The Struggle of the Diagnosed Terminally III Person to Maintain Hope

Abstract

Clinical, empirical, and subjective data are used to explore the concept of hope as it is lived by persons who are diagnosed as terminally ill. Interviews with 11 men who were in stage 2 (asymptomatic) HIV disease explicate the form that hope takes and its role in promoting health when a person must cope with a serious diagnosis. Other research and ideas about hope and dying are presented and a critique is presented of both these ideas and current nursing practice.

A Hope Intervention Compared to Friendly Visitors as a Technique to Reduce Depression among Older Nursing Home Residents

“…In the last three decades, interest in hope has intensified, as shown by a surge in qualitative and quantitative studies—many of which having occurred in healthcare settings. To date, this body of research has linked hope and healing [19], hope and coping [20–22], hope and goal setting [23], hope and finding meaning in suffering and illness [2, 24, 25], and hope as an antidote to hopelessness [26]. Among healthcare professionals, hope has been identified as a fundamental necessity [20], being vital to both life and living [25], and an essential human need—particularly among elderly persons [27].…”

“…To date, this body of research has linked hope and healing [19], hope and coping [20–22], hope and goal setting [23], hope and finding meaning in suffering and illness [2, 24, 25], and hope as an antidote to hopelessness [26]. Among healthcare professionals, hope has been identified as a fundamental necessity [20], being vital to both life and living [25], and an essential human need—particularly among elderly persons [27]. Research has emphasized the relational nature of hope, exploring in particular the centrality of caregivers, family, and friends to fostering hope [28].…”

Rehausser les soins palliatifs à l’aide des facteurs carative de Watson

“…L'importance du maintien de l'espoir a été abordée dans l'étude qualitative de Hall (1989) sur les hommes en phase terminale. Ses résultats montraient que les patients avaient besoin de garder espoir jusqu'à leur dernier soupir.…”

Towards a reconceptualization of hope for patients with a diagnosis of cancer

“…There is further evidence that this particular conception of hope IS consistent with that of practismg oncology nurses Owen (1989) reported that expert oncology nurses perceived hopeful patients as ones who, even though they had not given up hope for a cure, were not fightmg within themselves and had a feeling of acceptance of their prognosis As well, the literature which discusses nursmg interventions that foster hope often suggests that nurses should encourage patients to achieve aims that are attainable, and that they should base such interventions on what is considered to be realistic for that person (Dufault & Martocchio 1985, Herth 1991, Miller 1985 Impbed m much of this hterature is the notion that if the person with a termmal diagnosis professes a 'will to live' or high levels of hope, he/she is somehow not accepting reality (Hall 1990) The important assumption that underlies this notion is that we are m fact able to distinguish 'reahty' and 'realistic hope' from unrealistic hope m the context of dying What is not clear, however, is exactly whose reality we are refemtng to when we make this assumption, the reality of the health professional or the reality of the patient There is good reason to beheve that these 'realities' will be quite different Individuals construct their ovfvi reality or world views on the basis of their own beliefs and life expenences It is quite possible, therefore, that what one person may view as realistic, another may view as unrealistic It IS not surpnsmg, then, to find that there are no clear guidelines m the nursing literature as to whether there is a 'real' distmction between realistic and unrealistic hope, whether a certain level of hope or certain type of hope is detnmental, if hope is benefiaal only if it is realistic and, if this IS the case, just what realistic hope is In fact, Erseck (1992) has identified that, when discussed m the literature, such discrepanaes between the climaan's and patient's views of appropnate goals and expectations have been vanously labelled denial (Freud 1948, Shelp & Perl 1985, unreahshc hopes (McGee 1984), false hopes (Hickey 1986) or illusions (Taylor 1983) …”