Hope, meaning in life and religious/spiritual struggle predicts the quality of life in cancer patients with early and advanced malignancy: a structural equation modeling approach

Purpose: This study examined hope, meaning in life (MIL), and religious/spiritual struggle (RSS) as predictors of the quality of life (QOL) in cancer patients. We hypothesized a positive association of QOL with hope and MIL, whereas a negative association with RSS. The stage of cancer was hypothesized as a moderator variable between QOL and hope. Hope and MIL were assumed as positive predictors and RSS as negative predictor of QOL. Methods: Data stem from the cross-sectional survey study of 300 cancer patients (Mean age = 50.97 +/- 13.50 SD). Herth Hope Index, Meaning in Life Scale, Religious Spiritual Struggle Scale and WHO-QOL-BRIEF were used. The correlation coefficient and partial least square structural equation modeling approach (PLS-SEM) were used for assessing the measurement model and the structural model. Results: As hypothesized, QOL was found positively associated with Hope and MIL, but negatively associated with RSS. The stage of cancer was hypothesized as a negative moderator. The three predictors significantly predicted QOL in cancer patients and explained 75.3% of the variance in QOL, and the overall model fit was adequate (SRMR = 0.075). Hope and MIL had a positive impact on QOL (beta = .356, p < 0.01; beta = .355 p < 0.01, respectively), whereas RSS had a negative impact (beta = -.102, p < .05). The Stage of cancer did not moderate the path coefficient between the hope and QOL to a significant degree (beta = .097, p > 0.01). Conclusion: In cancer patients, hope and MIL are facilitators of QOL. Addressing religious and spiritual concerns and struggles is critical to overall QOL improvement.