The Effectiveness of Hope-Fostering Interventions in Palliative Care: A Systematic Review and Meta-Analysis

Hope is an important theme in serious illness and is associated with increased psycho-spiritual well-being and quality of life. Objective: To assess the effectiveness of interventions in palliative care that measure hope/hopelessness as an outcome. Selection criteria: The studies chosen were RCTs, quasi-experimental studies, and single pre-post studies that included interventions delivered to palliative care patients that measured hope/hopelessness as an outcome. Main Results: Thirty studies (12 RCTs, 4 quasi-experimental, 6 single group, pre-post; 3,227 patients) were included. Compared with usual care, interventions significantly increased hope levels at a medium effect size (SMD =0.575, 95% CI [0.20 to 094]), but did not significantly reduce hopelessness (SMD= -0.0859 (95% CI [-0.19 to 0.02]). Conclusions: The evidence suggested that interventions can be effective in increasing hope in palliative care patients. Future research should focus on designing and delivering high-quality interventions to increase hope.