Major

Nursing

Advisor

Paquette, Katherine

Advisor Department

Nursing, College of

Date

5-2017

Keywords

Nursing, Oncology, Hope, Outpatient

Abstract

In contemporary times, everyone you meet has either been directly or indirectly affected by cancer. Cancer often creates a whirlwind of emotions as the individual wonders how and why this has happened to them. In health care, oncology is a field that is in constant evolution with the development of new chemotherapeutic agents and clinical trials that bring a sense of hope to oncology patients. Outpatient infusion nurses quickly become a part of a person’s life when they begin their chemotherapy. These nurses are with patients through every scan, procedure, and eight-hour infusion day. Nursing is essential in fostering hope for these patients that focuses on enhancing quality of life from a holistic perspective. The purpose of this study was to explore nurses’ perspectives of hope in outpatient oncology patients.

A concept analysis was conducted utilizing Kim and Schwartz-Barcott’s Hybrid Model to determine common themes that arose from nurses’ perspectives on hope in outpatient oncology patients. The Hybrid Model consists of three phases: (1) Theoretical Phase,(2) Fieldwork Phase, and (3) Final Analytic Phase. In the Theoretical Phase, a literature review was conducted to gain insight on the concept of hope from nurses’ perspectives, and to identify the antecedents, critical attributes and consequences of hope. Although the review of literature provided sufficient theoretical knowledge on the concept of hope, very few studies explored hope from nurses’ perspective. This gap in the literature created the foundation for the Fieldwork Phase. Structured interviews were conducted with eight outpatient oncology nurses at a cancer institute in the Northeast. Data analysis revealed that the nurses attributed the patient’s hope to a combination of a strong sense of self, a good support system, and the opportunity to be on a new trial for their chemotherapy. In the Final Analytic Phase, findings from the interviews were compared to conceptual knowledge on hope from the literature. A strong sense of self and a good support system were consistent with antecedents of hope identified in the literature. Resilience emerged as an additional antecedent and the data suggested a physiological predisposition to resilience and hope. Resilience as an antecedent to hope in outpatient oncology patients may impact on the patient’s physiologic and psychologic response to chemotherapy. Quantity of life, as opposed to quality of life, was identified by the nurses as a consequence of hope that was valued by outpatient oncology patients.

This concept analysis can guide future nursing practice in oncology by serving as a resource for oncology nurses in understanding aspects of the concept of hope that may be unique to outpatient chemotherapy patients. Identifying factors that foster and hinder hope for outpatient oncology patients is essential to developing an individualized, evidence-based plan of care. Outpatient oncology nurses will be able to identify when hope is compromised and advocate for resources to foster hope for outpatient oncology patients.

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