Discursive Meaning of Hope for Older Persons with Advanced Cancer and their Caregivers

Abstract

This study used van Dijk's critical-discourse approach to explore the current societal discourse on hope and to explore the hope of older terminally ill cancer patients, their significant others and primary nurse. Forty-three newspaper articles dealing with hope and cancer were collected and analyzed to explore how hope is socially constructed by print media. Individual face-to-face, qualitative, open-ended interviews were conducted with three triads, each consisting of an older palliative cancer patient, a significant other, and a primary nurse. The predominant discourse of hope and cancer in the newspaper articles was considered ageist, conveying the message that only one legitimate hope existed for persons with cancer: hope for a cure. The study findings suggested that this message caused confusion and distress for the patients, significant others, and their primary nurses because their own discourses of hope were focused on comfort, peace, and maintaining relationships at the end of life.

A mixed method thematic review: the importance of hope to the dying patient

“…, Duggleby et al . ). Reynolds' () study revealed a causal link between controlled symptoms and an increase in hope.…”

“…Patients in four studies expressed having a peaceful death as hope‐inspiring, which was viewed as extremely valuable (Eliott & Olver , Duggleby et al . ). For some patients, hoping to live longer was transformed to hope for a peaceful death (Duggleby & Wright ).…”

“…Furthermore, hope for quality of life often replaced hope for a cure (Duggleby et al . ). Quality of life, associated with being active, experiencing emotional well‐being and trying to live as normal a life as possible, was a significant factor in hope levels (Reynolds , Sanatani et al .…”

Should palliative care patients’ hope be truthful, helpful or valuable? An interpretative synthesis of literature describing healthcare professionals’ perspectives on hope of palliative care patients

“…American nurses who worked with advance cancer and COPD patients therefore tried to interpret hope by asking patients about their hopes, 49 and Canadian palliative home care nurses in another study searched for new meanings beyond hope for cure. 30 However, only a few of the Australian healthcare professionals in another study discussed hope as spiritual/existential meaning with their palliative care patients, 27 although the study did not provide a reason for this scarcity. The narrative perspective, in addition, was absent in studies that exclusively focused on physicians.…”

Daily life for chronically ill oldest old persons

“…22 Staudinger et al 23 found that resilience in old age was characterized by flexibility and the ability to adjust to change. Illness might also be associated with themes such as quality of life, 24 hope, 25 optimism, well-being, 26 and inner strength.…”