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. 2025 Feb 13;33(3):189.
doi: 10.1007/s00520-025-09160-y.

Structural equation modeling of hope, psychological distress, quality of life, and influencing factors in advanced cancer patients undergoing cancer pharmacotherapy in Japan

Mari Kitashita  1   2
Affiliations

Structural equation modeling of hope, psychological distress, quality of life, and influencing factors in advanced cancer patients undergoing cancer pharmacotherapy in Japan

Mari Kitashita. Support Care Cancer. .

Abstract

Objective: The purpose of this study was to clarify the relationship between hope, psychological distress, and quality of life (QOL) of patients with advanced cancer undergoing cancer pharmacotherapy and their related factors.

Methods: Participants were patients with advanced lung, colorectal, and breast cancer undergoing outpatient pharmacotherapy. The Herth Hope Index, Hospital Anxiety and Depression Scale, and Functional Assessment of Cancer Therapy-General were used as measurement tools in a cross-sectional survey. Data were analyzed using descriptive statistics, correlation analysis, t-test, one-way analysis of variance (ANOVA), and Structural Equation Modeling (SEM).

Results: The number of valid responses to the questionnaire survey was 200 (91.7%). SEM included hope, psychological distress, QOL, social support, economic deprivation, physical symptoms, and performance status. The goodness of fit index for SEM was 0.989, adjusted goodness of fit index was 0.960, comparative fit index was 1.000, and root mean square error of approximation was 0.001. Hope had a negative impact on psychological distress (β = - 0.46) and a positive impact on QOL (β = .19).

Conclusion: Hope was shown to be a predictor of psychological distress and QOL in patients with advanced cancer receiving pharmacotherapy. Predictors of hope were social support and economic deprivation. The results suggest that early intervention for patients with characteristics that tend to lower levels of hope is effective in reducing patient anxiety and depression and improving QOL.

Keywords: Advanced cancer patient; Cancer pharmacotherapy; Chemotherapy; Hope; Psychological distress; Quality of life.

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Conflict of interest statement

Declarations. Ethics approval: This study was approved to be conducted following ethics review and approval by the Osaka Medical and Pharmaceutical University’s institutional review board (Specialized Committee on Nursing Research; Study No. 2022–186). In addition, research participants’ facilities used in the conduct of this study were also reviewed when necessary. This study was conducted in accordance with the Ethical Guidelines for Medical and Health Research involving Human Subjects. Consent to participate: Informed consent was obtained from all individual participants included in the study. Competing interests: The authors declare no competing interests.

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