Hope, older adults, and chronic illness: a metasynthesis of qualitative research

Abstract

Aim. To report a metasynthesis review of qualitative research studies exploring the hope experience of older persons with chronic illness. Background. Hope is a psychosocial resource used by persons to deal with their chronic illness experience. Data sources. A comprehensive search of multiple databases for studies of the hope experience (published 1980-2010) was completed. Inclusion criteria were included qualitative studies of the hope experience of persons (all genders; mean age 60 years and older), with chronic illnesses, and publications in any language and country. Review methods. The metasynthesis followed four procedural steps: (a) comprehensive search, (b) quality appraisal, (c) classification of studies, and (d) synthesis of findings.Results. Twenty studies were included in the metasynthesis representing research from a variety of different countries and populations with differing medical diagnoses. The characteristics of hope included: (a) dynamic or situational nature, (b) multiple co-existing types, (c) objects that were desirable realistic possibilities, (d) futurefocused, and (e) involvement of choice/will. Hope as 'transcending possibilities' represented the integration of two processes of transcendence and positive reappraisal. Reaching inwardly and outwardly and finding meaning and purpose were sub-processes of transcendence, whereas re-evaluating hope in light of illness and finding positive possibilities were sub-processes of positive reappraisal. Conclusions. The concept of hope may differ for older adults vs. younger adults in its interaction with suffering. Resources for hope are both internal and external. Finding meaning and positive reappraisal are important strategies to help older adults with chronic illness maintain their hope.

A Comparison of Single-Session Positive Reappraisal, Cognitive Restructuring and Supportive Counselling for Older Adults with Type 2 Diabetes

“…There is emerging evidence that positive reappraisal is particularly adaptive for older adults coping with chronic physical illness (e.g. Duggleby et al 2012;Hall et al 2010;Windsor 2009). We previously conducted a pilot study to examine whether positive reappraisal coping can be increased in older adults with a distressing chronic physical illness by using a one-session structured intervention and the results indicated increased positive reappraisal use and well-being at 1-week follow-up (Nowlan et al 2015b).…”

The neglected importance of hope in self-management programs – a call for action

“…11 Theories and conceptual models of hope vary considerably. For instance, Snyder's theoretical model of hope 19 is cognitive, draws on motivation theory and emphasizes goal setting while other models emphasize 'finding meaning and purpose' as key hope processes.…”

“…7 Relatedly, there is a large body of literature on self-management as the desired end-state for those completing a chronic disease patient education program 1,2,8 including research which suggests that patient empowerment and 'efficacyenhancing strategies', 9 promoted in many education programs, are key enabling factors for achieving higher levels of patient self-management. 4,10 'Hope' is a psychosocial resource used by people to deal with their chronic illness experience 11 and is suggested to be an important coping strategy during periods of suffering or uncertainty. 12 Some research on the theme of hope exists within the general illness and chronic disease literature as well as in the cancer literature.…”

The experiences of older people who live with a long-term condition

“…The lifestyle adjustments that people with a long-term condition, chronic illness or disability may have to make as they get older, but before retirement age, are documented (Goodwin and Compton 2004, Giddings et al 2007, Yen et al 2011, as are the experiences of older adults who develop chronic conditions (Gallagher et al 2008, Duggleby et al 2012. However, the experiences of people who reach the age of 65 with a pre-existing long-term condition have received less attention.…”