Hopeful adults with advanced stage cancer : nature, influences, focus, and patterns of hope over time

The diagnosis of terminal cancer begins one of the most complex and challenging individual experiences of human life that requires multiple coping responses, one of those being hope. There are limited knowledge and few studies that provide descriptions of hope over time for adults, ages 20-59, with advanced stage cancer. The purpose of this study was to describe hope as defined and experienced by adults with advanced stage cancer, evidencing high levels of hope. This descriptive, longitudinal research study used the technique of methodological triangulation (semistructured interview, Stoner Hope Scale, Ferrans & Powers Quality of Life Index, Visual Analogue Scales, and participant observation) to define and describe hope in a convenience sample of 12 hopeful adults with advanced stage cancer. Data were collected over time once a month for 3 months. By definition, this population exhibited high levels of hope at study entry. Hope scores did not change over time. Four qualities associated with the nature, influences, focus, and patterns of high levels of hope were identified: reliance on strong spiritual beliefs, maintenance of positive attitudes, accommodation of cancer symptoms, and the presence of supportive resource people. The emphasis or importance of each quality was determined and defined individually. Important in this study's findings is that hope goals are individually defined and are unique to the patient population, influenced by the phase of the illness and the developmental stage of the individual. Hope goals also vary in degree of expectancy and concreteness and require reassessment as conditions change. By identifying an individual's hope goals, nurses can then plan and implement interventions to move toward that hope goal.