Living With Hope Program for Rural Women Caregivers

2014-07-24 14:06:58 | BioPortfolio


Family caregivers of terminally ill persons describe hope as inner strength that will help them continue caregiving. Our research team has developed and pilot tested a Living with Hope Program (LWHP) for caregivers of family members with advanced cancer, with the goal of fostering hope and improving quality of life ( /research/livingwithhope). The caregivers involved in our pilot test found the LWHP easy to use and we found some evidence to suggest that the program may have increased their hope and improved their quality of life. We would like to further develop and test the LWHP by finding out more about how and how long it might work. We believe it will improve the quality of life of active and bereaved older rural women of persons with advanced cancer and may decrease the number of prescriptions and doctor visits over one year. Since rural women caring for persons with advanced cancer seem to have the least hope, we want to focus on them first before including other caregivers in our research. Two hundred rural women caring for a person with advanced cancer will be asked to take part in this study. Their feelings of control, loss and grief, quality of life and hope will be measured over a year. The numbers of time they visit their physician and how many prescriptions they have over the year will also be collected. This study will contribute to the refinement of a Living with Hope Program that may improve quality of life and personal health of older rural women caring for their spouse with advanced cancer and those who subsequently become bereaved.


1. Background: The research team has developed and pilot tested a Living with Hope Program (LWHP) for caregivers of family members with advanced cancer. The LWHP includes viewing an award winning Living with Hope video followed by writing a daily journal for two weeks. The pilot test findings suggested that the LWHP is an acceptable and feasible intervention for use by family caregivers. Although the LWHP shows promise in potentially increasing hope and quality of life, further testing and development is needed. Questions remain as to: a) what are the mechanisms through which the LWHP affects outcomes and b) how long it is effective?

2. Purpose: The overall purpose of this time series mixed method study is the further development and testing of the LWHP by:

1. Determining the mechanisms of the LWHP by testing the LWHP conceptual model in which self-efficacy and loss and grief are hypothesized intervening variables for changes in hope, and subsequently quality of life among rural women caring for persons with advanced cancer. In the LWHP model we hypothesize that administration of the LWHP will improve self-efficacy and decrease feelings of loss and grief. This will lead to a positive influence on the proximal outcome of hope and the distal outcome of quality of life.

2. Exploring the longitudinal effects of the LWHP on hope, quality of life and health services utilization among older rural women caring for spouses with advanced cancer. We want to determine if the LWHP has benefits beyond what was found in the pilot. The team will compare baseline scores of hope and quality of life to scores after the LWHP over time and health services utilization (one year prospective number of physician visits and prescriptions compared to the year before the LWHP). This study is unique, as it will follow caregivers over a one-year period. As approximately 50% of these caregivers will become bereaved one month after study enrolment; rather than dropping these caregivers from the study, the team felt that retaining these subjects would add to the understanding of hope, quality of life and health care utilization among caregivers by continuing to follow them through bereavement. Thus, patterns of hope, quality of life and health care services utilization will be delineated over time for active and bereaved caregivers.

3. Research Plan: Using a time-series embedded mixed method design, baseline measures will be collected from 200 rural women caring for a person who has advanced cancer. All subjects will receive the LWHP. Then subjects will be post tested on the variables at 1 and 2 weeks, 3, 6 and 12 months. Journals entries will be copied and transcribed. Using Health Services Personnel Health numbers, subject's health services utilization data (physician's visits and number of prescriptions) will be collected one year prior to the LWHP and one year post LWHP using administrative data from Saskatchewan Health.

4. Data Analysis: Path Analysis will be used to test the model post LWHP at 1 and 2 weeks. Two-factor ANCOVA will determine patterns over time and Cortazzi's narrative analysis will be used to analyze the subjects journals completed as part of the LWHP.

5. Significance: This study will contribute to the refinement of the Living with Hope Program that may improve quality of life and personal health of older rural women caring for their spouse with advanced cancer and those who subsequently become bereaved. The findings will also increase our understanding of the factors influencing hope, quality of life and health in a vulnerable, understudied population that is increasing in numbers with the aging of Canada's population. Family care giving is what sustains patients at the end of life, and with changing demographics and diminishing resources there is a potential that every Canadian will be an informal caregiver at some time. Effective psychosocial supportive interventions, such as the LWHP are critical for their support and well-being.

Study Design

Allocation: Non-Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Supportive Care


Advanced Cancer


Living with Hope Program


University of Saskatchewan
S7N 5E5




University of Saskatchewan

Results (where available)

View Results


Published on BioPortfolio: 2014-07-24T14:06:58-0400

Clinical Trials [4212 Associated Clinical Trials listed on BioPortfolio]

Evaluation of a Living With Hope Program

The Living with Hope program was developed by the research team, a panel of experts and palliative patients and their families. The program was evaluated with 60 advanced cancer patients 6...

Hope Promotion Program: Effectiveness in Palliative Patients

This study aims to: I. Develop and pilot test the effectiveness of a Hope Promotion Program compared with the standard treatment protocol, in hope, comfort and quality of life, based on a...

Randomized Controlled Trial Assessing the Efficacy of a Communication Skills Training Program

Today, oncological care offers more effective and personalized treatments than ever before, while cancer patients and their physicians are increasingly confronted with uncertainty. Physici...

Enhancing Hope Among Patients With Poor-Prognosis Breast Cancer and Oncologists

The study will access whether breast cancer patients and oncologists can become more hopeful after participating in a "hope enhancement workshop." Several validated tools, Adult Hope Scale...

Metabolic Imaging Predict Histopathologic Response to Preop ChemoXRT for Locally Advanced Rectal CA

In this research study of metabolic imaging in locally advanced rectal cancer, we hope to learn whether new medical imaging technology can help predict the response of rectal cancer to pre...

PubMed Articles [21432 Associated PubMed Articles listed on BioPortfolio]

Peer support for people with advanced cancer: a systematically constructed scoping review of quantitative and qualitative evidence.

The number of people living with advanced cancer is increasing, and appropriate support to this population is essential. Peer support is increasingly advocated as a component of care, but little is kn...

Implementation of optimized supportive care and hospital needs along the management of patients with advanced lung cancer.

Supportive care in cancer (SCC) have been recommended to be integrated in the management of patients with lung cancer all along the course of the disease. We took advantage of a pilot program of early...

The collective/affective practice of cancer survivorship.

Whether within an atmosphere of hope, or amidst relations of fear, the emotions of cancer are unavoidably collectively produced. Yet persistent individualistic paradigms continue to obscure how the em...

Balancing Hope and Risk Among Adolescent and Young Adult Cancer Patients with Late-Stage Cancer: A Qualitative Interview Study.

Previous studies have called for further research to explore adolescent and young adult (AYA) decision-making in the context of advanced cancer to understand the perspectives of this understudied popu...

HIPEC: HOPE or HYPE in the fight against advanced ovarian cancer?

Medical and Biotech [MESH] Definitions

A cancer registry mandated under the National Cancer Act of 1971 to operate and maintain a population-based cancer reporting system, reporting periodically estimates of cancer incidence and mortality in the United States. The Surveillance, Epidemiology, and End Results (SEER) Program is a continuing project of the National Cancer Institute of the National Institutes of Health. Among its goals, in addition to assembling and reporting cancer statistics, are the monitoring of annual cancer incident trends and the promoting of studies designed to identify factors amenable to cancer control interventions. (From National Cancer Institute, NIH Publication No. 91-3074, October 1990)

An antineoplastic agent that is a derivative of progesterone and used to treat advanced breast cancer.

Belief in a positive outcome.

A phylum of small sessile aquatic animals living as small tufted colonies. Some appear like hydroids or corals, but their internal structure is more advanced. Most bryozoans are matlike, forming thin encrustations on rocks, shells, or kelp. (Storer & Stebbins, General Zoology, 6th ed, p443)

The process of formulating, improving, and expanding educational, managerial, or service-oriented work plans (excluding computer program development).

More From BioPortfolio on "Living With Hope Program for Rural Women Caregivers"

Quick Search


Relevant Topics

Head and neck cancers
Cancer can occur in any of the tissues or organs in the head and neck. There are over 30 different places that cancer can develop in the head and neck area. Mouth cancers (oral cancers)  - Mouth cancer can develop on the lip, the tongue, the floor...

Women's Health
Women's Health - key topics include breast cancer, pregnancy, menopause, stroke Follow and track Women's Health News on BioPortfolio: Women's Health News RSS Women'...

Searches Linking to this Trial