Understanding psychological outcomes in cancer: The interplay between hope, dignity, demoralization, and posttraumatic growth.

[PURPOSE] The study investigates the relationship between hope and dignity with demoralization and posttraumatic growth (PTG) in cancer patients.

[METHODS] Α cross sectional study was conducted with convenience sampling. Participants completed the Hearth Hope Index (HHI), Patient Dignity Inventory (PDI), Demoralization Scale-II (DS-II) and Posttraumatic Growth Inventory (PTGI). Univariate and multivariate linear regressions were performed, taking into account demographic and clinical confounders.

[RESULTS] A total of 112 patients with various types of cancer participated. Mean age of the participants was 66 years and 22.3 % had lung cancer. Hope was found to be negatively correlated to demoralization (r = -0.75, p-value<0.01) and positively correlated to the various factors of PTGI (r = 0.45, p-value<0.01). Then, dignity was positively correlated with demoralization (r = 0.79, p-value<0.01) but negatively correlated with PTGI (r = -0.37, p-value<0.01). Univariate and multivariable linear regression analysis identified a negative relationship between hope and demoralization (adjusted coefficient beta = -0.574, 95 %CI = -0.769 to -0.380, p-value<0.001), a positive association between dignity and demoralization (adjusted coefficient beta = 0.209, 95 %CI = 0.156 to 0.261, p-value<0.001) and negative association between dignity and the factor "new possibilities" of the PTGI (adjusted coefficient beta = -0.070, 95 %CI = -0.116 to -0.024, p-value = 0.003). Finally, hope was associated with increased confrontation (adjusted coefficient beta = 0.258, 95 % CI = 0.047 to 0.469, p-value = 0.017), appreciation of life (adjusted coefficient beta = 0.215, 95 % CI = 0.074 to 0.357, p-value = 0.003), and spiritual change of the PTGI (adjusted coefficient beta = 0.134, 95 %CI = 0.019 to 0.249, p-value = 0.022).

[CONCLUSIONS] Enhancing hope and dignity in cancer patients may contribute significantly to reducing demoralization and enhancing posttraumatic growth. There is a need for holistic interventions that take into account the emotional and existential dimensions of cancer.