Understanding the Role of Hope in Cancer Care
by Sharon Chappy, RN, PhD, CNOR
Hope is important for people living with cancer, as it helps them adapt to the diagnosis, provide meaning, maintain well-being, and give direction. Recently, 14 people living with cancer and actively undergoing chemotherapy participated in a study where they told their stories of hope. Their responses were categorized into four themes:
Focusing on the Bigger Picture
Participants consistently reported that they were not solely focused on the immediate problem (their cancer), but on the bigger picture of life. They were not simply accepting their diagnosis, but were adapting to it. Cancer did not control their lives, but they knew it was something they had to live with. Waking up every day meant they were one more day into survival. The cancer was not the center of their universe.
When participants were asked what they hope for, they focused on seeing children get married, seeing grandchildren grow, traveling, not regressing in illness, and doing more things in life. Only a few noted they hoped for a cure. Most hoped to live well with cancer.
Taking Cover in the Storm
Participants reported their desire to shelter themselves from negative thoughts associated with cancer. One compared himself to an ostrich sticking his head in the sand any time he saw or heard something about cancer. Some said that information like cancer statistics or prognosis information decreased their hope, so they actively avoided it. They were not in denial about their illness; they were just protecting themselves from information that decreased hope.
Keeping It Normal
People with cancer who were undergoing chemotherapy wanted to continue living life the same way as before their diagnosis. They wanted to continue familiar routines, work, and activities and be treated the same as they were before the diagnosis. Study participants said they knew they couldn’t change the diagnosis, so they just tried to live their lives as normally as before.
People with cancer wanted to continue living life the same way as before their diagnosis.
Perhaps the most resounding finding was the influence that others, including family, friends, coworkers, and healthcare providers, had on participants’ levels of hope. Participants reported having confidence in treatments and turning toward other people, faith, and prayer to gain strength. Participants knew they were not facing their disease alone. They overwhelmingly noted the oncology center staff were sources of hope. Positive encouragement, compassion, and support were provided there. One woman noted, “I feel like I am in somebody’s arms here … every time I come in here, I feel like somebody is picking me up.”
Healthcare providers can positively influence hope and have the opportunity to contribute to hope through interpersonal connectedness when providing compassionate care. Healthcare providers should:
- assess the level of hope in those living with cancer;
- assess individuals’ information needs regarding their disease, treatment, and prognosis;
- individualize teaching plans to meet the needs of people with cancer while respecting their decisions to shield themselves from negativity;
- provide information in a compassionate, honest, and respectful manner;
- model caring behaviors like listening and smiling when providing care; and
- show confidence in the treatment being provided.
Personal acceptance of the cancer diagnosis and support from others helps people adapt to the challenges of the diagnosis and rigors of chemotherapy. People living with cancer may consciously avoid exposure to negative aspects associated with cancer. They want to maintain their pre-illness lifestyle as much as they are able. Caring and compassionate interactions with others can positively influence hope. People living with cancer should:
- adapt to their diagnosis to form the basis for hope;
- try to live their lives as before;
- be comfortable with healthcare providers;
- actively seek care where they are treated with respect and compassion;
- know it’s all right to shield themselves from information that may cause distress;
- let their healthcare providers know how much, and what types, of information is desired; and
- speak up if they want to “stick their head in the sand.”
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Dr. Sharon Chappy is an associate professor of Nursing at the University of Wisconsin, Oshkosh. Her father battled prostate cancer, and her involvement in his care provided the basis for this study.
This article was published in Coping® with Cancer magazine, July/August 2009.