Hospital. Mofid Children’s Hospital (2018) [29/05/18]; Available from: //en.mch.sbmu.ac.ir/. Accessed 20 May 2018

  33. Abdi N, Lari MA (2011) Standardization of three hope scales, as possible measures at the end of life, in Iranian population. Iran J Cancer Prevent 4(2):71–77

    Google Scholar 

  34. Geiser F, Zajackowski K, Conrad R, Imbierowicz K, Wegener I, Herth KA, Urbach AS (2015) The German version of the Herth Hope index (HHI-D): development and psychometric properties. Oncol Res Treat 38(7-8):356–360

    PubMed  Google Scholar 

  35. Herth K (1991) Development and refinement of an instrument to measure hope. Sch Inq Nurs Pract 5(1):39–51 discussion 53-6

    CAS  PubMed  Google Scholar 

  36. Nouzari R, Najafi SS, Momennasab M (2019) Post-traumatic growth among family caregivers of cancer patients and its association with social support and hope. Int J Community Based Nurs Midwifery 7(4):319–328

    PubMed  Google Scholar 

  37. Bekui BA et al (2020) Psychological and spiritual wellbeing of family caregivers of children with cancer at a teaching hospital in Ghana. Int J Africa Nurs Sci 13:100231

  38. Damreihani N, Behzadipour S, Haghpanh S, Bordbar M (2018) The effectiveness of positive psychology intervention on the well-being, meaning, and life satisfaction of mothers of children with cancer: a brief report. J Psychosoc Oncol 36(3):382–388

    PubMed  Google Scholar 

  39. Fathollahzade A, Rahmani A, Dadashzadeh A, Gahramanian A, Esfahani A, Javanganji L, Nabiolahi L (2015) Financial distress and its predicting factors among iranian cancer patients. Asian Pac J Cancer Prev 16(4):1621–1625

    PubMed  Google Scholar 

  40. Armonk N (2011) IBM SPSS statistics for Windows. IBM Corporation

  41. Brown LD, Cai TT, DasGupta A (2001) Interval estimation for a binomial proportion. Stat Sci 16:101–133

  42. Sergeant E (2018) Epitools Epidemiological Calculators; Available from: http://epitools.ausvet.com.au. Accessed Oct 2018

  43. Haukoos JS, Lewis RJ (2005) Advanced statistics: bootstrapping confidence intervals for statistics with “difficult” distributions. Acad Emerg Med 12(4):360–365

    PubMed  Google Scholar 

  44. Cohen J (1992) A power primer. Psychol Bull 112(1):155–159

    CAS  PubMed  Google Scholar 

  45. Hullmann SE, Fedele DA, Molzon ES, Mayes S, Mullins LL (2014) Posttraumatic growth and hope in parents of children with cancer. J Psychosoc Oncol 32(6):696–707

    PubMed  PubMed Central  Google Scholar 

  46. Sisk BA, Kang TI, Mack JW (2018) Sources of parental hope in pediatric oncology. Pediatr Blood Cancer 65(6):e26981

    PubMed  Google Scholar 

  47. Leite ACAB, Garcia-Vivar C, Neris RR, Alvarenga WA, Nascimento LC (2019) The experience of hope in families of children and adolescents living with chronic illness: a thematic synthesis of qualitative studies. J Adv Nurs 75(12):3246–3262

    PubMed  Google Scholar 

  48. Robert R, Stavinoha P, Jones BL, Robinson J, Larson K, Hicklen R, Smith B, Perko K, Koch K, Findley S, Weaver MS (2019) Spiritual assessment and spiritual care offerings as a standard of care in pediatric oncology: a recommendation informed by a systematic review of the literature. Pediatr Blood Cancer 66(9):e27764

    PubMed  Google Scholar 

  49. Nicholas DB, Barrera M, Granek L, D'Agostino NM, Shaheed J, Beaune L, Bouffet E, Antle B (2017) Parental spirituality in life-threatening pediatric cancer. J Psychosoc Oncol 35(3):323–334

    PubMed  Google Scholar 

  50. Ahmadi F, Khodayarifard M, Zandi S, Khorrami-Markani A, Ghobari-Bonab B, Sabzevari M, Ahmadi N (2018) Religion, culture and illness: a sociological study on religious coping in Iran. Ment Health Relig Cult 21(7):721–736

    Google Scholar 

  51. Sangelaji MH et al (2016) Correlation between spiritual attitude and hope with quality of life in adolescents with chronic disease. Med Ethics J 10(34):143–163

    Google Scholar 

  52. Yaghoobzadeh A, Soleimani MA, Allen KA, Chan YH, Herth KA (2018) Relationship between spiritual well-being and hope in patients with cardiovascular disease. J Relig Health 57(3):938–950

    PubMed  Google Scholar 

  53. Abbasnezhad M, Rahmani A, Ghahramanian A, Roshangar F, Eivazi J, Azadi A, Berahmany G (2015) Cancer care burden among primary family caregivers of iranian hematologic cancer patients. Asian Pac J Cancer Prev 16(13):5499–5505

    PubMed  Google Scholar 

  54. Moghaddasi J, Taleghani F, Moafi A, Malekian A, Keshvari M, Ilkhani M (2018) Family interactions in childhood leukemia: an exploratory descriptive study. Support Care Cancer 26(12):4161–4168

    PubMed  Google Scholar 

  55. Mojen LK et al (2018) Pediatric palliative care in Iran: applying regionalization of health care systems. Asian Pac J Cancer Prev 19(5):1303

    PubMed Central  Google Scholar 

  56. Tudy RA (2020) Visiting sick person (iyadah al-marid). Eubios J Asian Int Bioeth 30(5):259

    Google Scholar 

  57. Sudarisan SSP, Abraham B, George C (2019) Prevalence, correlates of depression, and its impact on quality of life of cancer patients attending a palliative care setting in South India. Psycho-Oncology 28(6):1308–1313

    PubMed  Google Scholar 

  58. Benedict C, McLeggon JA, Thom B, Kelvin JF, Landwehr M, Watson S, Ford JS (2018) Creating a family after battling cancer is exhausting and maddening: exploring real-world experiences of young adult cancer survivors seeking financial assistance for family building after treatment. Psychooncology 27(12):2829–2839

    PubMed  PubMed Central  Google Scholar 

  59. Malhotra C et al (2020) Financial difficulties are associated with greater total pain and suffering among patients with advanced cancer: results from the COMPASS study. Support Care Cancer 28:3781–3789

  60. Taleghani F, Fathizadeh N, Naseri N (2012) The lived experiences of parents of children diagnosed with cancer in Iran. Eur J Cancer Care 21(3):340–348

    CAS  Google Scholar 

  61. Shen A et al (2020) Quality of life among breast cancer survivors with triple negative breast cancer—role of hope, self-efficacy and social support. Eur J Oncol Nurs 46:101771

  62. Rezaei Z et al (2018) Quality of life of mothers of children with cancer in Iran. Koomesh 20(3):425–431

  63. Chongpison Y, Hornbrook MC, Harris RB, Herrinton LJ, Gerald JK, Grant M, Bulkley JE, Wendel CS, Krouse RS (2016) Self-reported depression and perceived financial burden among long-term rectal cancer survivors. Psychooncology 25(11):1350–1356

    PubMed  Google Scholar 

  64. Rahmani A, Azadi A, Pakpour V, Faghani S, Afsari EA (2018) Anxiety and depression: a cross-sectional survey among parents of children with cancer. Indian J Palliat Care 24(1):82–85

    PubMed  PubMed Central  Google Scholar 

  65. Martin F, Clyne W, Pearce G, Turner A (2019) Self-management support intervention for parents of children with developmental disorders: the role of gratitude and hope. J Child Fam Stud 28(4):980–992

    Google Scholar 

  66. Akdoğan R (2016) A holistic approach to cope with depression and hopelessness for parents of special needs children. Int J Early Child Spec Educ 8(2):134–150

  67. Ziapour A, Khosravi B (2020) Lived experience of mothers of children with disabilities: a qualitative study of Iran. J Public Health 2020:1–7

    Google Scholar 

  68. Samadi SA, McConkey R, Bunting B (2014) Parental wellbeing of Iranian families with children who have developmental disabilities. Res Dev Disabil 35(7):1639–1647

    PubMed  Google Scholar 

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Acknowledgements

The authors gratefully acknowledge the use of the services and facilities of the population studies centre at Paediatric Congenital Hematologic Disorders Research Centre (PCHDR), Research Institute for Children’s Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran. We thank our colleagues from the Paediatric Congenital Hematologic Disorders Research Centre in Mofid Children’s Hospital who provided insight and expertise that greatly assisted the research, although they may not agree with all of the interpretations/conclusions of this paper. Additionally, the authors would like to thank all of the staff members and mothers at the study sites who gave their valuable time effort and support to the original projects. Finally, it is with true pleasure that we acknowledge the contributions of the assistance supervisor, Dr. Fathimath Shifaza, for her valuable discussion and feedback on my thesis and Dr. Pawel Skuza for his assistance in data analysis and interpretation.

Funding

No direct funding. Author Ensieh Fathollah Zadeh received a scholarship for honour research from the Paediatric Congenital Hematologic Disorders Research Centre, Research Institute for Children’s Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Author information

Authors and Affiliations

  1. College of Nursing and Health Sciences, Flinders University, Sturt North Wing (N306), GPO Box 2100, Adelaide, 5001, Australia

    Ensieh Fathollah Zadeh

  2. College of Nursing and Health Sciences, Flinders University, Sturt North Wing (N323), GPO Box 2100, Adelaide, 5001, Australia

    Yvonne Parry

  3. Pediatric Congenital Hematologic Disorders Research Centre, Research Institute for Children Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Peyman Eshghi

  4. Level 2. Haemophilia Clinic of Mofid Children Hospital, Tehran, Iran

    Peyman Eshghi

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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Ensieh Fathollah Zadeh. The first draft of the manuscript was written by Ensieh Fathollah Zadeh and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript. This article is based primarily on the student’s thesis, and Ensieh Fathollah Zadeh is the principal author.

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Correspondence to Ensieh Fathollah Zadeh.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

The researcher obtained permission from Dr. Kaye Herth of Minnesota State University, the developer of the HHI, to use the adaptive version of the HHI instrument. This study was approved firstly by Flinders University Social and Behavioural Research Ethics Committee (SBREC7671) in Australia, then by the Paediatric Congenital Hematologic Disorders Research Committee (PCHDRC) at the Mofid Children’s Hospital (11269) and finally from Shahid Beheshti Medical Sciences University Medical Ethics and Law Research Center (MELRC) in Tehran, Iran (IR.SBMU.REC.1396.35).

Consent to participate

Implied consent was obtained from participants. Completing the questionnaire was voluntary and would not impact the mother or child’s access to care and support. All potential participants were informed clearly about the study aim and process, their rights and any risks and burdens that may occur, via the flyer and information sheet. The research information packs, including the information sheet, an envelope and a questionnaire, were provided for mothers prior to the recruiting process, and participation was completely voluntary. Written information sheets were provided to all potential participating mothers, with details of how to contact both the researcher in the local area and Australia and the research committee. Mothers were asked to fill the questionnaire alone, at a convenient time and place, seal it in a free envelope and post it to the specific collection box in the nursing station, so there is no further interaction between the researcher and participants.

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Appendix

Appendix

Table 1 Demographic and clinical information of respondents (mothers)
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Table 2 Demographic and clinical information of children
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Table 3 Respondents’ view of their supportive resources regarding financial support, psychosocial support, religiosity and spirituality
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Fig. 1
figure 1

Distribution of mothers’ total hope scores

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Fathollah Zadeh, E., Parry, Y. & Eshghi, P. Hope in Iranian mothers of children with cancer: a descriptive correlational study. Support Care Cancer 29, 3697–3705 (2021). https://doi.org/10.1007/s00520-020-05881-4

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