"False" hope

Climate-friendly food-choice intentions among emerging adults: extending the theory of planned behavior with objective ambivalence, climate-change worry and optimism

Climate-friendly food choices are still relatively rarely addressed in studies investigating climate engagement, particularly among young people. To address this research gap, we conducted a questionnaire study with senior high school students (N = 474). Our overarching theoretical framework is the Theory of Planned Behavior (TPB), which we extended with emotional factors (climate-change worry and optimism) and attitudinal ambivalence. We found that all factors included, except for optimism, correlated with the food-choice intentions. In multiple regression analyses, worry was the second strongest predictor, after attitudes. Moreover, a measure of objective ambivalence moderated the correlation between attitudes and intentions by weakening it. The results support the validity of using the TPB model when explaining intentions to make climate-friendly food choices among emerging adults. However, our results suggest that it is also important to consider emotions-in this case climate-change worry-and the existence of conflicting evaluations about choosing climate-friendly food.

Motivations and experiences of patients with advanced cancer participating in Phase 1 clinical trials: A qualitative study

BACKGROUND

Persons with advanced cancer may participate in Phase 1 clinical trials - first-in-human trials that are conducted with the main objectives of safety and dosing. The motivations for participation are not well understood and may include hope for cure.

AIM

To explore the perspectives of persons with advanced cancer in order to understand the motivations for participating in Phase 1 clinical trials, experiences while being on trial and views on palliative care provision.

DESIGN

Qualitative study with a constructivist stance, using thematic analysis based upon the grounded theory approach.

SETTING/PARTICIPANTS

20 persons with advanced cancer who were participating in a Phase 1 clinical trial.

RESULTS

Many participants described how Phase 1 clinical trial participation was their last hope, as they were cognisant of their advanced disease. Information-seeking needs differed - some needed comprehensive information while others relied on the doctor's recommendation. Participants experienced varied negative and positive physical and psycho-emotional concerns, and needed to draw on multiple sources of support such as family, friends and healthcare professionals. Some could list potential benefits of palliative care but felt they did not require it yet. The overarching theme was hope and positive thinking as a way of coping.

CONCLUSIONS

The concepts of hope as a way of coping and the supportive presence of healthcare professionals could be weaved into a future model of palliative care to improve the illness journey for patients considering Phase 1 clinical trial participation and other persons with advanced cancer.

Hope and climate-change engagement from a psychological perspective

This article reviews recent research about climate-change hope and engagement. Cognitive climate-change hope is consistently positively related to engagement, while the results are less consistent regarding hope as an emotion. It is argued that when conducting research about hope as an emotion sources of hope need to be considered, since they can be both constructive and less constructive seen from a climate-change engagement perspective. Additionally, collective climate-change action can lead to constructive hope. The conclusion is that in future research there is a need to go beyond the dichotomy between cognition and emotion and in interventions to go beyond optimistic messages and take into account preconditions for constructive hope.

Hope and suicidal ideation and behaviour

Understanding the factors that protect against suicidal ideation and behaviour may strengthen our ability to identify and support those at risk of death by suicide, above and beyond that which is possible by focusing solely on risk factors. A factor that may confer protection against the development of suicidal ideation and behaviour is hope, a future orientated construct that features within recent theories of suicide. Here, we provide an overview of the literature examining the role of hope in moderating and mediating the relationship between suicide risk factors and suicide ideation and behaviour. Evidence suggests that hope may be important in buffering against suicide ideation and behaviour across different population. Limitations and recommendation for future research are also discussed.

Bent, But Not Broken: Locus-of-Hope and Well-Being Among Malaysians Facing Economic Challenges Amidst the COVID-19 Pandemic

Hope is conceptualized as a cognitive set that has often been studied in the context of adversity. No studies, however, directly examine how locus-of-hope (LOH) influences psychological outcomes among vulnerable populations within collectivist cultural contexts. We address this gap by assessing the relationships between LOH and well-being among Malaysians facing financial struggles during the COVID-19 pandemic. We hypothesized that LOH will predict well-being but that external LOH will more strongly predict well-being than internal LOH. One-hundred and fifty-two (152) Malaysians (63 men, 89 women, average age 29.69 years old) who have (1) experienced loss of employment status (2) decrease in salary earnings or (3) earn below the lower 40% threshold of national household incomes completed a series of questionnaires assessing their LOH and well-being. Results indicate that controlling for age, perceptions of government efforts and trait optimism, LOH significantly predict well-being. Findings also show that internal LOH and LOH-family were the strongest predictors of well-being. Theoretical and practical implications are discussed in light of these findings.

Hope and therapeutic privilege: time for shared prognosis communication

Communicating an unfavourable prognosis while maintaining patient hope represents a critical challenge for healthcare professionals (HPs). Duty requires respect for the right to patient autonomy while at the same time not doing harm by causing hopelessness and demoralisation. In some cases, the need for therapeutic privilege is discussed. The primary objectives of this study were to explore HPs' perceptions of hope in the prognosis communication and investigate how they interpret and operationalise key ethical principles. Sixteen qualitative semistructured interviews with HPs from different positions and experience, including doctors and nurses in four different departments (intensive care, oncology, palliative care, rehabilitation), were conducted in the Ticino Cantonal Hospital, Switzerland. The interviews were recorded, transcribed verbatim and analysed using thematic analysis. HPs defined prognosis and patient hope as interdependent concepts related to future perspectives for subjective quality of life. Two main factors allow HPs to maximise the benefits and minimise the harm of their communication: respecting the patient's timing and sharing the patient's wishes. Time is required to reframe needs and expectations. Furthermore, communication needs to be shared by HPs, patients and their relatives to build common awareness and promote a person-centred approach to prognosis. In this process, interprofessional collaboration is key: doctors and nurses are complementary and can together guarantee that patients and relatives receive information in the most appropriate form when they need it. Organisational aspects and the HPs' emotional difficulties, particularly in coping with their own despair, are barriers to effective communication that need further investigation.

The hopeful dimension of locomotion orientation: Implications for psychological well-being

Individuals who have a strong locomotion orientation tend to be future-oriented and motivated to move from the present state toward a future state, making swift and steady progress toward their goals. The current study has assessed the conceptual possibility that such motivation leads locomotors to experience greater hopeful thinking, an active cognitive process that consists in planning the future and implementing these plans. The results of Study 1 lend preliminary support to this possibility. The practical implication was linked to the importance of hope in the subjective well-being experienced in everyday life. For this reason, Study 2 tested a model in which hopeful thinking mediated the subjective well-being experienced by locomotors. The results supported the hypothesis: locomotion orientation was associated with enhanced hope capabilities that, in turn, were associated with higher subjective well-being, with significant positive implications for individuals.

Is There a Problem With False Hope?

This article offers a general discussion of the concept of false hope. Its ultimate aim is to clarify the meaning and the relevance of that concept for medicine and medical research. In the first part (Sections I–V), the concept of hope is discussed. I argue that hope is more than a combination of a desire and a belief about the probability that the desire will be fulfilled. Imagination and anticipation are as well components of hope. I also discuss if hope implies orientation to action. In the second part (Sections VI–VIII), I examine the concept of false hope. I show that hope is false if it cannot be justified epistemically. There is, I argue, an intimate relation between false hope and ignorance. Hope is justified—“realistic”—when the hoping person knows and accepts experts’ judgement about the probability of hope fulfillment. I then argue that what matters for evaluating a person’s hope is not only whether it is realistic, but also whether it is reasonable in the light of the aim and goals that a person strives for in (the remainder of) his life. Part three (Sections IX and X) goes into the question of what is morally wrong about having or causing false hope. In the fourth part (Sections XI and XII), the relevance is shown of the insights from the previous parts for the debate on false hope in medicine and clinical research.

Changes in clients’ well-being (ORS) and state hope (SHS) during inpatient substance abuse treatment

Aims:

During inpatient substance abuse treatment, professionals seek to help clients to achieve improvement in various life domains affected by substance abuse. Progress monitoring during substance abuse treatment has been called for, and in this study we examine how clients’ levels of well-being and hope change during inpatient substance abuse treatment.

Methods:

Clients ( N = 168) entered the treatment facility between January 1, 2017 and August 31, 2018. The prospective data were gathered from one treatment unit located in central Finland on entry into treatment, during and at the end of treatment. Using the Outcome Rating Scale (ORS) as a therapeutic tool was standard procedure in the treatment unit. Demographic information on participants, information on their previous substance use and scores on the State Hope Scale (SHS) were collected through structured questionnaires. Non-parametrical tests (Mann–Whitney U test; Kruskal–Wallis χ2; Spearman’s rho) were used to study changes in indicators of well-being and hope.

Results:

As hypothesised, inpatient treatment had a positive effect on both ORS and SHS and they were interrelated. Differences in gender, living situation and previous admissions were found when studying how the background information of the participants was related to the change achieved in ORS and SHS.

Conclusions:

Inpatient substance abuse treatment seemed to enhance both well-being and hope of the clients of inpatient substance abuse treatment.

The recovery experience of people who were sex trafficked: the thwarted journey towards goal pursuit

BACKGROUND

In 2010, a shelter programme was established in the Netherlands to provide social and health services for trafficked people. This article describes how service users in this programme conceptualized and experienced their own process of recovery.

METHODS

In 2012, 14 people of non-Dutch nationality who had been trafficked for the purpose of sexual exploitation were interviewed at all three shelters of the programme. Data analysis followed a grounded theory approach.

RESULTS

Participants felt a strong need to turn over a new leaf in life, leaving negative experiences of the past behind and moving towards a life with a job, a family and friends. In contrast with their willingness to work towards realizing that future, they experienced a lack of autonomy and a thwarted sense of agency in redressing their present situation. Together with the ostracized nature of their place in Dutch society this left them 'in limbo': a feeling of standing still, while wanting to move forward. This led participants to find it more difficult to deal with problems related to their pasts and futures. They particularly appreciated Dutch language training, vocational skills training and opportunities for volunteer work.

CONCLUSIONS

Participants exhibited a strong desire to fulfil the basic psychological needs of competence, relatedness and autonomy, but were thwarted in pursuing these goals. Seemingly against all odds, while faced with several external regulators that limited their agency to change their situation, participants found ways to pursue these goals, through their enthusiasm for activities that helped them get closer to their envisioned futures (language and skills training and volunteer work). Identifying pathways toward attaining their goals allowed them to hope for a better future. That hope and pursuing their goals helped them to cope with the problems of their past and their worries about the future. Therefore, to facilitate service users' recovery in a post-trafficking setting, there is a need to provide them with opportunities to hope for, pursue and attain their personal goals within the structural boundaries of their situation. A future-orientated, strengths-based approach towards service provision and responsive and supportive environments help to do this.

Hope, coping and psychosocial adjustment after spinal cord injury

INTRODUCTION

The study was a prospective, longitudinal design. The purpose was to explore the role of hope in the coping and psychosocial adjustment process following a spinal cord injury. The study was conducted at Spinal cord injury rehabilitation units in Queensland, Australia and Christchurch, New Zealand.

MATERIALS AND METHODS

This was a longitudinal study conducted in two SCI rehabilitation centres, one in Australia and one in New Zealand. A total of 47 participants with newly acquired traumatic SCI were administered a survey consisting of the Adult Hope Scale; the Moorong Self-Efficacy Scale; the Centre for Epidemiology Studies-Depression Scale (CES-D); Life Satisfaction, Self-Rated Adjustment and Life Problems Subscales of the Life Situation Questionnaire and selected subscales from the Spinal Cord Lesion-related Coping Strategies Questionnaire (SCL-CSQ) and the COPE scales at 6 weeks post injury and 3 months post discharge.

RESULTS

Hope levels and coping strategies remained consistent over time. Hope levels significantly and positively correlated with life satisfaction and self-reported adjustment, and negatively correlated with life problems. Hope levels also positively correlated with positive coping styles, including positive reappraisal, planning, acceptance and fighting spirit. Finally, hope levels negatively correlated with the negative coping strategies behavioural disengagement and social reliance.

DISCUSSION

Hope and coping styles are likely to be determined by personality traits. The findings suggest that hope enhancing interventions should be explored as a means of improving outcomes for people with SCI.

Referral to an Acute Child and Adolescent Inpatient Unit: The Experiences and Views of Community Mental Health Referrers

Admission to an acute mental health inpatient unit is a significant event for a young person. The interface between inpatient and community teams negotiating the admission and later discharge can be fraught. To understand how to improve the transition between inpatient and community care, we interviewed 48 community clinicians about their experiences of engaging with an acute child and adolescent mental health inpatient unit. Through thematic analysis, we identified management of risk was a central issue. Participants wanted more time in hospital, and more communication and collaboration. They expressed appreciation, but some gave intense descriptions of dissatisfaction. The analysis suggests avenues to improve communication and experience, recognizing the (felt) power differential between inpatient and referring community clinicians. Managing the power dynamics requires inpatient clinicians to use active inquiry to bring forward community clinicians' views and be mindful of the risk of community clinicians experiencing communication as criticism.

Communicatively Constructing the Bright and Dark Sides of Hope: Family Caregivers' Experiences during End of Life Cancer Care

(1) Background: The communication of hope is complicated, particularly for family caregivers in the context of cancer who struggle to maintain hope for themselves and their loved ones in the face of terminality. In order to understand these complexities, the current study examines the bright and dark sides of how hope is communicated across the cancer journey from the vantage point of bereaved family caregivers; (2) Methods: We analyzed interviews with bereaved family caregivers using qualitative thematic and case oriented strategies to identify patterns in the positive and negative lived experiences when communicating about hope at the end of life; (3) Results: Two overarching patterns of hope emerged. Those who experienced hope as particularized (focused on cure) cited communication about false hope, performing (faking it), and avoidance. Those who transitioned from particularized to generalized hope (hope for a good death) reported acceptance, the communication of hope as social support, prioritizing family, and balancing hope and honesty; (4) Conclusion: Family caregivers face myriad complexities in managing the bright and dark sides of hope. Interventions should encourage concurrent oncological and palliative care, increased perspective-taking among family members, and encourage the transition from particularized to generalized hope.

Students' Mental Models of Positive Mood and Self-Regulation in Learning

This study explored first-year students' beliefs about the relevance of positive mood to self-regulation. Students were supplied with the definitions of ten constructs relating broadly to aspects of general health (Physical health), positive mood (Psychological well-being, Emotional response, Hope, Explanatory style, Self-Esteem) and self-regulation (Self-regulation, Self-efficacy, Motivation, Intelligence) and asked to indicate whether they believed a causal relationship to exist between pairs of constructs, and in which direction the causal relationship was perceived. An interactive qualitative analysis (IQA) approach was followed to extract a composite mental model of students' beliefs about positive mood and self-regulation. Findings indicate that students perceive positive mood constructs to be causally related to aspects of self-regulation. A mental model was extracted that depicted students' beliefs about positive mood and self-regulation as a complex system consisting of four interlinked feedback systems, namely Input states, Evaluatory mechanisms, Future perspectives and Active participation. Constructs associated with positive mood (Psychological well-being and Explanatory style) were identified as primary driver and primary outcome respectively.

The Negative Side of Positive Psychology

This article explores three ways in which the positive psychology movement’s construction and presentation of itself are negative. First, the negative side is construed as the negative side effects of positive psychology’s dominant, separatist message. Second, the negative side is construed as the negativity that can be found within the positive psychology movement. Here the author elaborates on the negative or dismissive reactions of some spokespersons for the movement to ideas or views that run counter to the movement’s dominant message: (a) negativity about negativity itself, which is explored by way of research in health psychology and coping styles; and (b) negativity about the wrong kind of positivity, namely, allegedly unscientific positivity, especially that which Seligman purports to find within humanistic psychology. This constitutes an epistemological position that contributes to “reality problems” for positive psychologists. The author concludes with the implications of positive psychology’s “Declaration of Independence” for psychology’s much discussed fragmentation woes. She appeals to the wisdom of William James for guidance in finding a third, more positive meaning of positive psychology’s negative side. This third meaning can be gleaned from a not-yet-dominant but more integrative message emerging within the movement, one compatible with the reactions of some humanistic psychologists to positive psychology.

How statewide LGB policies go from ‘‘under our skin’’ to ‘‘into our hearts’’: fatherhood aspirations and psychological well-being among emerging adult sexual minority men

Researchers have noted increasingly the public health importance of addressing discriminatory policies towards lesbian, gay, and bisexual (LGB) populations. At present, however, we know little about the mechanisms through which policies affect LGB populations’ psychological well-being; in other words, how do policies get under our skin? Using data from a study of sexual minority young men (N = 1,487; M = 20.80 (SD = 1.93); 65% White; 92% gay), we examined whether statewide bans (e.g., same-sex marriage, adoption) moderated the relationship between fatherhood aspirations and psychological well-being. Fatherhood aspirations were associated with lower depressive symptoms and higher self-esteem scores among participants living in states without discriminatory policies. In states with marriage equality bans, fatherhood aspirations were associated with higher depressive symptoms and lower self-esteem scores, respectively. Fatherhood aspirations were associated negatively with self-esteem in states banning same-sex and second parent adoptions, respectively. Our findings underscore the importance of recognizing how anti-equality LGB policies may influence the psychosocial development of sexual minority men.

Resilience in work-related stress among female sex workers in Hong Kong

The literature on positive psychology and resilience demonstrates that individuals utilize their personal strengths and environmental resources to facilitate positive adaptation. Using a qualitative approach, we investigated how these frameworks operated as self-protective strategies for female sex workers to maintain their psychological and physical well-being under stressful socioeconomic and work-related conditions. Twenty-three female sex workers in Hong Kong participated in in-depth interviews. We used the grounded theory approach for data analysis. The informants reported negative feelings in response to financial burden, clients' demands, threats to physical health, and stigma. Some female sex workers showed their resilience by being able to rationalize their role, believe their ability to make a change in life, and stay optimistic. They adopted strategies including emotional regulation and acceptance of their responsibility and limits to cope with stressful life events. The results help us understand the role of positive psychology and resilience in this vulnerable population.

Test of mindfulness and hope components in a psychological intervention for women with cancer recurrence

OBJECTIVE

Psychological interventions can attenuate distress and enhance coping for those with an initial diagnosis of cancer, but there are few intervention options for individuals with cancer recurrence. To address this gap, we developed and tested a novel treatment combining Mindfulness, Hope Therapy, and biobehavioral components.

METHOD

An uncontrolled, repeated measures design was used. Women (N = 32) with recurrent breast or gynecologic cancers were provided 20 treatment sessions in individual (n = 12) or group (n = 20) formats. On average, participants were middle aged (M = 58) and Caucasian (81%). Independent variables (i.e., hope and mindfulness) and psychological outcomes (i.e., depression, negative mood, worry, and symptoms of generalized anxiety disorder) were assessed pre-treatment and 2, 4, and 7 months later. Session-by-session therapy process (positive and negative affect, quality-of-life) and mechanism (use of intervention-specific skills) measures were also included.

RESULTS

Distress, anxiety, and negative affect decreased, whereas positive affect and mental-health-related quality-of-life increased over the course of treatment, as demonstrated in mixed-effects models with the intent-to-treat sample. Both hope and mindfulness increased, and use of mindfulness skills was related to decreased anxiety.

CONCLUSIONS

This treatment was feasible to deliver and was acceptable to patients. The trial serves as preliminary evidence for a multi-component intervention tailored to treat difficulties specific to recurrent cancer. The blending of the components was novel as well as theoretically and practically consistent. A gap in the literature is addressed, providing directions for testing interventions designed for patients coping with the continuing stressors and challenges of cancer recurrence.

Emotions and social relationships for breast and gynecologic patients: a qualitative study of coping with recurrence

BACKGROUND

In contrast to the large literature on patients' coping with an initial diagnosis of cancer, there have been few quantitative or qualitative studies of patients coping with recurrence. A qualitative study was undertaken to aid in the development of a tailored intervention for these patients.

METHODS

Individuals (N=35) receiving follow-up care for recurrent breast or gynecologic cancer at a university-affiliated cancer center participated in an individual or a group interview. Transcripts of interviews were analyzed using a coding format with two areas of emphasis. First, we focused on patients' emotions, as there is specificity between emotions and the corresponding ways in which individuals choose to manage them. Secondly, we considered the patients' social environments and relationships, as they too appear key in the adjustment to, and survival from, cancer.

RESULTS

Patients identified notable differences in their responses to an initial diagnosis of cancer and their current ones to recurrence, including the following: (i) depressive symptoms being problematic; (ii) with the passing years and the women's own aging, there is shrinkage in the size of social networks; and (iii) additional losses come from social support erosion, arising from a) intentional distancing by social contacts, b) friends and family not understanding that cancer recurrence is a chronic illness, and/or c) patients stemming their support requests across time.

CONCLUSION

The contribution of these findings to the selection of intervention strategies is discussed.

The role of expectations in children's experience of novel events

The expectations children bring to interactions, as well as the information they receive prior to them, may be important for children's experiences of new adults. In this study, 148 children (8-13 years old) reported on their expectations of adults, received one of three types of information about a new adult (positive, realistic, or control), and then "interacted" with a videotaped "controlling" adult. The effect of information type depended on children's age and prior expectations, with expectancy effects emerging in the context of positive information at the younger end of our age range and in the context of realistic information at the older end of our age range. Furthermore, the more expectations exceeded perceptions (i.e., the more disappointment), the lower children's rapport, affect, and prosocial intentions were and the more internal causal attributions they made. Results are discussed in terms of their theoretical and applied contributions.

“Our best hope is a cure.” Hope in the context of advance care planning

Objective:

Advance care planning (ACP) has the potential to enhance end-of-life care, yet often fails to live up to that potential. This qualitative interpretive study was designed to explore the process and outcomes of ACP using the patient-centered Advance Care Planning Interview (PC-ACP) developed by the Respecting Choices®program in Wisconsin.

Method:

Patients diagnosed with advanced lung cancer and close family members were recruited. Nine family dyads participated in the PC-ACP interview, which was audio-recorded. Follow-up interviews took place 3 and 6 months after the PC-ACP interview and were also recorded. Thematic analysis was conducted on transcribed interviews using constant comparison.

Results:

Analysis showed that hope was a significant theme in the ACP process and this article reports on that theme. Hope for a cure was one of many hopes that supported quality of life for the participant dyads. Three themes were identified: hope is multifaceted, hope for a cure is well considered, and hope is resilient and persistent. The seeming paradox of hoping for a cure of an incurable cancer did not interfere with the process of ACP. The dyads engaged in explicit discussions of end-of-life scenarios and preferences for care. ACP did not interfere with hope and hope for a cure did not interfere with ACP.

Significance of results:

Concerns about false hope are called into question. The principle of honoring hope is not necessarily in conflict with the principle of truthful communication. This is clinically significant, as the findings suggest we need not disrupt hope that we think of as “unrealistic” as long as it supports the family to live well. Further, ACP can be successful even in the context of hoping for a cure.

Staff and patient views of the concept of hope on a stroke unit: a qualitative study

AIM

This study explores the experience of hope for patients and staff in the context of a British stroke unit.

BACKGROUND

Hope is identified as a useful concept for exploring how people find meaning in recovery from illness. Uncovering the experience of hope in acute stroke care has provided evidence that can be used to facilitate rehabilitation.

METHODS

The methodology drew on the principles of ethnography, undertaking unstructured qualitative interviews with ten patients, ten multidisciplinary staff and 21 hours of participant observation including informal discussions with staff and patients. Data collection took place between November 2007 and November 2008.

FINDINGS

Four themes were identified: suffering, struggling with no hope and despair, hope for recovery and realistic hopefulness. Hope was experienced in the context of suffering a stroke demonstrated as loss of function, loss of mental capacity and dependency. Patients struggled to maintain a sense of hopefulness while feeling close to a slippery slope towards despair and death. Hope was expressed as a strong desire to recover, get back to normal and a time to reflect on their lives so far. Staff identified realistic hopefulness as focused on keeping things real while balancing giving hope and avoiding false hope.

CONCLUSION

Hope is placed within the emotional challenges of suffering and struggle inherent in recovery from stroke. The staff work with patients' hopes but offer realistic hopefulness as a practical strategy for recovery. Further interventions are required for working with feelings of despair or no hope.

The process of trying to quit smoking from the perspective of patients with chronic obstructive pulmonary disease

AIM

To investigate why some patients with chronic obstructive pulmonary disease (COPD) have difficulty quitting smoking and to develop a theoretical model that describes their perspectives on these difficulties.

METHODS

Grounded theory method was used from the selection of participants to the analyses of semi-structured interviews with 14 patients with COPD. Four additional interviews were conducted to ensure relevance.

RESULTS

The analysis resulted in a theoretical model that illustrates the process of 'Patients with COPD trying to quit smoking'. The model illuminates factors related to the decision to try to quit smoking, including pressure-filled mental states and constructive or destructive pressure-relief strategies. The constructive strategies lead either to success in quitting or to continuing to try to quit. The destructive strategies can lead to losing hope and becoming resigned to continuing to smoke.

CONCLUSION

The theoretical model 'Patients trying to quit smoking' contributes to a better understanding of the pressure-filled mental states and destructive strategies experienced by some patients with COPD in the process of trying to quit. This better understanding can help nurses individualise counselling. Moreover, patients' own awareness of these states and strategies may facilitate their efforts to quit. The information in the model can also be used as a supplement to methods such as motivational interviewing (MI).

Stress, coping, and hope

Hope is discussed in many literatures and from many perspectives. In this essay hope is discussed from the vantage of psychology and stress and coping theory. Hope and psychological stress share a number of formal properties: both are contextual, meaning-based, and dynamic, and both affect well-being in difficult circumstances. Two assumptions underlie this essay: (1) hope is essential for people who are coping with serious and prolonged psychological stress; and (2) hope is not a perpetually self-renewing resource; it has peaks and valleys and is at times absent altogether. The relationship between hope and coping is dynamic and reciprocal; each in turn supports and is supported by the other. This relationship is illustrated with two adaptive tasks common across situations that threaten physical or psychological well-being-managing uncertainty and coping with a changing reality. The essay describes ways in which coping fosters hope when it is at low ebb as well as ways in which hope fosters and sustains coping over the long term.

Hopefulness predicts resilience after hereditary colorectal cancer genetic testing: a prospective outcome trajectories study

Background -

Genetic testing for hereditary colorectal cancer (HCRC) had significant psychological consequences for test recipients. This prospective longitudinal study investigated the factors that predict psychological resilience in adults undergoing genetic testing for HCRC.

Methods -

A longitudinal study was carried out from April 2003 to August 2006 on Hong Kong Chinese HCRC family members who were recruited and offered genetic testing by the Hereditary Gastrointestinal Cancer Registry to determine psychological outcomes after genetic testing. Self-completed questionnaires were administered immediately before (pre-disclosure baseline) and 2 weeks, 4 months and 1 year after result disclosure. Using validated psychological inventories, the cognitive style of hope was measured at baseline, and the psychological distress of depression and anxiety was measured at all time points.

Results -

Of the 76 participating subjects, 71 individuals (43 men and 28 women; mean age 38.9 ± 9.2 years) from nine FAP and 24 HNPCC families completed the study, including 39 mutated gene carriers. Four patterns of outcome trajectories were created using established norms for the specified outcome measures of depression and anxiety. These included chronic dysfunction (13% and 8.7%), recovery (0% and 4.3%), delayed dysfunction (13% and 15.9%) and resilience (76.8% and 66.7%). Two logistic regression analyses were conducted using hope at baseline to predict resilience, with depression and anxiety employed as outcome indicators. Because of the small number of participants, the chronic dysfunction and delayed dysfunction groups were combined into a non-resilient group for comparison with the resilient group in all subsequent analysis. Because of low frequencies, participants exhibiting a recovery trajectory (n = 3 for anxiety and n = 0 for depression) were excluded from further analysis. Both regression equations were significant. Baseline hope was a significant predictor of a resilience outcome trajectory for depression (B = -0.24, p < 0.01 for depression); and anxiety (B = -0.11, p = 0.05 for anxiety).

Conclusions -

The current findings suggest that hopefulness may predict resilience after HCRC genetic testing in Hong Kong Chinese. Interventions to increase the level of hope may be beneficial to the psychological adjustment of CRC genetic testing recipients.

The impact of simple donor education on donor behavioral deferral and infectious disease rates in São Paulo, Brazil

BACKGROUND

Studies have shown that human immunodeficiency virus (HIV) residual risk is higher in Brazilian than in US and European blood donors, probably due to failure to defer at-risk individuals in Brazil. This study assessed the impact of an educational brochure in enhancing blood donors' knowledge about screening test window phase and reducing at-risk individuals from donating.

STUDY DESIGN AND METHODS

This trial compared an educational intervention with a blood center's usual practice. The brochure was distributed in alternating months to all donors. After donating, sampled participants completed two questions about their HIV window period knowledge. The impact on HIV risk deferral, leaving without donation, confidential unit exclusion (CUE) use, and test positivity was also analyzed.

RESULTS

From August to November 2007 we evaluated 33,940 donations in the main collection center of Fundação Pró-Sangue/Hemocentro de São Paulo in São Paulo, Brazil. A significant (p < 0.001) pamphlet effect was found on correct responses to both questions assessing HIV window phase knowledge (68.1% vs. 52.9%) and transfusion risk (91.1% vs. 87.2%). After adjusting for sex and age, the pamphlet effect was strongest for people with more than 8 years of education. There was no significant pamphlet effect on HIV risk deferral rate, leaving without donation, use of CUE, or infectious disease rates.

CONCLUSION

While the educational pamphlet increased window period knowledge, contrary to expectations this information alone was not enough to make donors self-defer or acknowledge their behavioral risk.

Why health expectations and hopes are different: the development of a conceptual model

BACKGROUND

In the literature, 'hope' has often been thought of as an ideal expectation. However, we believe the classification of hope as a type of expectation is problematic. Although both hopes and expectations are future-oriented cognitions, expectations are distinct in that they are an individual's probability-driven assessment of the most likely outcomes, while hopes are an assessment of the most desirable - but not necessarily the most probable - outcomes.

AIM

This paper presents a conceptual model of the factors that may serve as common antecedents of hopes and expectations, and a mechanism that may mediate their differentiation.

METHOD

Ovid Healthstar and PsycINFO database searches from January 1967 to October 2008 were conducted. An integrative literature review, synthesis and conceptual model development were carried out. Outcome Our model envisages the differentiation of hope from expectation as a dynamic, longitudinal process consisting of three phases: appraisal of possible outcomes, cognitive analysis for achieving hopes and goal pursuit. Key variables such as temporal proximity, controllability, external resources, goals, affect, agency and pathways may moderate the extent of divergence by influencing the perceived probability of achieving desired outcomes.

CONCLUSION

Hopes and expectations are distinct, but linked, constructs. This preliminary conceptual model presents how hopes and expectations develop, become differentiated and how social-cognitive factors may moderate this relationship. A better understanding of hopes and expectations may assist health professionals in communicating illness-related expectations while maintaining the integrity of patient hopes.

Communication Strategies and Cultural Issues in the Delivery of Bad News

Good communication is a fundamental skill for all palliative care clinicians. Patients present with varied desires, beliefs, and cultural practices, and navigating these issues presents clinicians with unique challenges. This article provides an overview of the evidence for communication strategies in delivering bad news and discussing advance care planning. In addition, it reviews the literature regarding cultural aspects of care for terminally ill patients and their families and offers strategies for engaging them. Through good communication practices, clinicians can help to avoid conflict and understand patients' desires for end of life care.

Hope in Cognitive Psychotherapies: On Working With Client Strengths

The field of psychology, which is traditionally rooted in the study and treatment of psychological disorders and pathology, recently has begun to embrace an examination of individual, as well as societal, strengths and virtues. This subspecialty within psychology, known as positive psychology, can be defined as the attempt to understand the characteristics and processes that contribute to optimal functioning, flourishing, and resiliency. The purpose of the present article is to draw a link between traditional psychology and positive psychology using the example of the positive psychological construct of hope. Specifically, we explore the ways in which hope theory can be incorporated into traditional forms of cognitive therapy for symptom reduction and elimination. First, the theory of hope (Snyder, 1994) is introduced and the concept of hopeful thought is defined. Next, we explore the distinction between Snyder’s definition of hope and Beck’s definition of hopelessness (Beck, Weissman, Lester, & Trexler, 1974). Finally, we present possible strategies for utilizing hope concepts in cognitive therapies. Studying individuals with high levels of hope has resulted in a wealth of information about the ways these individuals overcome obstacles and find multiple ways to the goals that they have set for themselves. Integrating these lessons into empirically based treatments for symptom reduction is likely to result in a synergy that utilizes the most sound aspects of both traditional psychology and positive psychology.

Links Between Cognitive-Behavioral Hope-Building and Positive Psychology: Applications to a Psychotic Patient

Several currently popular theories have emphasized the important role of hope in well-being. This article has outlined one framework for achieving hope via the normalizing and humanizing of patients, and the use of techniques such as priming or accessibility manipulation, reattribution, and other techniques derived from or inspired by current social-cognitive theories. As such they illustrate the possibilities for enriching the repertoire of cognitive therapists that can be offered by merging concepts from positive psychology and social psychology into a more ‘’hopeful’’ cognitive-behavior therapy. This social-cognitive approach is in line with the flexible and integrative underpinnings of cognitive therapy (Alford & Beck, 1996).

Hope Against the Cold: Individual Differences in Trait Hope and Acute Pain Tolerance on the Cold Pressor Task

Hope theory (see Snyder, 1994) is presented as a useful framework for understanding reactions to pain. In Study 1, persons scoring higher on the trait Hope Scale (Snyder, Harris et al., 1991) kept their hands in the freezing water (of a cold pressor task) for significantly longer. In Study 2, the higher-hope males, and not females, as measured by both trait and state hope (Snyder, Sympson et al., 1996), recognized the onset of the pain threshold significantly later. Moreover, in Study 2, results showed that individual differences measures of optimism, self-efficacy, depression, and positive and negative affects did not relate to the pain onset and tolerance variables. The implications of hope as related to the pain process and related research are discussed.

Predictors of Hope Among Members of Mental Health Self-Help Agencies

Hope is a key construct for successful community adjustment among those with severe mental illnesses, particularly given the strengths-based recovery model increasingly prevalent in mental health services and in social work. Consumer-run mental health self-help agencies (SHAs) are well suited to fostering hope via their supportive program environments. This study examines factors associated with hope among members of four self-help agencies via a two-stage least squares regression model (N = 310). Findings provide evidence of both individual and program-level associations with hope. These findings mirror social work ethical values of focusing on consumer strengths and self-determination, which are primary goals of SHAs.