Facilitating Hopefulness

Defining hope can be as illusive as "spooning fog." However, without hope the desire to go on living is lost. Despite the paucity of research on the connections betwecn hope and social and psychological functioning, recent research has pointed to hope as a primary element in helping cancer patients maintain a sense of control while suffering from the physical and psychological wounds of cancer. Although the process of hope has been elaborated in the literature, relalively little is known about the determinants of hope and how these factors interact to foster or inhibit the existence and nurturance of hope in cancer patients. The authors' primary purpose was to build a model of the determinants of hope using path analysis. These results were based on a cross-sectional survey of 194 outpatients: 96 with ocular melanoma and 98 with head and neck cancer. The resulting empirical model emphasized the importance of locus or control as either a direct determinant of hope or a factor that buffers distress and buttresses coping. The model also underscored the role that demographic characteristics-specifically age, sex, occupation, and education-play as determinants of hope. The contributions of coping and physical and psychosocial functioning also were pinpointed as indirect determinants of hope. Contrary to the literature and the hypothesized model, coping difficulties did not have a direct impact on hope and actual social support was a determinant of hope either directly or indirectly.