Interventions to improve hope and psychosocial outcomes in patients with advanced solid tumor cancer: A systematic review and meta-analysis.

Abstract

e24100 Background: Hope is critical for individuals facing cancer, impacting quality of life, emotional well-being, and engagement with treatment. Interventions aimed at fostering hope may buffer against negative experiences and improve coping. Although a growing body of research has investigated psychological and spiritual approaches to support hope, the strength and consistency of evidence across diverse cancer populations remains unexplored. This systematic review synthesizes data on interventions designed to improve hope among adults with malignancy and evaluates their effects compared with standard care. Methods: Major databases including Scopus, PubMed, Embase, and CENTRAL were searched through July 17, 2025. Inclusion criteria were adults with any solid-tumor malignancy undergoing an intervention designed to improve hope. Outcomes included hope measured by a validated hope-scale, anxiety, depression, and perceptions of treatment. English language randomized controlled trials, prospective or retrospective comparative studies, single-arm pre–post intervention studies were included. Abstracts and full texts were doubly screened; included manuscripts were doubly extracted and data extracted and summarized. Risk of bias assessment was performed using ROB2 and ROBINS-I. A random-effects meta-analysis was conducted to pool standardized mean differences comparing pre- and post- intervention HHI scores across studies. Results: 42,111 abstracts screened, 46 full texts screened, and 21 studies included representing 1,659 patients with various types of solid-tumor cancer, including breast, pancreatic, lung, colorectal, stomach, head/neck, urologic, gynecologic, prostate, hepatic and other non-specified advanced malignancy. Hope interventions included psychosocial interventions, nursing interventions, and mindfulness/spiritual interventions. Participants in the intervention groups demonstrated a significantly higher mean increase of 0.51 [0.22, 0.80] (p = 0.0) on the Herth Hope Index compared with a non-significant increase of 0.06 [-0.07, 0.19] in the control groups. Across studies, outcomes consistently demonstrated improvements in hope levels for patients undergoing hope-based interventions. Conclusions: This systematic review and meta-analysis illustrate that hope-focused interventions are associated with consistent improvement in hope and psychosocial outcomes for patients with malignancy compared with routine care.