Hope pictured in drawings by patients newly diagnosed with advanced cancer.

BACKGROUND: Hope is an integral part of a dying person's needs and an important phenomenon that has not been satisfactorily explored. The tension between hope for a cure and the reality of being terminally ill is a paradox, which in the context of palliative cancer care, nurses and health care professionals must take into consideration. OBJECTIVE: The purpose of this study was to elucidate the phenomenon of hope and to investigate the lived experiences of hope among newly diagnosed patients with advanced cancer. METHOD: The study used a phenomenological-visual method where drawings and post-drawing interviews were used. The participants were six patients who recently had been offered specialised palliative care treatment. They were five women and one man with different cancer diagnoses and between 30 and 82 years of age (median 65 years). The data consisted of six drawings and individual post-drawing interviews with the participants. The study was reported using the COREQ checklist. RESULTS: The study revealed one main concern 'Being in hope' and hope appeared in four different dimensions; internal, external, relational and transcendental. Hopelessness was present at all times. CONCLUSION: Hope pictured in drawings was expressed through colour, shape, lines, symbols and metaphors, and hope incorporated internal, external, relational and transcendental aspects. Hope was constantly fighting against hopelessness and hope integrated with past, present and future. RELEVANCE TO CLINICAL PRACTICE: Drawings, as well as other visual representations, are suitable tools when trying to understand an ineffable phenomenon such as hope experienced by people newly diagnosed with cancer.

Hope pictured in drawings by women newly diagnosed with gynecologic cancer.

BACKGROUND: In mysterious ways, hope makes life meaningful even in chaotic and uncontrolled situations. When a woman is newly diagnosed with gynecologic cancer, hope is ineffable and needs exploring. Drawings help express ineffable phenomena. OBJECTIVE: The aim of the study was to explore how women newly diagnosed with gynecologic cancer express the meaning of hope in drawings. METHOD: Participants were 15 women who on the same day had received the diagnosis of gynecologic cancer. They were between 24 and 87 years (median, 52 years) with a variety of gynecologic cancer diagnoses. Data from 15 drawings and postdrawing interviews with the women were analyzed using visual and hermeneutic phenomenology. RESULTS: Three themes emerged: hope as a spirit to move on, hope as energy through nature, and hope as a communion with families. CONCLUSION: Hope as pictured in drawings often appears through metaphors and incorporates internal, external, and relational aspects. With other words, inner willpower, experiences in open nature, and closeness to loved ones contribute to hope when newly diagnosed with gynecologic cancer. IMPLICATION FOR PRACTICE: The use of drawings in clinical situations might give cancer nurses new perceptions of hope and other phenomena. Patients might feel threat and despair when diagnosed with cancer; they need gentle truth about reality, and they long for being together with loved ones. Nurses are in a unique position to enable hope in this situation through listening and active engagement. Drawing might be a tool in understanding the hope. Drawings picture where words come short.

The meaning of hope in nursing research: a meta-synthesis.

The aim of this study was to develop a meta-synthesis of nursing research about hope as perceived by people during sickness and by healthy people. A meta-synthesis does not intend to cover all studies about hope; rather it tries to synthesize qualitative findings from different contexts, cultures and times to provide a global picture of the phenomenon under study. Noblit and Hare's meta-ethnographic approach was used. The approach is a systematic comparison of studies where each study is translated into the other. Data were 15 qualitative studies published in nursing or allied health journals and conducted in USA, Great Britain, Canada, Australia, Norway, Sweden and Finland. The meta-synthesis resulted in six metaphors that illustrate dimensions of hope. These metaphors permeated the experiences of hope regardless of whether the human being was healthy, chronically or terminally ill. They comprise the complexity of hope and were: living in hope, hoping for something, hope as a light on the horizon, hope as a human-to-human relationship, hope vs. hopelessness and fear: two sides of the same coin, and hope as weathering a storm. Knowing the multidimensionality of hope and what hope means from the patient's perspective might help nurses and other healthcare professionals to inspire hope as Florence Nightingale did when she walked with the lamp through the dark corridors and spread hope and light to the patients. We suggest that nurses working with patients with serious conditions such as cancer reflect on the meaning of the metaphors.

Hope as experienced in women newly diagnosed with gynaecological cancer.

AIM: This article presents findings from a hermeneutic-phenomenological study with the aim to investigate the meaning of the lived experience of hope in women newly diagnosed with gynaecological cancer. METHOD: Fifteen women were interviewed the day they were receiving the diagnosis at a gynaecological department of a Danish university hospital. The women, aged 24-87 (median 52 yrs), were diagnosed with ovarian, endometrial, cervical and vulvar cancer. RESULTS: Hope was found to be connected to both diagnosis, cure, family life and life itself and closely tied to hopelessness. The newly received cancer diagnosis made the women oscillate between hope and hopelessness, between positive expectations of getting cured and frightening feelings of the disease taking over. Five major interrelated themes of hope were identified: hope of being cured, cared for and getting back to normal, hope as being active and feeling well, hope as an internal power to maintain integration, hope as significant relationships and hope as fighting against hopelessness. Thus, hope was woven together with hopelessness in a mysterious way; it took command through inner strength and courage based on a trust in being cured and of being in relationship with significant others. CONCLUSION: The findings of the close relationship between the shades of hope and hopelessness support the need for nurses to continue to practice hope-inspiring nursing. Nurses need to understand the complexity of hope and its close connection to hopelessness when newly diagnosed with a threatening disease as cancer; and the findings might help nurses assist patients in fighting hopelessness.