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Randomized Controlled Trial
. 2022 Jan 15;128(2):401-409.
doi: 10.1002/cncr.33907. Epub 2021 Oct 6.

Dispositional hope as a potential outcome parameter among patients with advanced malignancy: An analysis of the ENABLE database

Benjamin W Corn  1 , David B Feldman  2 , Jay G Hull  3 , Mark A O'Rourke  4 , Marie A Bakitas  5   6
Affiliations
Randomized Controlled Trial

Dispositional hope as a potential outcome parameter among patients with advanced malignancy: An analysis of the ENABLE database

Benjamin W Corn et al. Cancer. .

Abstract

Background: Hopefulness, whether inherently present (dispositional hope) or augmented (by enhancement techniques), may affect outcomes. This study was performed to determine the association of dispositional hope with survival among patients diagnosed with advanced cancer.

Methods: Data from ENABLE (Educate, Nurture, Advise, Before Life Ends), a palliative care intervention, were reanalyzed to determine the association of higher dispositional hope and patient survival. This was a secondary analysis of data combined from the ENABLE II and ENABLE III randomized controlled trials (RCTs) with respect to dispositional hope and survival. A dispositional hope index was created from 3 hope items from 2 validated baseline questionnaires. Dispositional hope and survival data were collected during the 2 RCTs. In ENABLE II, participants were randomly assigned to the ENABLE intervention or to usual care. In ENABLE III, participants were randomly assigned to receive the intervention immediately or 12 weeks after enrollment.

Results: In all, 529 persons were included in Cox proportional hazards regression analyses to model the effects of dispositional hope on survival. An initial analysis without covariates yielded a significant effect of hope (Wald statistic, 8.649; hazard ratio, 0.941; confidence interval, 0.904-0.980; P = .003), such that higher dispositional hope was associated with longer survival. In a subsequent analysis that included all covariates, the effect of dispositional hope approached statistical significance (Wald statistic, 2.96; hazard ratio, 0.933; confidence interval, 0.863-1.010; P = .085).

Conclusions: Higher levels of dispositional hope were associated with longer survival in patients with advanced cancer. Prospective trials are needed to determine the effects of dispositional and augmented hope on the outcomes of patients with advanced cancer.

Trial registration: ClinicalTrials.gov NCT00253383 NCT01245621.

Keywords: Educate, Nurture, Advise, Before Life Ends (ENABLE); advanced cancer; hope; palliation; survival.

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Conflict of interest statement

Conflicts of Interest: None.

Figures

Figure 1.
Figure 1.
Kaplan-Meier survival curves for patients with relatively high versus low hope (determined by a median split on the entire patient sample). Cross-hatch lines indicate censored data. Not corrected for covariates
See this image and copyright information in PMC

References

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