Optimism's Impact on Quality of Life in Chronic Disease Patients: A Systematic Review
Abstract
Chronic diseases have a significant impact on patients' quality of life, physically, psychologically and socially. Optimism, as part of positive psychology, plays an important role in helping patients face health challenges and improve their well-being. Objective: To identify the relationship between optimism and quality of life in patients with chronic diseases through a systematic review. Method: Following PRISMA 2020 guidelines, a comprehensive search across databases such as PubMed, Scopus, Sage, and Nature identified 7,340 articles, with six studies meeting the inclusion criteria. The review included only full-text, English-language quantitative studies—specifically case-control, cross-sectional, cohort, randomised controlled trials (RCTs), or quasi-experimental designs—that examined the relationship between optimism and quality of life in patients with chronic illnesses. There were no restrictions on publication year. Exclusion criteria comprised review articles, meta-analyses, and book or book chapter publications. Each included study was critically appraised using the CASP tool, which assessed research objectives, study design, sampling methods, measurement validity, bias control, and data analysis to ensure methodological rigour. Results: The analysis showed that optimism was positively associated with improved quality of life, especially in physical aspects such as reduced fatigue and improved mobility, as well as psychological aspects such as emotional and spiritual well-being. Social support also strengthened the impact of optimism on quality of life. Community-based interventions, occupational therapy, and multimodal approaches proved effective in increasing patient engagement in meaningful activities. Conclusions: Optimism is an important factor in improving the quality of life of chronic patients, and optimism-based interventions can be an effective strategy to support holistic patient well-being.
References
Acoba, E. F. (2024). Social support and mental health: the mediating role of perceived stress. Frontiers in Psychology, 15. https://doi.org/10.3389/fpsyg.2024.1330720
Akan, G., & Kartal, A. (2023). The association between Patient Assessment of Chronic Illness Care Scores and quality of life in type 2 diabetes patients. Journal of Research in Nursing, 28(3), 199–211. https://doi.org/10.1177/17449871221144899
Albaugh, J. A. (2003). Spirituality and Life-Threatening Illness: A Phenomenologic Study. Oncology Nursing Forum, 30(4), 593–598. https://doi.org/10.1188/03.ONF.593-598
Applebaum, A. J., Stein, E. M., Lord‐Bessen, J., Pessin, H., Rosenfeld, B., & Breitbart, W. (2014). Optimism, social support, and mental health outcomes in patients with advanced cancer. Psycho-Oncology, 23(3), 299–306. https://doi.org/10.1002/pon.3418
Avancini, A., Trestini, I., Tregnago, D., Belluomini, L., Sposito, M., Insolda, J., Schena, F., Milella, M., & Pilotto, S. (2023). Willingness, preferences, barriers, and facilitators of a multimodal supportive care intervention including exercise, nutritional and psychological approach in patients with cancer: a cross-sectional study. Journal of Cancer Research and Clinical Oncology, 149(7), 3435–3445. https://doi.org/10.1007/s00432-022-04232-6
Bognár, S. A., Teutsch, B., Bunduc, S., Veres, D. S., Szabó, B., Fogarasi, B., Zahariev, O. J., Vörhendi, N., Almog, O., Hadani, Y., Gergő, D., Mihály, E., Erőss, B., Bunduc, S., Márta, K., & Hegyi, P. (2024). Psychological intervention improves quality of life in patients with early-stage cancer: a systematic review and meta-analysis of randomized clinical trials. Scientific Reports, 14(1), 13233. https://doi.org/10.1038/s41598-024-63431-y
Ciria-Suarez, L., Calderon, C., Fernández Montes, A., Antoñanzas, M., Hernández, R., Rogado, J., Pacheo-Barcia, V., Ansensio-Martínez, E., Palacín-Lois, M., & Jimenez-Fonseca, P. (2021). Optimism and social support as contributing factors to spirituality in Cancer patients. Supportive Care in Cancer, 29(6), 3367–3373. https://doi.org/10.1007/s00520-020-05954-4
Dąbrowska-Bender, M., Słoniewski, R., Religioni, U., Juszczyk, G., Słoniewska, A., & Staniszewska, A. (2017). Analysis of Quality of Life Subjective Perception by Patients Treated for Prostate Cancer with the EORTC QLQ-C30 Questionnaire and QLQ-PR25 Module. Journal of Cancer Education, 32(3), 509–515. https://doi.org/10.1007/s13187-015-0954-5
de Moor, J. S., de Moor, C. A., Basen-Engquist, K., Kudelka, A., Bevers, M. W., & Cohen, L. (2006). Optimism, Distress, Health-Related Quality of Life, and Change in Cancer Antigen 125 Among Patients With Ovarian Cancer Undergoing Chemotherapy. Psychosomatic Medicine, 68(4), 555–562. https://doi.org/10.1097/01.psy.0000222379.71389.91
Gabriel, I., Creedy, D., & Coyne, E. (2020). A systematic review of psychosocial interventions to improve quality of life of people with cancer and their family caregivers. Nursing Open, 7(5), 1299–1312. https://doi.org/10.1002/nop2.543
Goudarzian, A. H., Mazhari, S. A., Sobhanian, P., Farhadi, B., Kalantari, S., & Taebi, M. (2025). The relationship between spiritual well-being and fear of cancer progression in Iranian cancer patients. Frontiers in Psychology, 16. https://doi.org/10.3389/fpsyg.2025.1495988
Hacker, K. (2024). The Burden of Chronic Disease. Mayo Clinic Proceedings: Innovations, Quality & Outcomes, 8(1), 112–119. https://doi.org/10.1016/j.mayocpiqo.2023.08.005
Heuschkel, G., Fischer von Weikersthal, L., Junghans, C., Zomorodbakhsch, B., Stoll, C., Prott, F.-J., Fuxius, S., Micke, O., Richter, A., Sallmann, D., Büntzel, J., Hoppe, C., & Huebner, J. (2024). Spirituality in Oncology: Relations between Spirituality, Its Facets, and Psychological and Demographic Factors in Cancer Patients in Germany. Oncology Research and Treatment, 47(4), 123–134. https://doi.org/10.1159/000535919
Lestari, H. S. A., Sukartini, T., & Nihayati, H. E. (2023). Spiritual well-being in breast cancer patients. Pediomaternal Nursing Journal, 9(1), 26–30. https://doi.org/10.20473/pmnj.v9i1.42247
Lin, L., Lin, H., Zhou, R., Liu, B., Liu, K., & Jiang, R. (2024). Surviving and thriving: Assessing quality of life and psychosocial interventions in mental health of head and neck cancer patients. Asian Journal of Surgery. https://doi.org/10.1016/j.asjsur.2024.11.048
Llamas-Ramos, I., Alvarado-Omenat, J. J., Rodrigo-Reguilón, M., & Llamas-Ramos, R. (2023). Quality of Life and Side Effects Management in Cancer Treatment—A Cross Sectional Study. International Journal of Environmental Research and Public Health, 20(3), 1708. https://doi.org/10.3390/ijerph20031708
Newman, R. M., Polo, K. M., Amanat, Y., Campbell, C., Fleischer, A., & Morikawa, S. (2024). Occupational Therapy Practice Guidelines for Adults Living With and Beyond Cancer. The American Journal of Occupational Therapy, 78(5). https://doi.org/10.5014/ajot.2024.078501
Nguyen, L. B., Vu, L. G., Le, T. T., Nguyen, X. T., Dao, N. G., Nguyen, D. C., Huyen Thi Dang, T., Vu, T. M. T., Boyer, L., Fond, G., Auquier, P., Latkin, C. A., Zhang, M. W. B., Ho, R. C. M., & Ho, C. S. H. (2023). Impact of interventions on the quality of life of cancer patients: a systematic review and meta-analysis of longitudinal research. Health and Quality of Life Outcomes, 21(1), 112. https://doi.org/10.1186/s12955-023-02189-9
Peng, F., Li, H., Zhang, J., Li, X., Zhang, H., & Li, Y. (2023). Effects of different psychological interventions on quality of life and remission rate in patients with acute leukemia receiving chemotherapy: A randomized controlled trial. Frontiers in Psychology, 14. https://doi.org/10.3389/fpsyg.2023.1045031
Petersen, L. R., Clark, M. M., Novotny, P., Kung, S., Sloan, J. A., Patten, C. A., Vickers, K. S., Rummans, T. A., Frost, M. H., & Colligan, R. C. (2008). Relationship of Optimism–Pessimism and Health-Related Quality of Life in Breast Cancer Survivors. Journal of Psychosocial Oncology, 26(4), 15–32. https://doi.org/10.1080/07347330802359578
Peterson, C., Semmel, A., von Baeyer, C., Abramson, L. Y., Metalsky, G. I., & Seligman, M. E. P. (1982). The attributional Style Questionnaire. Cognitive Therapy and Research, 6(3), 287–299. https://doi.org/10.1007/BF01173577
Petruseviciene, D., Surmaitiene, D., Baltaduoniene, D., & Lendraitiene, E. (2018). Effect of Community-Based Occupational Therapy on Health-Related Quality of Life and Engagement in Meaningful Activities of Women with Breast Cancer. Occupational Therapy International, 2018, 1–13. https://doi.org/10.1155/2018/6798697
Poier, D., Büssing, A., Rodrigues Recchia, D., Beerenbrock, Y., Reif, M., Nikolaou, A., Zerm, R., Gutenbrunner, C., & Kröz, M. (2019). Influence of a Multimodal and Multimodal-Aerobic Therapy Concept on Health-Related Quality of Life in Breast Cancer Survivors. Integrative Cancer Therapies, 18. https://doi.org/10.1177/1534735418820447
Rha, S. Y., Song, S. K., & Lee, J. (2022). Self-efficacy for coping with cancer and quality of life in advanced gastric cancer patients. European Journal of Oncology Nursing, 58, 102120. https://doi.org/10.1016/j.ejon.2022.102120
Rider, J. V., & Tay, M. C. (2022). Increasing Occupational Engagement by Addressing Psychosocial and Occupational Factors of Chronic Pain: A Case Report. The Open Journal of Occupational Therapy, 10(3), 1–12. https://doi.org/10.15453/2168-6408.2027
Scherz, N., Bachmann-Mettler, I., Chmiel, C., Senn, O., Boss, N., Bardheci, K., & Rosemann, T. (2017). Case management to increase quality of life after cancer treatment: a randomized controlled trial. BMC Cancer, 17(1), 223. https://doi.org/10.1186/s12885-017-3213-9
Schiavon, C. C., Marchetti, E., Gurgel, L. G., Busnello, F. M., & Reppold, C. T. (2017). Optimism and Hope in Chronic Disease: A Systematic Review. Frontiers in Psychology, 7. https://doi.org/10.3389/fpsyg.2016.02022
Siboni, F., Alimoradi, Z., Atashi, V., Alipour, M., & Khatooni, M. (2019). Quality of life in different chronic diseases and its related factors. International Journal of Preventive Medicine, 10(1), 65. https://doi.org/10.4103/ijpvm.IJPVM_429_17
Stelcer, B., Bendowska, A., Karkowska, D., & Baum, E. (2023). Supporting elderly patients in strengthening their personal and spiritual health resources. Frontiers in Psychology, 14. https://doi.org/10.3389/fpsyg.2023.1237138
Suhertini, T., Irawati, D., & Maria, R. (2023). Studi Kasus: Perawatan Paliatif Karsinoma Stadium Lanjut Melalui Pendekatan Model Adaptasi Roy. Jurnal Ilmiah Keperawatan (Scientific Journal of Nursing), 9(1), 207–217.
Treaster, M. (2021). Optimism and Physical Health-Related Quality of Life in Chronic Illness: Mediating Effects of Control Beliefs and Health Behaviors. East Tennessee State University.
van der Doelen, M. J., Oving, I. M., Wyndaele, D. N. J., van Basten, J.-P., Terheggen, F., van de Luijtgaarden, A. C. M., Oyen, Wim. J. G., van Schelven, W. D., van den Berkmortel, F., Mehra, N., Janssen, M. J. R., Prins, J. B., Gerritsen, W. R., Custers, J. A. E., & van Oort, I. M. (2023). Health-related quality of life, psychological distress, and fatigue in metastatic castration-resistant prostate cancer patients treated with radium-223 therapy. Prostate Cancer and Prostatic Diseases, 26(1), 142–150. https://doi.org/10.1038/s41391-022-00569-8
Witt, S., Quitmann, J., Höglund, A. T., Russ, S., Kaman, A., Escherich, G., & Frygner-Holm, S. (2023). Effects of a Pretend Play Intervention on Health-Related Quality of Life in Children With Cancer: A Swedish–German Study. Journal of Pediatric Hematology/Oncology Nursing, 40(3), 158–169. https://doi.org/10.1177/27527530221121726
Yin, Y., Lyu, M., Chen, Y., Zhang, J., Li, H., Li, H., Xia, G., & Zhang, J. (2022). Self-efficacy and positive coping mediate the relationship between social support and resilience in patients undergoing lung cancer treatment: A cross-sectional study. Frontiers in Psychology, 13. https://doi.org/10.3389/fpsyg.2022.953491
Zhao, X., Tong, S., & Yang, Y. (2022). The Correlation Between Quality of Life and Positive Psychological Resources in Cancer Patients: A Meta-Analysis. Frontiers in Psychology, 13. https://doi.org/10.3389/fpsyg.2022.883157.
Copyright (c) 2025 Indonesian Journal of Global Health Research

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.



