Hope

Hope can be defined as the multidimensional, dynamic, and future-oriented expectation of achieving a positive outcome that has experiential, spiritual, rational and relational attributes that energize and provide a sense of freedom and resiliency (Felder, 2004). Cancer patients have identified hope as one of the most essential elements in their lives (Chapman & Pepler, 1998; Ballard, et al., 1997; Herth, 1990); hope and healthy spirituality are closely linked (Post-White, et al., 1996).

Facilitating Hope

Oncology nurses are in a unique position to inspire or nurture hope in our patients. We can accomplish this by incorporating presence, touch, active listening, humor or a sense of lightheartedness, and spirituality into our practices (Poncar, 1994; Herth, 1990). We can further nurture hope by helping our patients establish meaningful support systems, affirming their worth as individuals, and helping them recall positive memories (Herth, 1990).

Particularly with a patient in Diane's situation, we have a responsibility to promote hope that is realistic. We can accomplish this by assisting our patients in practicing reality surveillance, cognitive restructuring or reframing, values clarification, and setting realistic goals (Poncar, 1994; Herth, 1990; Miller, 1984). Ersek (2001) developed am assessment tool that may be helpful in assessing unrealistic hope.

Barriers to Hope

In addition to inspiring hope among our patients, we can avoid hope-hindering practices which patients have identified as poor symptom management, the sense of isolation or abandonment, and the devaluation of personhood. Providing information in an honest, respectful, compassionate manner can increase levels of hope. Conversely, providing information in a disrespectful or cold manner, trivializing the situation, or giving discouraging medical facts without offering something to hold on to decrease levels of hope (Koopmeiners, et al., 1997; Herth, 1990). We can always allow patients, such as Diane, to believe that they may be the exception to survival statistics.

Case Study

We can offer Diane the realistic hope that while cure for her disease may no longer by possible, she has treatment options and care for her is available throughout her disease trajectory. This caring is the unique responsibility of nursing.

Resources

Ballard A., Green, T., Logsdon, C. (1997). A comparison of the levels of hope in patients with newly diagnosed and recurrent cancer. Oncology Nursing Forum, 24(5): 899-904

Chapman, K. & Pepler, C. (1998). Coping, hope, and anticipatory grief in family members in palliative care. Cancer Nursing, 21(4) 226-234.

Ersek, M. (2001). The meaning of hope in the dying,. In B. Ferrell & N. Coyle (Eds.) Oxford Textbook of Palliative Nursing (pp. 339-351). New York : Oxford U University Press.

Felder, B. (2004). Hope and coping in patients with cancer diagnoses. Cancer Nursing , 2 27(4), 320-324.

Herth, K. (1990). Fostering hope in terminally-ill people. Journal of Advanced Nursing, 15, 1250-1259.

Koopmeiners, L., Post-White, J., Gutjnecht, S., Geransky, C., Nickelson, L., Drew, D., Mackay, K., & Kreitzer, M. (1997). How healthcare professionals contribute to hope in patients with cancer. Oncology Nursing Forum, 24, 1507-1513.

Mackey, K., & Kreitzer, M. (1997). How healthcare professionals contribute to h hope in patients with cancer. Oncology Nursing Forum, 24 (9), 1507-1513.

Miller, J. (1985). Inspiring hope. American Journal of Nursing. 85, 22-25.

Poncar, P. (1994). Inspiring hope in the oncology patient. Journal of Psychosocial N Nursing, 32 (1), 33-38.

Post-White, J., Ceronsky, V., Kreitzer, M., Nickelson, K., Drew, D., Mackey, K., K Koopmeiners, L., & Gutknecht, S. (1996). Hope, spirituality, sense of coherence, and quality of life in patients with cancer. Oncology Nursing Forum, 23(10), 1571-1579.

Music :

Debussy, Claude. Syrinx.

Felder, B. (2005)