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Contingent hope theory: The developmental exploration of hope and identity reconciliation among young adults with advanced cancers

Published online by Cambridge University Press:  30 July 2020

Jennifer Currin-McCulloch Open the ORCID record for Jennifer Currin-McCulloch [Opens in a new window] ,
Casey Walsh ,
Lauren Gulbas ,
Kelly Trevino ,
Elizabeth Pomeroy  and
Barbara Jones
Jennifer Currin-McCulloch*
Affiliation:
School of Social Work, Colorado State University, Fort Collins, CO
Casey Walsh
Affiliation:
Department of Health Services, University of Washington, Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
Lauren Gulbas
Affiliation:
Steve Hicks Schools of Social Work, The University of Texas at Austin, Austin, TX
Kelly Trevino
Affiliation:
Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY
Elizabeth Pomeroy
Affiliation:
Steve Hicks Schools of Social Work, The University of Texas at Austin, Austin, TX
Barbara Jones
Affiliation:
Steve Hicks Schools of Social Work, The University of Texas at Austin, Austin, TX
*
Author for correspondence: Jennifer Currin-McCulloch, Colorado State University, School of Social Work, 1586 Campus Delivery, EDUC 22, Fort Collins, CO 80523, USA. E-mail: [email protected]
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Abstract

Objective

The diagnosis of an advanced cancer in young adulthood can bring one's life to an abrupt halt, calling attention to the present moment and creating anguish about an uncertain future. There is seldom time or physical stamina to focus on forward-thinking, social roles, relationships, or dreams. As a result, young adults (YAs) with advanced cancer frequently encounter existential distress, despair, and question the purpose of their life. We sought to investigate the meaning and function of hope throughout YAs’ disease trajectory; to discern the psychosocial processes YAs employ to engage hope; and to develop a substantive theory of hope of YAs diagnosed with advanced cancer.

Method

Thirteen YAs (ages 23–38) diagnosed with a stage III or IV cancer were recruited throughout the eastern and southeastern United States. Participants completed one semi-structured interview in-person, by phone, or Skype, that incorporated an original timeline instrument assessing fluctuations in hope and an online socio-demographic survey. Glaser's grounded theory methodology informed constant comparative methods of data collection, analysis, and interpretation.

Results

Findings from this study informed the development of the novel contingent hope theoretical framework, which describes the pattern of psychosocial behaviors YAs with advanced cancer employ to reconcile identities and strive for a life of meaning. The ability to cultivate the necessary agency and pathways to reconcile identities became contingent on the YAs’ participation in each of the psychosocial processes of the contingent hope theoretical framework: navigating uncertainty, feeling broken, disorienting grief, finding bearings, and identity reconciliation.

Significance of Results

Study findings portray the influential role of hope in motivating YAs with advanced cancer through disorienting grief toward an integrated sense of self that marries cherished aspects of multiple identities. The contingent hope theoretical framework details psychosocial behaviors to inform assessments and interventions fostering hope and identity reconciliation.

Keywords

Advanced cancerGrounded theoryHopeIdentity reconciliationYoung adult
Type
Original Article
Information
Palliative & Supportive Care , Volume 19 , Issue 4 , August 2021 , pp. 437 - 446
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Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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