Date of Award

2015

Degree Type

Dissertation

Degree Name

Doctor of Philosophy in Nursing

Department

Nursing

First Advisor

Ginette G. Ferszt

Abstract

Fostering hope for clients experiencing end of life is an essential component of Hospice and Palliative Care nursing practice. There is a limited repertoire of literature that describes the perspectives on hope held by Hospice and Palliative Care nurses. The purpose of this doctoral research study was to describe the perspectives on hope of Hospice and Palliative Care nurses who work in one Hospice and Palliative Care organization in the northeast. The specific research questions that guided this inquiry included: How do Hospice and Palliative Care nurses describe the concept of hope? In what ways do the nurses think that hope is helpful to clients? What nursing interventions do nurses utilize to facilitate clients' hopes?

A qualitative methodology utilizing a self-report questionnaire on hope was used to collect data from Hospice and Palliative Care nurses who work in inpatient and home care settings. Manifest content analysis was the research methodology utilized for analysis of the data from nine open-ended surveys returned by the nurses. The perspectives on hope of the Hospice and Palliative Care nurses illuminated two potentially new critical attributes of hope to include spirituality and interconnectedness. The nurses described hope as being helpful to clients by allowing them to stay positive, stay in control, feel safe and find meaning in their circumstances. Descriptions of nursing strategies that foster hope did not consistently demonstrate integration of the elements of connectedness and spirituality into their interventions. Organizational issues, such as decrease in Hospice client lengths of stays, with a resulting increase in client acuity and conflicting end-of life-care plans may have been factors that impacted on these nurses' descriptions. It is not known what individual factors may have influenced the Hospice and Palliative Care nurses' perspectives on hope. Further research is required to understand the circumstances that may impact on Hospice and Palliative Care nurses' perspectives on hope.

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