Exploring the therapeutic value of hope in palliative nursing (original) (raw)
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Journal of Medical Imaging and Radiation Sciences, 2012
Palliative care and hope have both been known to improve the quality of life (QoL) of palliative cancer patients. Hope is a complex, multidimensional concept that is influenced by a variety of factors and is considered to be an effective coping strategy when dealing with serious illness. Review of the literature identifies an abundance of hopefostering strategies that healthcare professionals (HCPs) can use to assist patients to improve their QoL. Ethical issues can arise during HCPs' struggles to remain truthful while attempting to maintain patients' hopes. Increased communication regarding realistic treatment outcomes between the multidisciplinary team and the patient and family is essential for maintaining a patient's hope during the terminal stage of disease. Effective communication with patients demonstrates respect for autonomy and allows for informed decisionmaking regarding end-of-life interests. This results in the achievement of final end-of-life goals and will increase QoL, which is considered to be the goal of palliative care. R ESUM E Il est connu que les soins palliatifs et l'espoir permettent d'am eliorer la qualit e de vie des patients canc ereux aux soins palliatifs. L'espoir est une notion complexe et multidimensionnelle influenc ee par une vari et e de facteurs. On consid ere qu'il s'agit d'une strat egie efficace de r eponse du sujet a une maladie grave. L'analyse bibliographique r ev ele qu'il existe un grand nombre de strat egies favorisant l'espoir que les professionnels de la sant e peuvent utiliser pour aider les patients a am eliorer leur qualit e de vie. Des questions ethiques font surface lorsque les professionnels de la sant e s'efforcent de respecter la v erit e tout en maintenant l'espoir chez leurs patients. Une meilleure communication concernant les r esultats r ealistes des traitements entre l' equipe multidisciplinaire et le patient et sa famille est essentielle pour maintenir l'espoir chez le patient durant la phase terminale de la maladie. Une bonne communication avec le patient est une expression de respect de l'autonomie et permet une prise de d ecision eclair ee concernant les int erêts de fin de vie, permettant la r ealisation des derniers objectifs et une am elioration de la qualit e de vie, ce qui constitue la finalit e des soins palliatifs.
A Hope-enhancement Instrument for Palliative Care Cancer Patients
Cureus, 2019
Millions of new cancer cases are diagnosed each year. Patients often become hopeless during the disease. This study aimed to develop a short-intervention instrument targeted to raise hope in cancer patients. Methods Using a panel of experts, an instrument was developed, which consisted of 11 counseling items. The instrument was applied to a sample of 153 palliative care cancer patients randomized into three groups (G1: instrument applied by Rater 1, G2: control, and G3: instrument applied by Rater 2). Application of the instrument required 20-30 minutes. Using the Herth Hope Index (HHI) scores as the main outcome, changes over time (baseline, 1-hour, and one-week) were evaluated. Results The mean baseline HHI scores were 41.38±4.46. The HHI scores were statistically similar at the baseline (p>0.05) but significantly different at one hour and one week in favor of the G1 and G3 groups (p<0.001). In G1, the HHI significantly increased from baseline to one-hour measurements (t=-12.413, p<0.001) and remained unchanged at one week (t=1.088, p=0.282). Similarly, there was a significant increase in the HHI scores from baseline to one-hour measurements in G3 (t=-9.144, p<0.001), which remained unchanged between one hour and one week (t=-0.099, p=0.921). Conclusion This study demonstrated the effectiveness of a structured, short counseling intervention in increasing hope among palliative care cancer patients.
Hope in advanced cancer patients
European Journal of Cancer, 2008
Individuals diagnosed with advanced cancer frequently experience physical and psychological distress. Hope has been identified as an essential resource in the lives of people with cancer, helping them to cope during times of suffering and uncertainty. Therefore, in order to help bolster hope, health care providers require an understanding of its meaning from the perspective of advanced cancer patients and an awareness of those interventions demonstrated empirically to foster hope in this patient population. This paper summarises salient evidence pertaining to hope in advanced cancer patients and their families or informal caregivers. We examine the challenging issue of how to define hope, discuss the issue of measuring hope and review the state of evidence addressing interventions that may enhance or bolster hope in the face of advanced disease.
Fostering hope in terminally‐ill people
Journal of Advanced Nursing, 1990
This study explored the meaning of hope and identified strategies that are used to foster hope in a convenience sample of 30 terminally‐ill adults using the technique of methodological triangulation (interview, Herth Hope Index and Background Data Form) Cross‐sectional data were collected on 20 of the subjects, and longitudinal data were collected on 10 of the subjects in order to provide a clearer understanding of the hoping process during the dying trajectory Hope was defined as an inner power directed toward enrichment of ‘being’ With the exception of those diagnosed with AIDS, overall hope levels among subjects were high and were found to remain stable over time and across the background variables Seven hope‐fostering categories and three hope‐hindering categories were identified based on the interview responses The findings could serve as a guide for the development of interventions to foster hope in terminally‐ill people
Is there hope in palliative care
Is there hope in palliative care? Dave McKay MBChB FRNZCGP Patients receiving bad news that they have a serious life threatening illness will ask ‘What hope is there for me?’ Many feelings surge through the per- son, their family, friends and their medical carers. One response to the illness is a search between hope and hopelessness. An understanding evolves and changes at times and over time during the course of the illness. Change is the critical process. Hope is no longer a single or concrete phe- nomenon when one is dying; this is a fundamental in understanding for the patient, their family and the doctor. This paper explores hope within the context of terminal illness and palliative care, defining its essential influences and effects. Hope does not only apply to the patient but applies to all of those involved, each of whom is searching for their own meanings. Hope is discussed from its origins to effects on the patient, family and their doctor. It appears there are stages of hope similar to the stages of dying. A dynamic understanding of hope can be used to beneficial effect when faced with despair caused by a diagnosis of terminal disease.
An interpretive phenomenological analysis of hope in cancer patients: A qualitative study
2021
Background In positive psychology, increased recognition of the phenomenon of hope among people suffering from cancer, along with alleviating their negative mental states like anxiety, depression, and fear of death is evident and promising. The aim of the study was to explore the lived experience of hope in cancer patients. Materials Qualitative phenomenological research approach was used. A semi-structured in-depth interview with open-ended questions was administered to explore the patient's hope related experiences during the journey of cancer. A purposive sampling technique was used to select a total of 10 participants for the study. The size of the sample was decided on the basis of literature for the interpretive phenomenological study. Results Results revealed five major common themes related to hope during illness: (1) survival expectation; (2) will to live; (3) prognostic clarification; (4) positivity of health providers; and (5) recovery of other patients: A source of h...
Fostering hope through palliative rehabilitation
2013
Ho l i st i c c a re www.ejp c. e u. c o m C ancer patients' need for rehabilitation is growing, as more and more people live with the long-term consequences of disease and its treatment due to early detection and improved treatment regimens. 1 There are a number of people living with incurable cancer who have symptoms that need to be managed for many years, paralleling long-term conditions. 2 Beyond clinical management, a sense of hope is vital in enhancing their quality of life, as it plays an integral role in their psychosocial well-being. 3 This paper describes how a small group of patients in a hospice day care centre regained hope through a two-month palliative rehabilitation programme, which included: 4 G Evaluation/assessment of their symptoms and referral to the appropriate members of the palliative care team G Physical care; for example, therapeutic interventions to reduce lymphoedema and non-pharmacological management of dyspnoea G Coordinated multidisciplinary care G Psychological care G Supportive care G Spiritual care G Aromatherapy G Group work, incorporating social care G Exercise G Relaxation G Diversional therapy All these various aspects of care are considered to be important components of palliative rehabilitation. 4
The Lived Experience of Hope in Family Caregivers Caring for a Terminally Ill Loved One
Journal of Hospice & Palliative Nursing, 2012
Caring for a terminally ill loved one has been described as work that is exhausting and difficult. One factor that influences well-being for caregivers is hope. The purpose of this phenomenological study was to explore the question: What is the meaning of hope for the family caregiver in the context of end-of-life care and what nursing actions influence hope? Data collection through open-ended dialogic engagement occurred at two time points to capture the essence of the experience for family caregivers throughout the end-of-life experience. Participants (n = 6) were recruited within a rural, Midwestern hospice program in the United States. The lived experience of hope for family caregivers in this population emerged as four interconnecting themes: engaging, strengthening, and maintaining connections; easing of self; finding meaning in the situation; and acceptance. Hope for family caregivers assists navigation through the caregiving experience, finding positive meaning within the situation, and moving toward an acceptance of the situation and healing. Hope is supported through nursing actions of relational and informational support. Nurses and other healthcare professionals are in a prime position to offer support through a variety of interventions and actions, which are aimed at positively influencing hope in this population.