Hostname: page-component-78c5997874-m6dg7 Total loading time: 0 Render date: 2024-11-05T11:10:09.320Z Has data issue: false hasContentIssue false
  • English
  • Français

Harmonizing hope: A grounded theory study of the experience of hope of registered nurses who provide palliative care in community settings

Published online by Cambridge University Press:  15 August 2011

Kelly Penz  and
Wendy Duggleby
Kelly Penz*
Affiliation:
College of Nursing, Southern Saskatchewan Campus, University of Saskatchewan, Saskatchewan, Canada
Wendy Duggleby
Affiliation:
Aging and Quality of Life, Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
*
Address correspondence and reprint requests to: Kelly Penz, College of Nursing, University of Saskatchewan, Southern Saskatchewan Campus, 4500 Wascana Parkway Regina, SK S4P 3A3, Saskatchewan, Canada. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

The purpose of this study was to explore the hope experience of registered nurses (RNs) who provide palliative care services in community settings. The specific aims of the study were to (1) describe their hope experience, (2) develop a reflexive understanding of the processes of their hope, and (3) construct a substantive theory of hope of palliative care RNs.

Methods:

Using constructivist grounded theory methodology, purposeful theoretical sampling was used to enroll 14 practicing community palliative care RNs in the study. Twenty-seven open-ended telephone interviews were conducted and nine daily journal entries on hope were copied. Interviews and journals were transcribed verbatim and analyzed using Charmaz's grounded theory approach.

Results:

Participants described their hope as a positive state of being involving a perseverant and realistic understanding of future possibilities. Their hope sustained and motivated them, and helped them to strive to provide high-quality care. The main concern for participants was keeping their hope when faced with work life challenges and contrasting viewpoints (i.e., when their hopes differed from the hopes of others around them). They dealt with this through harmonizing their hope by the processes of “looking both ways,” “connecting with others,” “seeing the bigger picture,” and “trying to make a difference.” Their experience of hope was defined within the social context of their work and lives.

Significance of results:

The results of this study suggest that hope is very important to palliative care RNs, in that it helps them to persevere and sustains them when faced with work life challenges in their practice. This study also highlights the need for continued research in this area as there appears to be a lack of evidence on the meaning of hope for healthcare professionals, and, in particular, understanding hope in the context of palliative and end-of-life care delivery.

Keywords

HopePalliative care nursingNursing work lifeCommunityConstructivist grounded theory
Type
Original Articles
Information
Palliative & Supportive Care , Volume 9 , Issue 3 , September 2011 , pp. 281 - 294
Copyright
Copyright © Cambridge University Press 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Appelin, G., Broback, G. & Bertero, C. (2005). A comprehensive picture of palliative care at home from the people involved. European Journal of Oncology Nursing, 9, 315–324.CrossRefGoogle ScholarPubMed
Arnaert, A., Seller, R. & Wainwright, M. (2009). Homecare nurses' attitudes toward palliative care in a rural community in western Quebec. Journal of Hospice and Palliative Nursing, 11, 202–208.Google Scholar
Benzein, E., Norberg, A. & Saveman, B. (2001). The meaning of the lived experience of hope in patients with cancer in palliative home care. Palliative Medicine, 15, 117–126.CrossRefGoogle ScholarPubMed
Borneman, T., Stahl, C., Ferrell, B.R., et al. (2002). The concept of hope in family caregivers of cancer patients at home. Journal of Hospice and Palliative Nursing, 4, 21–33.Google Scholar
Carstairs, S. (2005). Still not there quality end-of-life care: A progress report. http://sen.parl.gc.ca/scarstairs/PalliativeCare/Still%20Not%20There%20June%202005.pdf.Google Scholar
Carter, H., McKenna, C., MacLeod, R., et al. (1998). Health professionals' responses to multiple sclerosis and motor neurone disease. Palliative Medicine, 12, 383–394.Google Scholar
Charmaz, K. (2000). Grounded theory: Objectivist and constructivist methods. In Handbook of Qualitative Research, 2nd ed.Denzin, N.K. & Lincoln, Y.S. (eds), pp. 509–535. Thousand Oaks, CA: Sage Publishers, Inc.Google Scholar
Charmaz, K. (2004). Grounded theory. In Approaches to Qualitative Research: A Reader on Theory and Practice. Hesse-Biber, S.N. & Leavy, P. (eds), pp. 496–521. New York: Oxford University Press.Google Scholar
Charmaz, K. (2006). Constructing Grounded Theory: A Practical Guide Through Qualitative Analysis. Thousand Oaks, CA: Sage Publishers, Inc.Google Scholar
Dufault, K. & Martocchio, B.C. (1985). Hope: Its spheres and dimensions. Nursing Clinics of North America, 20, 379–391.Google Scholar
Duggleby, W. & Wright, K. (2005). Transforming hope: How elderly palliative patients live with hope. Canadian Journal of Nursing Research, 37, 71–84.Google ScholarPubMed
Duggleby, W. & Wright, K. (2007). The hope of professional caregivers caring for persons at the end of life. Journal of Hospice & Palliative Nursing, 9, 42–49.CrossRefGoogle Scholar
Duggleby, W.D., Degner, L., Williams, A., et al. (2007). Living with hope: Initial evaluation of a psychosocial hope intervention for older palliative home care patients. Journal of Pain & Symptom Management, 33, 247–257.Google Scholar
Dunne, K., Sullivan, K. & Kernohan, G. (2005). Palliative care for patients with cancer: District nurses' experiences. Journal of Advanced Nursing, 50, 372–380.CrossRefGoogle ScholarPubMed
Feudtner, C., Santucci, G., Feinstein, J.A., et al. (2007). Hopeful thinking and level of comfort regarding providing pediatric palliative care: A survey of hospital nurses. Pediatrics, 119, e186–e192.Google Scholar
Gelling, L., Fitzgerald, M. & Blight, I. (2002). Hope in the ICU: A qualitative study exploring nurses' experiences of the concept of hope. Nursing in Critical Care, 7, 271–277.Google Scholar
Herth, K. (1993). Hope in the family caregiver of terminally ill people. Journal of Advanced Nursing, 18, 538–548.CrossRefGoogle ScholarPubMed
Holtslander, L. & Duggleby, W. (2009). The hope experience of older bereaved women who cared for a spouse with terminal cancer. Qualitative Health Research, 19, 388–400.CrossRefGoogle ScholarPubMed
Holtslander, L.F., Duggleby, W., Williams, A.M., et al. (2005). The experience of hope for informal caregivers of palliative patients. Journal of Palliative Care, 21, 285.CrossRefGoogle ScholarPubMed
Koopmeiners, L., Post–White, J., Gutknecht, S., et al. (1997). How healthcare professionals contribute to hope in patients with cancer. Oncology Nursing Forum, 24, 1507–1513.Google Scholar
Kulig, J.C. (2001). Hope at the community level according to rural-based public health nurses. Online Journal of Rural Nursing and Health Care, 2, 1–19.CrossRefGoogle Scholar
Luker, K.A., Austin, L., Caress, A., et al. (2000). The importance of ‘knowing the patient': Community nurses' constructions of quality in providing palliative care. Journal of Advanced Nursing, 31, 775–782.CrossRefGoogle ScholarPubMed
Mok, E. & Chiu, P.C. (2004). Nurse–patient relationships in palliative care. Journal of Advanced Nursing, 48, 475–483.Google Scholar
Musselwhite, K., Cuff, L., McGregor, L., et al. (2007). The telephone interview is an effective method of data collection in clinical nursing research: A discussion paper. International Journal of Nursing Studies, 44, 1064.Google Scholar
Newton, J. & Waters, V. (2001). Community palliative care clinical nurse specialists' descriptions of stress in their work. International Journal of Palliative Nursing, 7, 531–540.Google Scholar
Pask, E.J. (2003). Moral agency in nursing: Seeing value in the work and believing that I make a difference. Nursing Ethics, 10, 165–174.Google Scholar
Pask, E.J. (2005). Self–sacrifice, self-transcendence and nurses' professional self. Nursing Philosophy, 6, 247–254.CrossRefGoogle ScholarPubMed
Patton, M.Q. (2002). Qualitative Research and Evaluation Methods, 3rd ed.Thousand Oaks, CA: Sage Publications, Inc.Google Scholar
Payne, N. (2001). Occupational stressors and coping as determinants of burnout in female hospice nurses. Journal of Advanced Nursing, 33, 396–405.Google Scholar
Post-White, J., Ceronsky, C., Kreitzer, M.J., et al. (1996). Hope, spirituality, sense of coherence, and quality of life in patients with cancer. Oncology Nursing Forum, 23, 1571–1579.Google Scholar
Romanow, R.J. (2002). Building on Values: The Future of Health Care in Canada–Final Report. Saskatoon: Commission on the Future of Health Care in Canada.Google Scholar
Sherwin, E.D., Elliott, T.R., Rybarczyk, B.D., et al. (1992). Negotiation the reality of caregiving: Hope, burnout and nursing. Journal of Social and Clinical Psychology, 11, 129–139.Google Scholar
Simmons, B.L. & Nelson, D.L. (2001). Eustress at work: The relationship between hope and health in hospital nurses. Health Care Management Review, 26, 7–18.CrossRefGoogle ScholarPubMed
Spiers, J.A. (2002). The interpersonal contexts of negotiating care in home care nurse—Patient interactions. Qualitative Health Research, 12, 1033–1058.CrossRefGoogle ScholarPubMed
Stephen-Haynes, J. (2002). The concept of hope—A phenomenological study. Journal of Community Nursing, 16, 28–30.Google Scholar
Thulesius, H., Hakansson, A. & Petersson, K. (2003). Balancing: A basic process in end-of-life cancer care. Qualitative Health Research, 13, 1353–1377.CrossRefGoogle ScholarPubMed
Wilkes, L.M. & Beale, B. (2001). Palliative care at home: Stress for nurses in urban and rural New South Wales, Australia. International Journal of Nursing Practice, 7, 306–313.CrossRefGoogle Scholar
Wilson, K., Roe, B. & Wright, L. (1998). Telephone of face-to-face interviews? A decision made on the basis of a pilot study. International Journal of Nursing Studies, 35, 314–321.Google Scholar
Wilson, V. & Edwards, L. (2005). Telephone interviewing in educational settings. http://www.scre.ac.uk/spotlight/spotlight84.html.Google Scholar