Associations of Family Cohesion, Coping Style, and Meaning in Life with Hope in Patients with Hematologic Malignancies: An Exploratory Cross-Sectional Study

Background: Hope is an important psychological resource in patients with hematologic malignancies, but how family functioning is associated with hope remains unclear. Methods: We retrospectively analyzed routine psychometric data from 226 hospitalized adults with hematologic malignancies assessed between June 2022 and December 2025 (39 patients [17.3%] had ≤10% missing items, imputed using individual scale means). Measures included the Herth Hope Index, Meaning in Life Questionnaire, Medical Coping Modes Questionnaire, and Family Adaptability and Cohesion Evaluation Scale. Correlation, multivariable linear regression, exploratory logistic regression, and an exploratory bootstrap decomposition of parallel indirect associations were performed. Results: Mean hope was slightly below an oncology reference value (difference −1.22 points; p < 0.001), a difference in uncertain clinical relevance; family cohesion and facing coping scores were below normative values, whereas resignation and avoidance were higher (all p < 0.001). Hope correlated positively with presence of meaning (r = 0.595), facing (r = 0.510), and family cohesion (r = 0.444), and negatively with resignation (r = −0.611). In multivariable linear regression, presence of meaning, search for meaning, facing, resignation, family cohesion, family adaptability, education, and ECOG performance status were associated with hope (R2 = 0.653). Family cohesion showed a total association with hope of 0.209; the combined indirect association through facing, resignation, and presence of meaning was 0.111 (53.04% of the total association in the statistical decomposition). Conclusions: Family cohesion, coping style, and meaning in life are closely associated with hope in hematologic malignancies. Because of the cross-sectional design, these findings cannot establish causal direction; they support routine assessment of family functioning and the testing of family-based interventions in future prospective studies.