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Quality of life in cancer patients: The role of optimism, hopelessness, and partner support

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Abstract

The interaction of optimism, hopelessness and social support as predictors of Health-Related Quality of Life (HRQL) among seriously ill people is not well understood. Also, the impact of partner characteristics on patient quality of life has often been overlooked. In this study the relationships between optimism, hopelessness, partner support and HRQL were investigated in 155 cancer patients and their partners. Special attention was given to the effects of optimism and hopelessness as mediators and moderators in the partner support–HRQL relationship. The impact of partner optimism and hopelessness on perceived partner support and patient HRQL was also studied. The results indicated substantial gender differences in the relationships between the study variables. High levels of partner support were associated with female patients’ optimistic appraisals, and together they predicted better HRQL at 8 months follow-up. Partial support was found for the effect of optimism as a mediator. For male patients, low hopelessness was the key variable predicting good HRQL. Clear evidence for the moderator effects of optimism/hopelessness was not found, and the expected impact of partner’s characteristics on partner support or patient HRQL could not be confirmed. Although partner support, patient optimism and hopelessness all appeared to be important determinants of HRQL in cancer patients, the relationships between these variables differed by gender. The proposed mediation and moderation models needs to be confirmed in future studies.

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Abbreviations

HRQL:

Health-Related Quality of Life

MCS:

mental component summary

PCS:

physical component summary

References

  1. White CA, Macleod U (2002) Cancer. BMJ 325(7360): 377–380

    Article  PubMed  Google Scholar 

  2. Northouse LL, Mood D, Templin T, Mellon S, George T (2000) Couples’ patterns of adjustment to colon cancer. Soc Sci Med 50(2):271–284

    Article  CAS  PubMed  Google Scholar 

  3. Northouse LL, Mood D, Kershaw T, et al (2002) Quality of life of women with recurrent breast cancer and their family members. J Clin Oncol 20(19):4050–4064

    Article  PubMed  Google Scholar 

  4. Schroeder KEE, Schwarzer R (2001) Do partners’ personality resources add to the prediction of patients’ coping and quality of life? Psychol Health 16(2):139–159

    Article  Google Scholar 

  5. Schou I, Ekeberg O, Ruland CM (2005) The mediating role of appraisal and coping in the relationship between optimism–pessimism and quality of life. Psychooncology 14(9):718–727

    Article  CAS  PubMed  Google Scholar 

  6. Lazarus RS, Folkman S (1984) Stress, Appraisal, and Coping. Springer, New York

    Google Scholar 

  7. Scheier MF, Matthews KA, Owens JF, et al (1989) Dispositional optimism and recovery from coronary artery bypass surgery: The beneficial effects on physical and psychological well-being. J Pers Soc Psychol 57(6):1024–1040

    Article  CAS  PubMed  Google Scholar 

  8. Taylor SE, Armor DA (1996) Positive illusions and coping with adversity. J Pers 64(4):873–898

    Article  CAS  PubMed  Google Scholar 

  9. Carver CS, Pozo-Kaderman C, Harris SD, et al (1994) Optimism versus pessimism predicts the quality of women’s adjustment to early stage breast cancer. Cancer 73(4):1213–1220

    Article  CAS  PubMed  Google Scholar 

  10. Carver CS, Pozo C, Harris SD, et al (1993) How coping mediates the effect of optimism on distress: A study of women with early stage breast cancer. J Pers Soc Psychol. 65(2):375–390

    Article  CAS  PubMed  Google Scholar 

  11. Scheier MF, Carver CS, Bridges MW. Optimism, pessimism, and psychological well-being. In: Chang E (ed) Optimism and Pessimism: Implications for Theory, Research, and Practice, 1st ed. American Psychology Association, Washington, 2001: 127–145

  12. Schou I, Ekeberg O, Ruland CM, Sandvik L, Karesen R (2004) Pessimism as a predictor of emotional morbidity one year following breast cancer surgery. Psychooncology 13(5):309–320

    Article  CAS  PubMed  Google Scholar 

  13. Trunzo JJ, Pinto BM (2003) Social support as a mediator of optimism and distress in breast cancer survivors. J Cons Clin Psychol 71(4):805–811

    Article  Google Scholar 

  14. Epping-Jordan JE, Compas BE, Osowiecki DM, et al (1999) Psychological adjustment in breast cancer: Processes of emotional distress. Health Psychol 18(4):315–326

    Article  CAS  PubMed  Google Scholar 

  15. Allison PJ, Guichard C, Gilain L (2000) A prospective investigation of dispositional optimism as a predictor of health-related quality of life in head and neck cancer patients.Qual Life Res 9(8):951–960

    Article  CAS  PubMed  Google Scholar 

  16. Snyder CR, Sympson SC, Michael ST, Cheavens J. Optimism and hope constructs: Variants on a positive expectancy theme. In: Chang E (ed), Optimism and Pessimism; Implications for Theory and Practice, 1st ed. American Psychology Association, Washington, 2001: 101–123

  17. Everson SA, Goldberg DE, Kaplan GA, et al (1996) Hopelessness and risk of mortality and incidence of myocardial infarction and cancer. Psychosom Med 58(2):113–121

    CAS  PubMed  Google Scholar 

  18. Watson M, Haviland JS, Greer S, Davidson J, Bliss JM (1999) Influence of psychological response on survival in breast cancer: A population-based cohort study. Lancet 354(9187):1331–1336

    Article  CAS  PubMed  Google Scholar 

  19. Northouse LL, Dorris G, Charron-Moore C (1995) Factors affecting couples’ adjustment to recurrent breast cancer. Soc Sci Med 41(1):69–76

    Article  CAS  PubMed  Google Scholar 

  20. Snyder CR (2002) TARGET ARTICLE: Hope theory: Rainbows in the mind. Psychol Inq 13(4):249

    Article  Google Scholar 

  21. Emery CF, Frid DJ, Engebretson TO, et al (2004) Gender differences in quality of life among cardiac patients. Psychosom Med 66(2):190–197

    Article  PubMed  Google Scholar 

  22. Parker PA, Baile WF, de Moor C, Cohen L (2003) Psychosocial and demographic predictors of quality of life in a large sample of cancer patients. Psychooncology 12(2):183–193

    Article  PubMed  Google Scholar 

  23. Carlsson M, Hamrin E (1994) Psychological and psychosocial aspects of breast cancer and breast cancer treatment. A literature review. Cancer Nurs 17(5):418–428

    Article  CAS  PubMed  Google Scholar 

  24. Courtens AM, Stevens FC, Crebolder HF, Philipsen H (1996) Longitudinal study on quality of life and social support in cancer patients. Cancer Nurs 19(3):162–169

    Article  CAS  PubMed  Google Scholar 

  25. Symister P, Friend R (2003) The influence of social support and problematic support on optimism and depression in chronic illness: A prospective study evaluating self-esteem as a mediator. Health Psychol 22(2):123–129

    Article  PubMed  Google Scholar 

  26. Carver CS, Lehman JM, Michael HA (2003) Dispositional pessimism predicts illness-related disruption of social and recreational activities among breast cancer patients. J Pers Soc Psychol 84(4):813–821

    Article  PubMed  Google Scholar 

  27. Kiecolt-Glaser JK, Newton TL (2001) Marriage and health: His and hers. Psychol Bull 127(4):472–503

    Article  CAS  PubMed  Google Scholar 

  28. Pistrang N, Barker C (1995) The partner relationship in psychological response to breast cancer. Soc Sci Med 40(6):789–797

    Article  CAS  PubMed  Google Scholar 

  29. Frasure-Smith N, Lesperance F, Juneau M, Talajic M, Bourassa MG (1999) Gender, depression, and one-year prognosis after myocardial infarction. Psychosom Med 61(1):26–37

    CAS  PubMed  Google Scholar 

  30. McGee HM, Horgan JH (1992) Cardiac rehabilitation programmes: Are women less likely to attend? BMJ 305(6848):283–284

    Article  CAS  PubMed  Google Scholar 

  31. Rohrbaugh MJ, Cranford JA, Shoham V, Nicklas JM, Sonnega JS, Coyne JC (2002) Couples coping with congestive heart failure: Role and gender differences in psychological distress. J Fam Psychol 16(1):3–13

    Article  PubMed  Google Scholar 

  32. Keller M, Henrich G (1999) Illness-related distress: Does it mean the same for men and women? Gender aspects in cancer patients’ distress and adjustment. Acta Oncol 38(6):747–755

    Article  CAS  PubMed  Google Scholar 

  33. Scheier MF, Carver CS, Bridges MW (1994) Distinguishing optimism from neuroticism (and trait anxiety, self-mastery, and self-esteem): A reevaluation of the life orientation test. J Pers Soc Psychol 67(6):1063–1078

    Article  CAS  PubMed  Google Scholar 

  34. Everson SA, Kaplan GA, Goldberg DE, Salonen R, Salonen JT (1997) Hopelessness and 4-year progression of carotid atherosclerosis. The Kuopio ischemic heart disease risk factor study. Arterioscler Thromb Vasc Biol 17(8):1490–1495

    CAS  PubMed  Google Scholar 

  35. Julkunen J, Greenglass ER. Family support measure. Unpublished Research Manual. 1989

  36. Okkonen E, Vanhanen H. Family support, living alone, and subjective health of a patient in connection with coronary artery bypass surgery. Heart Lung 2006; 35(4): 234–244

    Google Scholar 

  37. Greenglass E (1993) Structural and social-psychological factors associated with job functioning by women managers. Psychol Rep 73:979–986

    Google Scholar 

  38. Aalto A-M, Aro AR, Teperi J. RAND-36 as a measure of health-related quality of life. reliability, construct validity and reference values in the Finnish population (in Finnish with an English Summary). Helsinki: Stakes, Research Reports 101, 1999

  39. Järvinen O, Julkunen J, Saarinen T, Laurikka J, Huhtala H, Tarkka MR (2004) Perioperative myocardial infarction has negative impact on health-related quality of life following coronary artery bypass graft surgery. Eur J Cardiothorac Surg 26(3):621–627

    Article  PubMed  Google Scholar 

  40. Hays RD, Morales LS (2001) The RAND-36 measure of health-related quality of life. Ann Med 33(5):350–357

    Article  CAS  PubMed  Google Scholar 

  41. Tabachnick BG, Fidell LS (1996) Using Multivariate Statistics, 3rd ed. HarperCollins, New York, NY

    Google Scholar 

  42. Baron RM, Kenny DA (1986) The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. J Pers Soc Psychol 51(6):1173–1182

    Article  CAS  PubMed  Google Scholar 

  43. Frazier PA, Tix AP, Barron KE (2004) Testing moderator and mediator effects in counseling psychology research. J Counsel Psychol 51(1):115–134

    Article  Google Scholar 

  44. Preacher KJ, Leonardelli GJ. Calculation of the Sobel test: An interactive calculation tool for mediation test (computer software). Retrieved June 2, 2005, from http://www.unc.edu/∼preacher/sobel/sobel.htm

  45. Scheier MF, Carver CS (1985) Optimism, coping, and health: Assessment and implications of generalized outcome expectancies. Health Psychol 4(3):219–247

    Article  CAS  PubMed  Google Scholar 

  46. Carver CS, Scheier MF (1994) Situational coping and coping dispositions in a stressful transaction. J Pers Soc Psychol 66(1):184–195

    Article  CAS  PubMed  Google Scholar 

  47. Cohen S, Wills TA (1985) Stress, social support, and the buffering hypothesis. Psychol Bull 98(2):310–357

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgement

This study was supported by a grant from the Cancer Society of Finland.

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Authors and Affiliations

  1. Department of Psychology, University of Helsinki, Helsinki, Finland

    Mila Gustavsson-Lilius & Juhani Julkunen

  2. Department of Oncology, University Central Hospital, Helsinki, Finland

    Päivi Hietanen

Authors
  1. Mila Gustavsson-Lilius
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  2. Juhani Julkunen
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  3. Päivi Hietanen
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Correspondence to Juhani Julkunen.

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Gustavsson-Lilius, M., Julkunen, J. & Hietanen, P. Quality of life in cancer patients: The role of optimism, hopelessness, and partner support. Qual Life Res 16, 75–87 (2007). https://doi.org/10.1007/s11136-006-9101-4

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  • DOI: https://doi.org/10.1007/s11136-006-9101-4

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