Hopelessness, Depression and Social Support with End of Life Turkish Cancer Patients

  • Sahin, Zumrut Akgun (Department of Internal Medicine Nursing, Kars Health School, Kafkas University) ;
  • Tan, Mehtap (Department of Internal Medicine Nursing, Faculty of Health Science, Ataturk University) ;
  • Polat, Hatice (Department of Internal Medicine Nursing, Faculty of Health Science, Ataturk University)
  • Published : 2013.05.30


Background: This study was performed to evaluate relationships between different demographic variables and hopelessness and depression in end of life Turkish cancer patients. This study was a descriptive survey with repeated measures conducted a university hospital in the city of Erzurum, in the eastern part of Turkey. The study enrolled 216 patients undergoing palliative treatment at the hospital. Materials and Methods: Data were collected using questionnaires (demographic questionnaire, Beck Hopelessness Scale (BHS), Beck Depression Scale (BDS) and analyzed for demographic and disease-related variable effects on hopelessness and depression. Results: Th hopelessness score was significantly high in female, illiterate, married, and living in rural areas cancer patients. Both hopelessness and depression scores were significantly higher with longer disease duration, receiving radiotherapy treatment, and having metastatic disease. Conclusions: These findings demonstrate the coexistence of the physical, psychological, and cognitive problems faced by patients with cancer. Nurses can conduct brief screening assessments to identify patients with probable distress and and psychosocial support, as well as referrals to support services.


  1. Abramson LY, Metalsky GI, Alloy LB (1989). Hopelessness depression: a theorybased of depression. Psychol Rev, 96, 58-372.
  2. Akechi T, Kugaya A, Okamura H, et al (1998). Predictive factors for psychological distress in ambulatory lung cancer patients. Support Care Cancer, 6, 281-6.
  3. Avci IA, Okanli A, Karabulutlu E, Bilgili N (2009). Women's marital adjustment and hopelessness levels after mastectomy. Eur J Oncol Nurs, 13, 299-303.
  4. Baider L, Perez T, De-Nour AK (1989). Gender and adjustment of chronic disease: a study of couples with colon cancer. Gen Hosp Psychiatry, 11, 411-8.
  5. Ballard A, Gren T, Mcaa A, Logsdon MC (1997). A comparison of the level of hope in patients with recently diagnosed and recurrent cancer. Oncol Nurs Forum, 24, 899-904.
  6. Beck AT, Lesker D, Trexler L (1974). The measurement of pessimism. the hopelessness scale. J Consult Clin Psychol, 42, 861-5.
  7. Beck AT (1961). An inventory for measuring depression. Arch Gen Psychiatry, 4, 561-71.
  8. Efficace F, Marrone R (2002). Spiritual issues and quality of life assessment in cancer care. Death Stud, 26, 743-56.
  9. Eskin M (1993). Reliability of the Turkish version of the perceived social support from friends and family scales. J Clin Psychol, 49, 515-22<515::AID-JCLP2270490408>3.0.CO;2-K
  10. Guren E, Tekgul S, Cimen P (2005). Changes in the level of anxiety and depression in patients with lung cancer. Izmir J Chest Dis, 11, 9-13.
  11. Greer S (1992). The management of denial in cancer patients. Oncol, 6, 33-6.
  12. Grumann MM, Spiegel D (2003). Living in the face of death: interviews with 12 terminally ill women on home hospice care. Palliat Support Care, 1, 23-32.
  13. Hert K (1992). Abbreviated instrument to measure hope: development and psychometric evaluation. JAN, 17, 1251-9.
  14. Hisli N (1988). Beck depresyon envanterinin gecerliligi uzerine bir calimsa. Psikol Der, 22, 118-26.
  15. Irwin P, Kramer S, Diamond N et al (1987). Sex differences in psychological distress during definitive radiation therapy for cancer. J Psychosoc Oncol, 4, 63-75.
  16. Jenkins PL, May VE, Hughes LE (1991). Psychological morbidity associated with local recurrence of breast cancer. Int J Psychiatry Med, 21, 149-55.
  17. Jones JM, Huggins MA, Rydall AC, Rodin GM (2003). Symptomatic distress, hopelessness, and the desire for hastened death in hospitalized cancer patients. J Psychosom Res, 55, 411-8.
  18. Kadan-Lottick NS, Vanderwerker LC, Block SD, et al (2005). Psychiatric disorders and mental health service use in patients with advanced cancer. Cancer, 104, 2872-81.
  19. Lampic C, Peterson VW, Larsson G (1996). Anxiety and depression in hospitalized patient with cancer: agreement in patient-staff dyads. Cancer Nurs, 19, 419-27.
  20. Lewis FM (1986). The impact of cancer in the family: a critical analysis of the research literature. Patient Educ Couns, 8, 269-89.
  21. Lloyd-Williams M (2001). Screening for depression in palliative care patients: a review. Eur J Cancer Care, 10, 31-5.
  22. Miaskowski C (2004). Gender differences in pain, fatigue, and depression in patients with cancer. J Natl Cancer Inst Monogr, 32, 139-43.
  23. Mystakidou K, Tsilika E, Parpa E, et al (2009). Illness-related hopelessness in advanced cancer: influence of anxiety, depression, and preparatory grief. Arch Psychiatr Nurs, 23, 138-47.
  24. Nausheen B, Kamal A (2007). Familial social support and depression in breast cancer: an exploratory study on a Pakistani sample. Psychooncology, 16, 859-62.
  25. Neron S, Correa JA, Dajezman E, et al (2007). Screening for depressive symtomps in patients with unresectable lung cancer. Support Care Cancer, 15, 1207-12.
  26. Okamura M, Yamawaki S, Akechi T, et al (2005). Psychiatric disorders following first breast cancer recurrence: prevalence, associated factors and relationship to quality of life. Jpn J Clin Oncol, 35, 302-9.
  27. Pehlivan S, Ovayolu O, Ovayolu N, et al (2012). Relationship between hopelessness, loneliness, and perceived social support from family in Turkish patients with cancer. Support Care Cancer, 20, 733-9.
  28. Pessin H, Rosenfeld B, Breitbart W (2002). Assessing psychological distress near the end of life. Am Behav Sci, 46, 357-72.
  29. Procidano ME, Heller K (1983). Measures of perceived social support from friends and from family: three validation studies. Am J Community Psychol, 11, 1-24
  30. Rusteen T, Wiklund I, Honestad R, Moum T (1998). Nursing intervention to increase hope and quality of life in newly diagnosed cancer patient. Cancer Nurs, 21, 235-45.
  31. Rustoen T, Wiklund I (2000). Hope in newly diagnosed patients with cancer. Cancer Nurs, 23, 214-7.
  32. Savasir I, Sahin NH (1997). Cognitive-behavioral therapy evaluation: commonly used scales. Turkish Psychological Association Publishing, 38-40.
  33. Scherer-Rath M (2001). Living dead ends. Challenges for pastoral advise and assistance of people in life crises. Meunster: Lit Verlag 2001.
  34. Smith EM, Gomm SA, Dickens CM (2003). Assesssing the independent contribution to quality of life from anxiety and depression in patients with advanced cancer. Palliat Med, 17, 509-13.
  35. Song M (2003). Effects of end-of-life discussions on patients' affective outcomes. Nurs Outlook, 52, 118-25.
  36. Tan M, Karabulutlu E (2005). Social support and hopelessness in Turkish patients with cancer. Cancer Nurs, 28, 236-40.
  37. Taylor EJ (2003). Spiritual needs of patients with cancer and family caregivers. Cancer Nurs, 26, 260-6.
  38. Todd K, Roberts S, Black C (2002). The living with cancer education programme, I: development of an Australian education and support programme for cancer patients and their family and friends. Eur J Cancer Care, 11, 271-9.
  39. Voigtmann K, Kollner V, Einsle F, et al (2010). Emotional state of patients in radiotherapy and how they deal with their disorder. Strahlenther Onkol, 4, 229-35.
  40. Yildirim Y, Sertoz OO, Uyar M, Fadiloglu C, Uslu S (2009). Hopelessness in Turkish cancer inpatients: the relation of hopelessness with psychological and disease-related outcomes. Eur J Oncol Nurs, 13, 81-6.
  41. Zabora JR, Blanchard CG, Smith ED, Susan C (1997). Prevalence of psychological distress among cancer patients across the disease continuum. J Psychosoc Oncol, 15, 73-87.

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