BACKGROUND As the global population continues to age, the number of women aged 65 + diagnosed with cancer, or caring for a spouse with cancer, continues to increase. The psychological response to cancer among this growing population of patients and informal caregivers has been poorly researched in general, and psycho-oncology literature among older Muslim women research is particularly sparse. This study examines and compares the relationship between depression, hope and perceived support among

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... older Muslim Palestinian and Jewish Israeli women either diagnosed with cancer or informal caregivers of spouses with cancer. METHODS A cross-sectional study of a convenience sample of Muslim Palestinian women (91 patients, 61 spousal caregivers) and Jewish Israelis (127 patients, 214 spousal caregivers) women. Patients were aged ≥ 65, either receiving treatment for active disease or < 6 months from diagnosis. Measurements included depression (Geriatric Depression Scale, 5-item), hope (Snyder's Adult Hope Scale) and perceived social support (Cancer Perceived Agents of Social Support of social support questionnaire). RESULTS Overall levels of depression measured among the Muslim Palestinian women were significantly higher than among Jewish Israelis (p < 0.0001). For the Jewish Israelis, higher levels of depression were found among patients compared to caregivers (interaction effect role X ethnicity p < 0.0001). Overall levels of hope among Muslims were higher compared to Jewish Israelis (p < 0.0001), being similar for both patients and caregivers (non significant role effect p = 0.094). Hope was higher among Jewish caregivers vs. patients (interaction effect role X ethnicity p < 0.021). Despite a higher number of household members, levels of perceived support from spouse, family, as well as friends and faith, were lower among Muslim Palestinian in general, most significantly among caregivers. CONCLUSIONS We observed significant differences in depression, hope and perceived support amaong groups. Our findings highlight the different psychological responses among older women from different cultural landscapes facing similar confrontation with cancer, either as patients or spousal caregivers. Cultural sensitivity is imperative to guide possible interventions aimed at ameliorating the impact of cancer care upon older women.