Hope expectations and recovery from illness - rodzaje nadziei, Kinga

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Rodzaje nadziei

Z artykułu: Hope expectations and recovery from illness: a narrative synthesis of

qualitative research

Rose Wiles, Cheryl Cott & Barbara E. Gibson

Accepted for publication 22 July 2008

There is considerable literature focused on, and seeking to define, the concept of hope in relation to experiences of illness and health care (Morse & Doberneck 1995, Cutliffe 1997, Kylma & Vehvilainen-Julkunen 1997, Penrod &

Morse 1997, Lohne 2001, Cutliffe & Herth 2002, Simpson

2004). Hope has been identified either as generalized or as

particularized.

There is considerable debate in the

theoretical and conceptual literature on hope, which argues

drawing on the work of Marcel (1962), that particularized

hope is not hope at all but a wish or an expectation

(Barnard 1995, Beste 2005).

Hope-as-expectation, thus, might be defined as ‘anticipating

an event or outcome is likely to occur’, whereas hope as a

want or desire might be defined as ‘desiring an event or

outcome to occur’.

There is considerable debate

about the importance of ‘realistic’ hopes and the role of

healthcare professionals in encouraging ‘realistic’ hopes

The notion of ‘realistic’ hope

bears similarities to hope-as-expectation, while ‘unrealistic’

hopes bear similarities to hope-as-want. However, there are

a number of issues that make it problematic to assess the

nature of hope in this way. First, people may have very

different views about what it is or is not ‘realistic’ to hope

for, and may draw on different types of information to do

so (Davison et al. 1991). Second, healthcare professionals

do not necessarily possess expert knowledge about what it

is or is not realistic to expect

Hope also has a temporal dimension in that its intensity

and nature may vary over time and in relation to other life

events (Kylma & Vehvilainen-Julkunen 1997).

Data abstraction

Each paper was reviewed to explore (i) the distinctions

between expectations and wants; (ii) the characterization of

realistic and unrealistic hopes; (iii) the temporal changes in

hope; and (iv) the actions to sustain hope. Data were

extracted using a grid organized according to these topics

to summarize the findings of each study.

The review

The aim of the review was to explore how expectations and

wants are distinguished within empirical research on hope

and illness and the related issues of realistic hope and

temporality.

Want and expectation

None of the reviewed papers distinguish between hope as a

wish, want or desire and hope as an expectation. While some

refer to expectations in relation to hope, these are not defined

conceptually or treated as separate categories.

Realistic and unrealistic hopes

Having hopes when the

probability of their being realized is low is viewed by some

authors as potentially damaging.

Smith and Sparkes (2005) and Ezzy (2000) suggest that ‘unrealistic’ hopes also prevent individuals from finding ways to adapt positively to their situation and reconstruct their identities as people with changed abilities and life goals.

Verhaeghe et al. (2007) found that family members of people with traumatic coma imagined a good outcome, while at the same time being aware that this was unlikely to occur.

Hope – time

The unstable nature of hope narratives and lack of understanding of how and why shifts occur are noted by both

authors.