The HOPES Study

The HOPES is the result of a longstanding co-operation between the Institute for Urologic Disorders and one of the leading health epidemiological research centres of the U.S.A., the New England Research Institutes (NERI). NERI (www.neriscience.com) was found in 1986, and since then has a leading role in health research. The MMAS (Massachusetts Male Aging Study) which was implemented in 1990, as well as the more recent BACH study (Boston Area Community Health Survey), are only two projects of NERI with a historical impact on urology.

Overview of HOPES

The Hospitalized and Outpatient Profile and Expectation Study (HOPES) is a hospital-based survey of a broad range of psychosocial characteristics, preferences for care and urologic symptoms. The study was conducted at the Papageorgiou General Hospital which is based at the city of Thessaloniki, Greece. For the research design, patients were recruited in two discrete samples: a) Hospital Group (HG), which was defined as a cross section of patients in all hospital departments, and b) Urology Group (UG), which consisted of urology inpatients and outpatients.

HOPES Researcher team

Apostolos Apostololidis, urologist

Carol Link, statistician

Dimitris Hatzichristou, urologist

Gretchen Chiu, statistician

Heather Litman, statistician

John Mc Kinlay, epidemiologist

Kostas Hatzimouratidis, urologist

Paraskevi-Sofia Kirana, health psychologist

Raymond Rosen, psychologist

Zoi Tsimtsiou, general practitioner

HOPES rationale

The HOPES was based on a conceptual framework that aimed to describe individual level psychosocial factors that may explain discrepancies in patients response to symptoms, and emphasised the potential role of subjective well- being  (Kirana PS et al: Int J Clin Practice, 2009;63:1435-45).  

Research Design

HOPES is a hospital based cross sectional study of patients 18-80 years old. The study was performed in a large, community hospital which is based in a city of one million citizens in Thessaloniki, Greece. The Hospital is publicly funded and access is free of charge to the community. Patients were assessed on a broad range of factors, including psychological characteristics, lifestyle factors and health conditions. The HOPES final sample consists of 681 patients with approximately equal gender/ age distribution.

Sample recruitment

The study design aimed to recruit a representative cross section of eligible inpatients for the Hospital Group sample. Specifically the aim was to recruit a representative number of patients from each department, according to the monthly distribution of admissions across departments.

In addition, the study design aimed to recruit an equal number of women and men for each age group (18-40y, 41-60y, 61-80y). This was important in order to identify the contributing role of age and gender.

Patients were recruited by selecting all sequentially eligible patients in each eligible hospital department.

Data collection

Study measures were obtained during a 2-hour, standardized, in-person interview, conducted by research-trained psychologists/interviewers in the hospital.

Quality control

A minimum of 10% double data entry ensured accurate data entry. Prior to analysis, subjects missing more than half of the questionnaire were removed from the analysis sample.

Study variables

The study assessed patients for various characteristics such as, demographics, co morbidities, patient preferences for care, urologic symptoms, as well as  psychosocial variables: a) dispositional personality characteristics, b) cognitions about ones self and health, c) social support, d) subjective well- being, e) lifestyle factors. In total, the HOPES study protocol consisted of 33 research tools.

Initial findings on baseline characteristics of the sample.

Initial descriptive data on baseline characteristics of the study sample provide information on: demographics,

  • reporting of urologic symptoms: lower urinary tract symptoms, incontinence, sexual dysfunctions, as well as bother and treatment seeking for these.
  • chronic health conditions
  • psychosocial variables including dispositional characteristics, coping styles and stress, cognitions about the self and health, life satisfaction, affect, lifestyle factors.

A detailed description of the mean scores on all major variables measured in the study, by gender and by age group: for the hospital group, for the urology group.

HOPES publications

 Kirana PS, Rosen R, Hatzichristou D. Subjective well-being as a determinant of individuals' responses to symptoms: a biopsychosocial perspective. Int J Clin Pract. 2009 Oct;63(10):1435-45.

 Apostolidis A, Kirana PS, Chiu G, Link C, Tsiouprou M, Hatzichristou D. Gender and age differences in the perception of bother and health care seeking for lower urinary tract symptoms: results from the hospitalised and outpatients' profile and expectations study. Eur Urol. 2009 Dec;56(6):937-47. Epub 2009 Aug 12.

Nakopoulou E, Kirana PS, Chiu G, Link C, Rosen R, Hatzichristou D. Level of bother and treatment-seeking predictors among male and female in-patients with sexual problems: a hospital-based study. J Sex Med. 2010;7(2 Pt 1):700-11.

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