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J Pain Symptom Manage. 2014 Nov;48(5):831-8.e2. doi: 10.1016/j.jpainsymman.2014.02.008. Epub 2014 Apr 18.

Improving communication on hope in palliative care. A qualitative study of palliative care professionals' metaphors of hope: grip, source, tune, and vision.

Author information

  • 1Section of Medical Ethics, Department of General Practice, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. Electronic address: h.j.olsman@amc.uva.nl.
  • 2Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
  • 3Division of Palliative Care Medicine, Department of Oncology, University of Alberta, Edmonton, Alberta, Canada.
  • 4Section of Medical Ethics, Department of General Practice, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
  • 5Department of Medical Oncology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
  • 6Department of Ethics of Care, University of Humanistic Studies, Utrecht, The Netherlands.

Abstract

CONTEXT:

Hope is important in palliative care. However, palliative care professionals' perspectives on hope are not well understood. Metaphors of hope are a way of better understanding these perspectives.

OBJECTIVES:

To describe palliative care professionals' perspectives on hope by examining the hope metaphors they spontaneously used to describe their own hope and their perspectives on the hope of patients and their families.

METHODS:

Semistructured interviews with palliative care professionals were recorded, transcribed, and analyzed using a narrative approach. Results were discussed until the researchers reached consensus and reinforced by other health-care professionals and by observing several palliative care settings.

RESULTS:

The 64 participants (mean (SD) age, 48.42 (9.27) years and 72% female) were physicians (41%), nurses (34%), chaplains (20%), or other professionals (5%), working in Canada (19%) or The Netherlands (81%). Participants described the hope of patients, their families, or themselves as a 1) grip, which implied safety; 2) source, which implied strength; 3) tune, which implied harmony; and 4) vision, which implied a positive perspective. Compared with Dutch participants, Canadian participants generally put more emphasis on spirituality and letting go of their own hope as a grip (safety). Compared with other included professionals, physicians used hope as a grip (safety) most often, whereas chaplains used hope as a tune (harmony) most often.

CONCLUSION:

Our findings help to increase the understanding of hope and contribute to improving communication skills in palliative care professionals.

Copyright © 2014 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

KEYWORDS:

Palliative care; communication; ethics; metaphor; nurse-patient relations; physician-patient relations; qualitative research; spirituality; terminal care

PMID:
24747223
[PubMed - indexed for MEDLINE]
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