Effects of complementary and alternative medicine use on hopelessness in ovarian cancer patients

Abstract

9598 Background: Hopelessness is a significant factor affecting the quality of life (QOL) of cancer patients (pts). Despite the millions of dollars spent annually on Complementary and Alternative Medicine use (CAM) there is little research demonstrating any beneficial effect of CAM on QOL and hope despite the fact that these are reasons patients cite for using CAM. Methods: A secondary dataset (n=130 pts) was concatenated from subsets of 2 QOL studies of ovarian cancer pts. A recursive path model was estimated to quantify the hypothesized direct and indirect effects of recurrence and age (>55 yrs) on spirituality (FACT Spirituality Scale), # of CAM use (special diet, psychotherapy, movement, physical therapies, mind/body, spiritual practices, vitamins, herbs) and on feelings of hopelessness (Beck’s Hopelessness Scale). Age and recurrence were also hypothesized to affect hopelessness indirectly through spirituality, which in turn should raise CAM use and reduce hopelessness. Results: Pt median age was 55, range 34–87 years. 73 had recurrent disease (RD). 57 were survivors > 3 years from diagnosis without RD. 97% of all pts reported use of CAM however CAM had only a minimal positive, insignificant effect on hopelessness controlling for other factors. RD directly increased hopelessness (path coefficient [PC] 0.32, p<0.001) which was significantly offset due to heightened spirituality by some RD pts (PC 0.24, p<0.01) that reduced hopelessness (PC −0.56, p<0.001). Older pts were likely to use fewer CAMs (PC −0.26, p<0.01) but were not more spiritual or more hopeful, controlling for RD. A continuous age variable was positively correlated with RD implying another path of age to hopelessness. Conclusions: A significant causal relationship between CAM use and hopelessness was not established. Feelings of hopelessness, natural in pts with RD, were significantly offset through their spirituality. Increasing spirituality, especially among RD pts may significantly improve feelings of hopefulness. Future research should explore direct effects of specific CAM therapies, excluding spiritual practices, on QOL and hope, the interactive relationship between spirituality and hopefulness and continuous effects of age on both recurrence and hope. No significant financial relationships to disclose.