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Chronic Illness: The Concept of Hope

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Introduction

            Various published researches have termed chronic illnesses as the major causes of disability and death in the US. The most common type of such deadly conditions includes type 2 diabetes, obesity, arthritis, stroke, and cancer. Even though they are costly, they are preventable. For patients with the condition, hope has been found to influence their feeling of improvement positively. The more hopeful a patient is, the higher the likelihood of them feeling some improvement in their condition. Factors influencing the feelings of hope include perceptions of family support, income levels and knowledge about the illnesses. The intention of this paper is an exploration of the role of the concept of hope in patients with chronic illnesses. To comprehend the concept well and gain a deeper insight into it, the paper analyzes five articles by various authors touching on hope while incorporating some ideas from an interview with Mr. C, a patient who has Parkinson's disease.

Summary of Literature

            In the first article, “Hope in people with cancer: a multivariate analysis from Turkey,” the authors explore a study conducted to determine hope levels among people with cancer and some of the variables that influence it (Kavradim, Özer & Bozcuk, 2013). The second article, “The Stress-Buffering Effects of Hope on Adjustment to Multiple Sclerosis,” just like the first also looks into the place of hope in a patient’s overall ability to cope with chronic illness (Madan & Pakenham, 2014). Particular focus is on multiple sclerosis. There lacks a proper understanding of the beneficial impacts of hope. The third article, “The trajectory of hope: pathways to find meaning and reconstructing the self after a spinal cord injury” is connected to the first two in terms of content (Parashar, 2015). It explores the importance of hope in recovery efforts following spinal cord injury. The article looks at a study that seeks to determine the relevance of hope in different stages of recovery for spinal cord injury patients.

            The fourth article of consideration is "Renegotiating hope while living with lymphedema after cancer: a qualitative study” that explores the issue of hope in relation to lymphedema (Hamilton & Thomas, 2015). It involves a look into a qualitative study to investigate further the concepts of normalcy, loss, and hope and their effect on cancer patients. The final article that will also links with the rest in its focus on hope is “The creation of hope in patients with lung cancer,” (Salander, Bergknut & Henriksson, 2014). The chronic illness of concern, in this case, is lung cancer. The issues that matter most to lung cancer patients who hope to better their situation are of greatest concern in this case. According to the article, to increase a patient’s feeling of goodness, priority should be on the patient's preferences.

            For a chronic illness patient, the kind of support that they receive from fellow family members helps them in adjusting successfully to their new situation. Such family involvement in the affected person's wellbeing brings the family close. The interview with Mr. C who suffers from Parkinson's disease presents an example of a scenario where the family is involved, a potential learning opportunity for practicing nurses who hope determine how chronic illnesses impact family relationships. The support of the family brings a great sense of hope to the suffering patient. The hope significantly influences his approach to life.  

            The study that Kavradim, Özer, and Bozcuk (2013) investigate in their article makes use of exploratory and descriptive and exploratory design. The study was conducted from December of 2009 to January 2010. It involved 240 patients all receiving chemotherapy treatment and consistently attending Turkey University’s Day Chemotherapy Unit. Data collection was through a Herth Hope Scale and personal information form. The evaluation of the determinants of hope was through multivariate and univariate regression analysis (Kavradim, Özer and Bozcuk, 2013). 

            The mean scores depicted high hope levels among the patients who took part in the research. The study found that factors influencing the hope-score included a patient's perception of family support, feelings of improvement, net income, mouth ulcers, levels of anxiety, and fear. The relation of the factors to the levels of hope was independent of each other.  The conclusion was that financial, psychological, and physical well-being and support need had a direct and independent relation to hope among people with cancer. The outcome calls for a need on the part of the clinicians to increase their efforts in practicing and implementing interventions that either foster or hinder hope.

            In the second article, Madan and Pakenham (2014), the two authors investigate how dispositional hope, its components and its stress-moderating effects impact an individual’s adjustment to MS. In their study, 296 people suffering from MS filled questionnaires. The predictors were hope, pathways, and agency, while the adjustment outcomes were positive states of mind, anxiety, depression, and life satisfaction. The outcome of the regression analysis supported the prediction made that hope had a direct relation to improved outcomes of adjustment.  The findings reinforce the great importance of hope in coping with MS.

            The third study by Parashar (2015) explores an examination of twenty individuals with SCI at certain intervals using semi-structured interviews. It was concluded that following fatal injuries, hope is the force that motivates people. Hope plays a similar role in the lives of people who find that they have to deal with lymphedema or lung cancer.

Concept of Hope in Light of Family Experience

Human beings live anticipating certain things or events to happen in their lives. They may be waiting for a pay rise, promotion at work, birth of a child, education, and good health among others. Such expectations of future outcomes are what constitute hope. It has a bias towards the positive and is the drive behind most human activities. Hope is an essential human strength in all aspects of life. People need it the most when faced with life-altering events that tend to change their normal way of life for the worst. Chronic illnesses are an example of such circumstances that call for promotion of hope among the affected persons. Despite its huge significance, hope is yet to receive the kind of significance that it deserves. 

            Family support increases a client’s hopes and as such bettering their experiences with chronic illnesses. Mr. C’s family provided him with the strength he needed as the condition he was suffering from altered various aspects of his life. Family for him was not merely about his wife and children but also the nurses and other members at the long-term nursing care home. His wife also had a chronic illness as she suffered from long-term irritable bowel syndrome. With time Mr. C was unable to perform certain simple functions such as putting on his shirt. Given his wife’s condition, she was also not in a good position to help him out much. Being unable to handle such would have disillusioned him further complicating his already worse state. However, the care center helped him with such tasks. When such tasks are handled, the patient gains a better feeling about their quality of life and a more positive outlook on things. 

            Mr. C and his wife Mrs. W both seem to acknowledge the role of hope in their wellbeing given the chronic illnesses that afflict them. They chose to move to the care center believing that their stay there will enable them access better care. For them, accessing relevant care means chances of better times with their chronic conditions despite lack of a definite cure. Before the onset of the Parkinson's disease, Mr. C was quite independent in many aspects of his life. The illness incapacitated him making him become dependent on other family members. The other members of the family note the changes and are take up more roles that he would have had to play. The children grow up to become independent while Mr. C becomes dependent. Having people around him that he can rely on to handle normal functions places him in a good position, according to him a reason to look up to the day that follows.

            Nurses at the care center acknowledge the role of hope in Mr. C’s attitude towards life. They work to ensure they keep his hopes alive for a better experience with the condition.  This enables him to have daily access to his wife while allowing his children to visit him once in a while. The study that Kavradim, Özer and Bozcuk (2013), explored in their article “Hope in people with cancer: a multivariate analysis from Turkey,” identified family support as having a direct role in the level of hope that people with chronic illnesses had in their life. The nurses implemented practices that maintained hope in Mr. C.

            A patient's priorities also have a huge stake in their feelings of hope as Salander, Bergknut and Henriksson (2014) note in their study. The nurses at the care center are aware of this fact what makes it possible for him to fulfill some of his plans that include meeting his family, and performing outdoor activities such as camping and traveling. They avoid complete control over his choices giving him the opportunity to enjoy significant autonomy levels. The interview brings out Mr. C as someone who is frightened by the thought of death. He is determined to continue fighting to stay alive. He participates in social activities, reads the Bible with his wife, and even makes time to meet his wife twice a day. Such activities seem like an attempt at a normal life. Even though they are not much in the view of someone leading a normal life, they enable him to have a better feeling about himself. Parashar (2015) notes in his study that such engagements give one a sense of meaning in their life, a reason to feel better about their life.

            The concept of hope enabled me to get a deeper insight into Mr. C. His willingness to take steps aimed at improving his experienced pointed to the faith he had in the potential of a better life for him given his health condition. He refuses to let the disease break him down and make him despise the fact that he was still alive. He found some use in in his life. He still enjoys the company of his wife and other persons at the care center. He challenges my attitude towards life sparking in me the resolve for to keep my hope alive irrespective of the challenges that I may face in my life. Hope ensures that I do not lose sight of my goals in light of life-altering events.

Conclusion

            Clearly, hope is the key to good feelings among persons with chronic illnesses. The five articles on hope in the face of their respective chronic illnesses is a pointer to the role that the concept plays in one's life. The authors opine that without hope, patients suffering from chronic illnesses have a hard time adjusting to the changes occasioned by their condition. Their feelings regarding the future are very negative. Hope helps them take part in activities that increase their chances of survival and, therefore, serve to boost their lifespans. The interview with Mr. C helps reinforce the need for hope among patients with chronic illnesses. He takes steps to improve his Parkinson’s disease condition. His experience and the concept of hope enable me to gain a deeper understanding of its impact and motivate me to keep my hopes alive even in the face of life-threatening conditions. Stakeholders in the healthcare sector need to promote programs that improve patients’ handling of chronic illnesses.

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