Anyone who has become a little introspective over the last 18 months can be excused. Many of us have suddenly found ourselves confined to our homes for extended periods, with reduced social interactions and facing down a pandemic with an uncertain timeline ahead. Last year, hope was something to hang on to, but optimism was perhaps harder to find.

“… hope may be understood as… attentional focus on the possibility that the future will be good, characteristically in the face of difficulty. Optimism, on the other hand… expectations that the future will be good (which may be with or without reasons)”1

Fortunately, with vaccines available and, hopefully, more effective therapeutics on the horizon, the outlook is brighter.

But what of hope in other areas of healthcare?

In medical communications, the concept and/or messaging of ‘giving hope to patients’ is a familiar (and noble) one. Relying on clinical data alone is rarely a path to effectively telling the story of a new drug or treatment’s merits: but everyone in the healthcare and pharmaceutical industry is driven to improve the lives of patients.

Deborah James (broadcaster, author and member of the excellent ‘You, Me and the Big C’ podcast team) often talks about ‘hope and options’ sustaining her as she lives with stage IV bowel cancer.2,3 Hope can assist patients through the trajectory of illness, from initial diagnosis, through treatment and follow-up.4

Hope as a concept, and ‘staying positive’, are common discussion points in clinical care.1

Charles Snyder, an American psychologist specialising in positive psychology, developed a ‘Hope Theory’. This suggests that there are two inter-related components of hope:1

  • Pathway thinking (Way power)
    • Considering strategies to reach a goal or goals
    • Hopeful people tend to create many pathways to get around possible obstacles
  • Agency thinking (Willpower)
    • Being motivated, and feeling able to begin and progress towards goals

There are a variety of methods available to assess hope; the most widely used measure is the Adult Hope Scale, designed to assess hope as a stable characteristic of a person, rather than a fleeting psychological state (you can view the scale here: https://ppc.sas.upenn.edu/sites/default/files/hopescale.pdf).1,5

Several studies have shown a connection between having a high level of hope and health-promoting behaviours, such as not smoking, regular exercise and health diet. Since these behaviours have been associated with improved outcomes in diseases such as cancer, it is possible that hope itself could ultimately be a predictor of a patient’s journey and outcomes.1

Various interventions, including teaching of cognitive coping techniques, PRISM (Promoting Resilience in Stress Management) and meaning-centred group psychotherapy have all demonstrated increased hopefulness in patients with cancer.1

Organisations such as ‘Life’s Door’ aim to empower hope, meaning and quality of life throughout illness, aging, and at the end of life – with a vision of including hope in the physician’s tool box as an essential medical intervention.6

We are all familiar with ‘hope’ as a concept – but we might not think of it as an aspect that can have a measurable impact on outcomes for patients, or we might believe that it is an innate characteristic that cannot be changed by external forces. Hope enhancement techniques could be an important tool as part of a holistic treatment plan, and may form an important part of patient support programs. My hope is that we continue to explore the possibilities, bringing hope and optimism to the forefront of healthcare.

  1. Long KNG, et al. Global Epidemiology 2020;2:100018. Available at: https://www.sciencedirect.com/science/article/pii/S259011332030002X [Accessed September 2021].
  2. The Sun. ‘Options and Hope’: I’ve found new fire after 13th operation and want to make the most of every day. Available at:  https://www.thesun.co.uk/fabulous/15428147/deborah-james-new-fire-op-make-most-every-day/ [Accessed September 2021].
  3. F*** You Cancer: How to face the big C, live your life and still be yourself. Deborah James. Published by Vermilion. 2018.
  4. Corn BW, et al. Lancet Oncol 2020;21:e452–59.
  5. The Trait Hope Scale. Available at: https://ppc.sas.upenn.edu/sites/default/files/hopescale.pdf [Accessed September 2021].
  6. Life’s Door – Who We Are. Available at: https://lifesdoor.org/en/about-us/ [Accessed September 2021].