I have always considered hope as an integral aspect of life. Hope is a concept that appeals to nursing as a discipline and has various definitions in literature discussions and other disciplines such as psychiatry and social sciences. This work uses research papers to clarify the concept of hope as an evidence-based concept in Nursing. Many critical attributes inform the idea of hope, namely goals, spirituality, comfort, interpersonal relationships, caring, control, expectations, and life review. Understanding hope gives me an insight into the individual patient's recovery journey and helps with selecting the most effective support mechanism. This work looks to examine the concept of hope from a healthcare perspective while focusing on hospital nursing as found in the literature.
Definition of the Concepts
Concept Analysis involves the exploration of characteristics or attributes of a concept with the intention of differentiating it between other concepts (Rodgers, Jacelon, Knafl, 2018). Understanding the defining traits, limits, prediction, and outcomes of an idea enable its measurement and manipulation. Many disciplines describe hope differently but mostly focus on its appeal as a motivation to survive the disruptions in life. In health care, hope is of interest due to illnesses' disruptive nature. Herth suggests that understanding hope by nurses would enable them to relate with patient's experience and offer better support (Younus, 2017).
Delegate your assignment to our experts and they will do the rest.
Under the nursing sphere, hope as a concept has various definitions as given by different authors. From a precursor to well-being and health by keeping out worldly stress, adhering to a coping strategy and by enabling self- domination (Niebieszczanski et al., 2016). Evidence from studies carried out under various settings on the concept of hope has yielded quantifiable results. Younus mentions Stoner and Keampfer finding on the relation between hope and life expectancy information. Also finding out how the level of hope impacts to level of coping tendencies in patients with cancer (Younus, 2017).
A review of found out that hope has a future regardless of the diagnosis, escorted with a reason/passion for living. It also involves finding treatment in alternative or professional care system that one feels will lead to survival (Younus, 2017). Niebieszczanski et al., 2016 reviews a grounded theory methodology study to indicate that hope is expecting a personal tomorrow. A study on the level of hopefulness on 50 geriatric patients under hospital confinement was carried out by Mayers and Gardner. The results concluded that the patients sustained optimistic feelings of hope despite the confinement (Niebieszczanski et al., 2016).
The concept of hope sustains our choice of strategies to employ at different stages in illness and health to inspire patients (Younus, 2017). Younus describes hope as an expectation greater than nothing. However, under that definition, we can perceive false-hopes when hope doesn't yield many years of survival when faced with a life-threatening illness. When defining hope as a general or complex state, there no particular definition of objects of hope (Younus, 2017). By this definition, hope is permissible at all stages of life as a hugely positive concept able to effect changes into people's lives (Younus, 2017). Other studies by the same scholar on older people views hope as a power within, which facilitates the transcendence of current situations. It also projects a reality-based expectation of a better tomorrow for self and others.
Defining Critical Attributes of hope
A critical definition of hope as presented by Al-Ghabeesh (2014) provides a scale for hope and the order for interventions to inspire hope. These measures consist of mutuality and affiliation depicting close relations that have characteristics such as feeling, caring, belonging, sharing plus being needed (Al-Ghabeesh, 2014). This work agrees with Niebieszczanski’s selection of four critical attributes of hope. The first being concentration on the future as being opportune. The second attribute is energy being action directed, and involving actively in particular or general dimensions being the third. The last critical quality is future redefinition and the feeling of uncertainty/uneasiness (Niebieszczanski, 2016).
Antecedents of Hope
Antecedents are the events or situations that take place prior to the concept of hope. By determining the antecedents and outcomes, it is possible to explain the context of use of the concept of hope (Younus, 2017). Pain, suffering, and despair originating from chronic diseases are considered to be antecedents of hope. The trajectory associated with illness such as heart failure, cancer or stroke is highly unpredictable (Younus, 2017). Besides, antecedents of hope could be life-changing events such as loss, uncertainty or hardship.
Positive personal characteristics can also be antecedents of hope, together with one's life view that portrays the sense of meaningfulness, optimism, and believe that growth comes out of struggle. Another antecedent of hope is a spiritual connection with a supreme maker. In the process of hoping, people watch for reinforcements of hope in themselves as well as in the environment indicated by supernatural and physical signs (Al-Ghabeesh, 2014). Uncontrollable symptoms, spiritual distress, fatigue or loneliness are considerable threats to hope
Consequences of Hope
The implications of the concept of hope are the events that take place if hope is conceived. The supreme indicator of success in patients suffering from terminal illness is when their goals become achievable (Niebieszczanski et al., 2016). Achieving goals is the ability to cope and experience satisfaction in life despite the limitations. These are consequences of hope in a positive way.
Empirical Referent
Al-Ghabeesh, (2014) define empirical referent as the creation of the categories of the actual phenomenon whose existence indicates the occurrence of hope. The sense of well-being, adherence to medication, ability to manage self in spite of limitations and right positive attitude are hope's empirical referents.
Cases Studies
Three case study categories herein further expound on the concept of hope. This work derives cases from literature from actual examples from works by other authors. The model case demonstrates defining attributes of the idea. The borderline case contains some of the characteristics, while the contrary case offers an incidence that is not the concept.
Model Case
A model case study reported by Niebieszczanski et al. (2016), offers an example with all critical attributes. In this case, a 70-year-old patient diagnosed recently with a heart failure visited a clinic for follow up care. She explained that she could only walk for 5 minutes before going short of breath. In her record, she underwent poor treatment of hypertension for more than a decade. She had also been treating diabetes mellitus and went through a leg amputation less than a year ago caused by a terminal foot ulcer. Her response to how she felt being in that situation was that she felt ‘completely okay.’ Her reason for feeling perfect was the fact that she was not in the hospital bed and being alive. She was also looking forward to attending a family event attended by dear ones the following week (Niebieszczanski et al., 2016).
Borderline Case
In a borderline case by Walker and Avant (2015), a male diagnosed with cardiac arrest quit his medication since it was affecting his sex life. He was worried that he might not enjoy intimate moments as he did previously. This case contains some attributes of hope but not all (Walker & Avant, 2015). The patient in this scenario has no vivid picture of his future after his diagnosis. He sees a continuity to his sex life; however, his failure to adapt to the limitation makes this a borderline case
Contrary Case
A contrary case example considers a 39-year-old visit his physician complaining about chest discomfort. Evaluation of heart attack showed that he had an elevation of cardiac enzymes. This he interpreted as a sign that he will die soon, then refused a cardiac catheterization. The patient notified a nurse that his father died from a heart attack. Apart from that, he also lost two siblings to the same case. As a result, he left his wife and children claiming to void them off suffering when he meets his fate. This is a contrary view to hopefulness as the patient did not see a future beyond the diagnosis (Ghazavi, 2015).
Implications to Nursing Practice
There’s growth to supporters of the suggestion that nurses are instrumental sources of hope to vulnerable people and the ill (Niebieszczanski et al., 2016). Patients and nurses are constantly interacting are the reason behind this support. However, it is unclear how nursing as a discipline supports the concept. I concur that maturity in the concept will be established when all preconditions and results are identifiable (Rodgers, Jacelon, Knafl, 2018). From a nursing perspective, interventions with predictable outcomes are a requirement. Presently, hope activities embedded in nursing practice are difficult to describe. Furthermore, nurses would require skills in this concept to provide hope support as a care process (Rodgers, Jacelon, Knafl, 2018). Nurses would also expect a massive level of self-awareness and personal hope to impact the same to patients. In addition to emotional work and systems to support their work since it is challenging interacting with a person in despair (Younus, 2017)).
Conclusion
Researchers need to feed more information into an emerging concept for its establishment in nursing practice (Rodgers, Jacelon, Knafl, 2018). It is evident that hope focuses on the meaningfulness of future activities and events. Goals are identified using a cognitive process judging from people’s future expectations and feeling about life (Younus, 2017). In health settings, hope is defined within the context of people’s perception of life and what is important to them (Niebieszczanski et al., 2016). Hope experiences between patients and nurses in hospital cultures, interactions and events would help devise an evidence-based concept. In turn, nurses would improve their hope enhancing skills in their daily interactions.
Influence of Hope Concept in Nursing Theory to My Study
As a nursing student, I see the importance of building more knowledge on hope as a concept that can be offered as a support process in hospitals (Rodgers, Jacelon, Knafl, 2018). I expect to interact with many patients; thus I will require emotional intelligence skills to understand hope from their context. By conducting research and studies, my nursing course would be significantly faceted with more empirical knowledge on impacting hope in daily practice. Apart from curriculum knowledge on nursing theory, it would be important to also seek knowledge from other disciplines that focus on the same concept. Such subjects include psychiatry, religious studies, and other social sciences.
References
Al-Ghabeesh, S. H. (2014). Hope in cancer, concept analysis. Journal of Cancer Research 48 (1), 1224-1230
Ghazavi, Z. K. (2015). Effect of hope therapy on the hope of diabetic patients. Iranian journal of nursing, 20 (1), 75–80.
Niebieszczanski, R. J. et al. (2016). ‘Your personality is the intervention’: a grounded theory of mental health nurses’ beliefs about hope and experiences of fostering hope within a secure setting. The Journal of Forensic Psychiatric and Psychology, 27 (3), 419-442. Doi: https://doi.org/10.1080/14789949.2015.1134626
Rodgers, B. L. Jacelon, C. S., Knafl, K. A. (2018). Concept analysis and the advance of nursing knowledge. Journal Nuring Scholarship, 50 (4), 451-459. doi: 10.1111/jnu.12386
Younus, A. (2017). Offering Hope in Healthcare: An important nursing reality. Journal of Pioneering Medical Sciences. Retrieved from http://blogs.jpmsonline.com/2017/02/12/offering-hope-in-healthcare-an-important-nursing-reality/
