Tuesday, 15 September 2015

How important is hope to dying patients?

Kathleen Broadhurst
Ann Harrington
School of Nursing and Midwifery, Flinders University, Australia

Hope has been identified internationally as being crucial to life. Given its subjectivity, hope can be a difficult concept to comprehend although a general definition described a sense of anticipation and longing for a specific event to occur.

Hope was found to be important for patients dealing with adversity. The question arises as to how patients keep hope alive when confronted by a diagnosis of a terminal illness?

A literature review was instigated to investigate the meaning of hope to patients receiving palliative care and to examine the themes that foster hope for dying patients:
  1. Disease status: Good symptom control, hope for a cure, accepting prognosis and hope for a peaceful death all featured.
  2. Positive personal relationships: Love of family and friends and good relationships with professional carers increased hope.
  3. Positive character traits in the individual such as determination and optimism assisted with hope-generation.
  4. Quality of life: living life to the full, everyday living and well-being together with uplifting memories increased hope.
  5. Setting and achieving goals, including retaining independence and symptom control, generated hope and were seen as the converse of hopelessness. 
  6. Spirituality/Religion: faith in God and prayer were a vital resource for maintaining hope.
  7. Hope after death: Leaving a legacy and focusing on a positive future for family and friends enabled hope to be maintained despite life-limiting illness.
The review clearly showed that hope was beneficial to those with a terminal illness and hope was maintained in the face of dying. In some studies hope actually increased in some patients despite approaching death.

Reference

Broadhurst K & Harrington A (2015) A mixed method thematic review: The importance of hope to the dying patient. Journal of Advanced Nursing DOI: 10.1111/jan.12765


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