Herth Hope Index trajectory and its predictors in middle-aged and elderly patients with lung cancer: A prospective longitudinal observational study

Objective For middle-aged and elderly patients with lung cancer undergoing radiotherapy, the care and support received from family members or close social supporters during treatment significantly influence the physical and mental state and treatment outcomes of the patient. Hope, a positive emotional state, reflects patients’ attitudes and expectations toward their condition, treatment process, and prognosis. The level of hope may vary among middle-aged and elderly patients with lung cancer undergoing radiotherapy. Therefore, exploring individual differences and developmental changes during radiotherapy is important. This study aims to evaluate whether heterogeneity exists in the levels of hope among middle-aged and elderly patients with lung cancer during thoracic radiotherapy, identify related predictive factors, and understand the level of family care received by patients at this stage, to provide targeted interventions for patients with lung cancer with different levels of hope. Methods A total of 124 patients with lung cancer were included. Their levels of hope and extent of family care were evaluated at four time points. Growth mixture models, univariate analysis, and multivariate logistic regression were used to study the trajectory in the level of hope, its association with outcomes, and its predictive factors. Results Two hope trajectory classes were identified: the slow decline (27.4%) and the rapid decline (72.6%). Age, marital status, level of education, and extent of family care were factors influencing the hope trajectory categories during radiotherapy for middle-aged and elderly patients with lung cancer (P < 0.05). Conclusion The trajectories of hope among middle-aged and elderly patients with lung cancer during radiotherapy were heterogeneous. Healthcare providers can tailor interventions based on the factors that influence these hope trajectory categories.