The purposes of this study were to (a) ascertain if there is a relationship between functional status and hope in elders with and without cancer and (b) determine if there are differences between these two groups with respect to hope and functional status. Roy's adaptation model of nursing provided the conceptual framework, and hope, as an indicator of adaptation, was measured by Miller's Hope Scale (MHS). Functional status as related to Roy's four adaptive modes was assessed by six domains of the Philadelphia Geriatric Center's Multi-level Assessment Instrument (MAI).

The data for this descriptive cross-sectional study were collected primarily through structured interviews. The cancer group was a convenience sample of 86 men and women attending an outpatient oncology clinic who were at least 65 years of age and diagnosed with lung, breast, colorectal, prostate, or bladder cancer. After screening out those who were cognitively impaired and/or omitted MHS items, 71 cancer subjects were included in the final analyses. The without cancer group consisted of 88 men and women in the community who were at least 65 years of age, perceived their health status as good or excellent, and had never been diagnosed with cancer.

Using a regression model with the combined groups, physical health (t = 2.89, p $<$.01) was the only MAI domain along with the demographic variables of income (t = 2.80, p $<$.01) and education (t = 2.08, p $<$.05) that were significantly related to MHS scores. Age, gender, and whether the subject had cancer were not significantly related to MHS scores.

Conclusions derived from findings indicate that declining physical health is a threat to hope in elders, not the diagnosis of cancer. Findings related to income and education indicate that lower socioeconomic status may be a threat to hope. Inadequate income also could be the result of costs related to poor physical health, and less formal education may have been a reflection of test-taking skills rather than level of hope. Recommendations for further study include the use of longitudinal designs and intervention studies, consideration of other illnesses common in the elderly, and a concentrated effort to include minorities when studying elders with and without cancer.