Experience of hope in older people with chronic illness: A meta-synthesis

BACKGROUND

The increase in life expectancy has contributed to an increase in the number of older people, but this population has to learn to live with at least one chronic illness. Thus, hope has become an important resource for the older adult to face the repercussions of chronic illness.

OBJECTIVE

To synthesise qualitative evidence on the experience of hope in older people with chronic illness.

METHODS

This meta-synthesis included qualitative studies which present the experiences of hope in older people diagnosed with at least one chronic illness. The searches were made from six databases, guided by the SPIDER tool. The identified articles were then independently screened by two reviewers. The results were analysed according to the thematic synthesis approach.

RESULTS

Eighteen articles were included, and four analytical themes were constructed. The results allow us to understand that older people live with long-term conditions and hope for an ordinary life. To react to new changes and to maintain hope, they create goals that motivate them in daily life. The treatment is initially seen as a salvation, but the information acquired with the evolution of the illness modifies this perception. In addition, the uncertainty about the success of the treatment creates conflict in their hope. In the support and care of older people in the new context of illness, meaningful relationships strengthen hope most of the time. There is still the hope of being reconciled with death, but there are times when suffering overcomes the hope of living.

CONCLUSIONS

This meta-synthesis highlights that the experience of hope in older people is dynamic and influenced by the context of changes related to illness, treatment, significant relationships and proximity to death.

IMPLICATIONS FOR PRACTICE

A better understanding of the role and characteristics of hope in older people with chronic illness may help to develop more effective interventions to promote and maintain hope.

"What Do We Know about Hope in Nursing Care?": A Synthesis of Concept Analysis Studies

Hope is a central concept within the nursing literature, which is crucial towards the development of nursing knowledge. Nursing teams play a crucial role in exploring the meaning of hope and promoting hope among patients and their families. This study aims to synthesize concept analysis studies of hope in the context of nursing care and to propose an evidence-based update of the definition of hope in the International Classification for Nursing Practice (ICNP®). Method: This is a literature review, involving the synthesis of studies concerning the concept analysis of hope in nursing practice. Peer-reviewed articles with fully accessible Portuguese or English text were considered. As we aimed to include a historical perspective of the concept, no restriction upon the time of publication was set. Articles were selected in March 2022 and updated in July 2023 using the Medline, CINAHL, and Scopus databases. The search terms used were "hope" AND "concept" AND "analysis" AND "nurs*". Only articles written in English or Portuguese were included. Two reviewers conducted the research synthesis and report independently to minimize the risk of bias in the included studies. This paper adheres to the PRISMA checklist. To clarify the concept of hope as perceived by patients and develop hope as an evidence-based nursing concept, 13 studies were reviewed. The concept of hope, its attributes, antecedents, and consequences, as well as similar concepts, were studied by nurses and synthesized into a definition. The identified antecedents include pivotal life events, stressful stimuli, and experiencing satisfaction with life. The analysis of its attributes, antecedents, and consequences has contributed to understanding its relevance in nursing care and provided a proposed update of hope in the ICNP®. This review provides conceptual clarity on how hope is defined and used in nursing practice and the potential factors that may impact the promotion of hope to provide opportunities for future nursing research.

Family members' perspectives of hope when supporting a relative experiencing mental health problems

Current research views hope as a process that plays a positive role in the recovery of individuals with mental health problems. However, little attention has been given to the role of hope in the lives of their families. We aimed to address that gap. We deployed a qualitative descriptive design and carried out individual interviews with nine family members who supported a relative with mental health problems. A cross-comparison of the data generated three major themes: understandings of hope; factors that diminish hope and factors that nurture hope. The participants viewed hope as a positive and productive feeling or attitude that was life-affirming, and empowering. They also associated it with behaviours and dispositions such as attentiveness and empathy and the possibility of a return to a more stable and 'normal' life. The participants experienced hope as initially eroded when their relative was first diagnosed and institutionalized. Hope was further diminished due to the poor communication practices of some mental health professionals and the stress of the caring role itself. On the other hand, hope was nurtured through the support of other family members, friends, neighbours and peers. Acquiring knowledge and understanding about the relative's state of mental health nurtured hope and enabled the participants to have a more meaningful role in their recovery process. Practices of self-care such as independent activities and counselling also strengthened hope and some mental health professionals played a positive role in supporting these. Most striking about the reports of many of the participants was their assertion of their abiding love for their relative. Their account of their ability to see beyond the illness of their relative was an insight that we did not find in other accounts of the experiences of family members. We highlight the need for family members to have timely access to relevant information about their relatives' illness. We conclude that hope is relational at its core because of the interplay of intrapersonal, interpersonal and social factors that diminish or nurture it over time. Specifically, we propose that friends, neighbours and peer support groups as key actors in nurturing the hope of both family members and their relatives.

Factors that promote and threaten Hope in caregivers of children with chronic conditions

to identify the factors that promote and threaten Hope in family caregivers of 2- to 3-year-old children with chronic conditions. qualitative study with 46 family caregivers of children between 2 and 3 years old with a chronic condition, discharged from two Neonatal Intensive Care Units. Data was collected through semi-structured interviews guided by the Model for Intervention in Mutual Help Promoter of Hope. Data were submitted to deductive thematic analysis. the following were identified as factors that promote Hope: The experience shared with members of the social support network; The relationship with the child; Clinical improvement of the child; Spirituality; Positive guidance for the future. The following were identified as factors that threaten Hope: Conflictual relationships and discredit of the child by close people; Uncertainties about the future; Insecurities about the ability to care for the child. the threatening factors of Hope generated suffering, pain, anguish, anxiety, and loneliness in caregivers. The promoting factors of Hope generated comfort, motivation, strength and joy. The findings allow Nurses to recognize the strengths and weaknesses of caregivers and adopt behaviors that promote Hope in caregivers of children with chronic conditions.

Living experiences of people living with HIV-AIDS from the client's perspective in nurse-client interaction in Indonesia: A qualitative study

BACKGROUND

Nurse-client interaction when providing nursing services is limited to optimizing treatment and self-care, with limited focus on the psychological problems of people living with HIV-AIDS. However, psychological problems manifest more often than the health risks of the disease itself. This study aimed to determine the emotional response of people living with HIV-AIDS who received limited attention from nurses from the perspective of nurse-client relationship.

PATIENTS AND METHODS

A phenomenological qualitative design was used through in-depth face-to-face interviews in a semi-structured manner, in an effort to obtain complete data. This research used purposive sampling with Participatory Interpretative Phenomenology analysis, involving 22 participants (14 males and 8 females).

RESULTS

This research produces several themes, with six subcategories: 1) Difficulty of social access, 2) Forcing to accept their situation and suppressing their will, 3) Wanting to be recognized like other people in general, 4) Social stigma and self-stigmatization affecting surroundings, 5) Lacking enthusiasm for life expectancy, 6) Always lingering under the shadow "when death picks up."

CONCLUSION

The results showed that mental stress was experienced more than physical problems by people living with HIV-AIDS, thus prompting new changes to nursing services for HIV-AIDS patients that emphasize psychosocial aspects, in addition to clinical features, facilitated by satisfying relationships between nurses and clients to provide quality services.

Hope-Based Program for Portuguese Outpatients with Advanced Chronic Illness in a Community Setting: A Randomized Control Trial

Background: Hope is widely considered a subjective phenomenon able to bring beneficial consequences to human health and existence. Maintaining hope amid a life-threatening disease and during palliative care is critical. The study aims to examine the effectiveness of a psychosocial supportive Hope Promotion Program (HPP) in enhancing hope, comfort, and quality of life in Portuguese adult outpatients with advanced and progressive chronic illness. Method: Using a parallel Randomized Control Trial (RCT) with pre-post design, 56 cancer outpatients from two day hospitals. Participants were randomly assigned to either a control group (n = 28) or an intervention group (n = 28). The primary outcome measure was hope. Secondary measures included comfort and quality of life. Participants were assessed at baseline, day 15, and day 30 of follow-up. Results: Baseline characteristics were similar between the two groups. In the intervention group, there was a significant increase in the total hope scores after the HPP (day 15). Significant differences were still present after one month (p < 0.05). There was also a significant increase in comfort and quality of life scores in the intervention group one month after HPP (p = 0.018). Conclusions: The HPP may be an effective intervention to increase hope and improve comfort and quality of life among palliative patients. Future studies should increase sample size, diversify settings, and include longer and more detailed follow-ups.

Resilience and related factors in colorectal cancer patients: A systematic review

PURPOSE

To explore resilience and its related factors in adult colorectal cancer patients.

METHODS

Three databases (CINAHL, Scopus and PubMed) were searched for literature published from January 2009 to February 2021 using the terms colorectal and resilience or resilient or resiliency. The review was registered with PROSPERO and followed the PRISMA statement guidelines.

RESULTS

The studies (n = 11) showed that most colorectal cancer patients exhibit moderate levels of resilience. Resilience was identified as a mediator in the positive or negative aspects of illness, while three studies investigated resilience as an outcome variable. Resilience was associated with social support, mental and physical burden, post-traumatic growth, hope, and quality of life. The studies showed that resilience might not be an immutable situation; social support seemed to provide patients the tools necessary for managing their illness, as well as helped them confront future events. The interventions designed to help with self-care issues and coping strategies eased a patient's mental and physical burden, and improved resilience.

CONCLUSIONS

Resilience among colorectal cancer patients was connected to both negative and positive aspects of the illness. Psychosocial and illness-related practical support might be key for strengthening resilience in these patients. However, longitudinal and intervention studies are required to confirm these indications. Research should study resilience as an outcome variable and provide information related to resilience at different phases of cancer, and what type of support is offered by professionals.

Waves of family hope: narratives of families in the context of pediatric chronic illness

OBJECTIVE

to analyze narratives about the experience of hope of families in the context of pediatric chronic illness.

METHOD

a narrative research using Family Systems Nursing as a conceptual framework. Three families of children and adolescents diagnosed with complex chronic illness participated in this study, totaling 10 participants. Data collection was developed using family photo-elicitation interviews. Family narratives were constructed and analyzed according to inductive thematic analysis with theoretical data triangulation.

RESULTS

the analytical theme - Waves of Family Hope in the Context of Pediatric Chronic Illness - is composed of four different types of hope: uncertain hope, caring hope, latent hope, and expectant hope. Movement through these hopes generates a driving energy and depends on a number of factors: support, information, searching for normality, and thoughts and comparisons.

CONCLUSION

the results highlight the interaction and reciprocities of the members of the family unit, and the dynamics of hope, and illustrate the different types of hope and the factors that influence them. This study highlights the experience of hope as a family resource rather than just an individual resource, and supports health professionals in the planning of family care considering hope as an essential and dynamic family resource.

The hopes of nurses who care for people diagnosed with chronic mental illness in closed wards

PURPOSE

To identify factors influencing the hopes of mental health nurses and to explore their experiences with a sense of hope.

DESIGN AND METHODS

A descriptive research survey was conducted with 113 nurses at three closed psychiatric wards in South Korea.

FINDINGS

Nurses' hope, interpersonal skill competence, and professional self-concept were all found to have statistically significant correlations (r = 0.60-0.73, p < 0.01). These factors explained 62% of the variance in nurses' hope. In ten themes influencing hope, 71.1% were positive, 28.9% negative.

PRACTICE IMPLICATIONS

The findings suggest that the promotion of nurses' interpersonal skill competence and professional self-concept is helpful for increasing hope levels. Both positive and negative experiences with hope are important in developing strategies of nursing roles.

The Humanbecoming Concept Inventing Model: Hope

The scholar explores the meaning of the nursing phenomenon of hope as a universal humanuniverse living experience using the humanbecoming concept inventing model. The now-truth of hope surfacing is envisioning possibles amid burdening challenges arising with the communion-aloneness of seeing the familiar in new light. The ingenuous proclamation of hope as a theoretical statement is imaging powering with the connecting-separating of transforming. The conceptualization of hope using the unique humanbecoming concept inventing model contributes to the advancement of nursing knowledge.

Hope-based interventions in chronic disease: an integrative review in the light of Nightingale

ABSTRACT Objective: To identify the available evidence in the scientific literature about the strategies or interventions used to promote hope in people with chronic diseases. Method: An integrative literature review of literature published between 2009-2019, which was conducted in online browsers/databases: b-On, EBSCO, PubMed, Medline, ISI, SciELO, PsycINFO, Google Scholar. Forty-one studies were found, of which eight met the inclusion criteria. Results: Most studies used a quantitative approach. There was a predominance of studies from Asia and America, addressing patients with multiple sclerosis, diabetes, congestive heart failure, and cancer. Hope-based interventions were categorized by the hope attributes: experiential process, spiritual/transcendence process, rational thought process, and relational process. Conclusion: Hope-based interventions, in its essence, are good clinical practices in the physical, psychological, social and spiritual domains. This is congruent with the vision of nursing, first proposed by Florence Nightingale. There seem to be gaps in the literature regarding specific hope promoting interventions.