Hope in action—facing cardiac death: A qualitative study of patients with life-threatening disease

Abstract

Coping with existential challenges is important when struck by serious disease, but apart from cancer and palliative care little is known about how patients deal with such issues and maintain hope. To explore how patients with life-threatening heart disease experience hope when coping with mortality and other existential challenges, we conducted a qualitative study with semi-structured interviews. We made a purposive sample of 11 participants (26–88 years) who had experienced life-threatening disease: eight participants with serious heart disease, two with cancer, and one with severe chronic obstructive pulmonary disease. Analysis was by systematic text condensation. The findings showed that hope could enhance coping and diminish existential distress when patients were confronted with mortality and other existential challenges. Hope was observed as three types of dynamic work: to shift perception of mortality from overwhelming horror toward suppression or peaceful acceptance, to foster reconciliation instead of uncertainty when adapting to the new phase of life, and to establish go-ahead spirit instead of resignation as their identity. Meaning of life could, hence, be sustained in spite of serious threats to the persons' future, everyday life, and self-conception. The work of hoping could be supported or disturbed by relationships with family, friends, and health care professionals. Hope can be regarded as an active, dynamic state of existential coping among patients with life-threatening disease. Physicians may support this coping and thereby provide personal growth and alleviation of existential distress by skillfully identifying, acknowledging, and participating in the work of hoping performed by the patient.

Patients’ experiences of the transcatheter aortic valve implantation trajectory: A grounded theory study

“…They found that hope could enhance and diminish existential distress and was described in the four themes: Perceiving the realities of death—between overwhelming horror and peaceful acceptance ; Adapting to a new phase in life—between reconciliation and uncertainty ; Identity as seriously ill—between go‐ahead spirit and resignation; and lastly, The impact of relationship—between support and concern . Their study reported that to be cared for by skilled personnel and hear the physicians say that they should together act and make it all turn out well, provided patients with hope (Schaufel et al., ). This is consistent with our findings where it was obvious that hope was created when patients felt respected and they participated in the treatment and when they trusted the doctors.…”

Meanings of People’s Lived Experiences of Surviving an Out-of-Hospital Cardiac Arrest, 1 Month After the Event

“…This attitude was also described by people living with life-threatening diseases, who said that dying from an MI was considered a good way to go, like turning off the switch. 29 A person's narrative automatically includes the present, the past, and the future. When describing the present, the person relates events to what has been and what is about to come.…”

Self-reported Attributes of Police-chiefs Compared to Civil Leadership: Inner drive, Tolerance to stress and Enterprise

“…High levels of enterprise block tendencies for resignation and submissiveness in the face of adversity and instead reflect the desire to continue. Among patients presenting chronic heart disease, an enterprising outlook seems essential to satisfactory prognosis [16].…”