Preparing for the Worst While Hoping for the Best

Patricia Mary Davidson · Kathleen Dracup · Jane Louise Phillips · John Daly · GERALDINE V. PADILLA

55 citations0/0 files storedThe Journal of Cardiovascular Nursing

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Optimism, Hope, and Well-being Heart Failure Treatment and Management Cardiac Health and Mental Health

Abstract

BACKGROUND: Patients with heart failure have higher mortality rates than those with most malignant diseases. The heart failure illness trajectory is one of gradual decline characterized by unpredictable events such as acute decompensation of heart failure or a sudden cardiac death. Health professionals have an obligation to give patients and their families concise and honest information concerning their prognosis. The challenge exists to give what ostensibly may seem a bleak prognosis within a context of hope and optimism. AIM: To explore the role of hope in heart disease and the potential utility of this construct in the development of nursing interventions. METHODS: The electronic databases CINAHL, MEDLINE, EmBASE, and PSYCHlit were searched from 1982 to August 2004 using the key words "hope," "hopelessness," "heart disease," and "heart failure." Articles were subsequently sorted to meet the inclusion criteria of (1) a philosophical discussion of the construct of hope and/or (2) investigation of hope in heart disease. RESULTS: This search retrieved 768 articles, and 24 met the inclusion criteria. Key findings from the review indicate that "hope" and "hopelessness" are underdeveloped, yet important constructs and conceptually linked with depression and spirituality. Intriguing findings from descriptive, observational studies have demonstrated the positive impact of expression of hope on cardiovascular outcomes. These findings need to be validated in randomized controlled trials. CONCLUSIONS: This critical literature review has determined that "hope" is strongly associated with the individual's future orientation. Increased understanding of this concept may assist in refining patient-focused interventions and developing therapeutic strategies to enhance hope.

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References

1992Effects of optimism on psychological and physical well-being: Theoretical overview and empirical update 1992Abbreviated instrument to measure hope: development and psychometric evaluation 2002Towards clarification of the meaning of spirituality 2002Demoralization: Its Phenomenology and Importance 1993Psychometric considerations in evaluating health-related quality of life measures 2001Spiritual coping strategies: a review of the nursing research literature 1997Hopelessness and 4-Year Progression of Carotid Atherosclerosis 2000Enhancing hope in people with a first recurrence of cancer

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2015A singing choir: Understanding the dynamics of hope, hopelessness, and despair in palliative care patients. A longitudinal qualitative study 2022Hope, Health, and the Climate Crisis 2017Spiritual distress and spiritual care in advanced heart failure 2011Healing the Heart: A Randomized Pilot Study of a Spiritual Retreat for Depression in Acute Coronary Syndrome Patients 2011Hope in action—facing cardiac death: A qualitative study of patients with life-threatening disease

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