Congress Abstracts 2006

53

MIXED METHOD EVALUATION OF A LIVING WITH HOPE PROGRAM FOR OLDER TERMINALLY ILL CANCER PATIENTS. Wendy Duggleby, DSN, RN, AOCN^®, University of Saskatchewan, Saskatoon, Canada; Lesley Degner, PhD, RN, University of Manitoba, Winnipeg, Canada; Allison Williams, PhD, McMaster University, Hamilton, Canada; Karen Wright, PhD, RN, University of Saskatchewan, Saskatoon, Canada; Dan Cooper, MDiv, Regina/QuAppelle Health Region, Regina, Canada; David Popkin, MD, Saskatoon Cancer Center, Saskatoon, Canada; and Lorraine Holtslander, MN, RN, University of Saskatchewan, Saskatoon, Canada.

Terminally ill cancer patients endure and cope with their psychosocial pain by maintaining hope. The research team developed a theory-driven intervention, the Living with Hope Program (LWHP), to foster hope and increase quality of life for older terminally ill cancer patients living at home.

The overall purpose of the proposed study is to evaluate the effectiveness of the LWHP in increasing hope and quality of life for older adult community-living terminally ill cancer patients. Psychosocial research of community living older adults is an ONS research priority.

Duggleby and Wright's (2005) theory of "Transforming Hope" was used to develop the intervention and was the framework for this study.

Using a mixed method concurrent nested experimental design 60 terminally ill cancer patients over the age of 60 years were randomly assigned to a treatment and control group. Baseline hope [Herth Hope Index (HHI)] and quality of life scores [McGill Quality of Life Questionnaire, (MQOL)] were collected at the first visit in the patients' homes by a trained research assistant. Those in the treatment group received the LWHP that includes viewing an international award winning video on hope and choosing one of three hope exercises to work on over a one-week period. The control group received standard care. Data was collected one week later from both groups using the HHI and MQOL. Qualitative data using open-ended hope questions were collected from the treatment group.

Data Analysis: Qualitative data was analyzed using thematic analysis. To determine differences between groups, linear regression modeling was used with baseline HHI and MQOL as covariates.

Subjects receiving the Living with Hope Program had statistically significant higher hope (df=3, F=30.087, p=.000) and quality of life scores at visit two (df=3, F=9.022, p=.000) than those in the control group. Qualitative data confirmed this finding with the majority (61.5%) of subjects in the treatment group reporting the LWHP increased their hope. This preliminary evaluation of the effectiveness of the LWHP suggests that it may increase hope and quality of life for older terminally ill cancer patients at home.

Funding Sources: Saskatchewan Health Research Foundation Establishment Grant