Fostering Hope in Patients and Families

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Fostering Hope inPatients and Families

• Linda Morgante, RN,MSN,CRRN,MSCN
• Advanced Practice Nurse
• Corrine Goldsmith Dickinson Center for Multiple
  Sclerosis, NYC

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Background

• Hope/Helplessness/Hopelessness
• Linear perspective
• Little in nursing literature regarding hope
• Relied on other disciplines for information
• Worked off hopelessness information

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Hopelessness

• Lynch (1969) defined hopelessness as lacking the
  energy for either imagining or wishing.
• Deeply passive, not in any of the good sense of
  the word, but in its most unhappy sense.

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Hopelessness

• Wish to give up
• Cannot imagine beyond the limits of what is
  presently happening
• The loss of the ability to dream

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Miller, J. Coping with Chronic Illness
Overcoming Powerlessness, 1999
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Hope

• Hope is an essential element of life it
  embodies our vision of the future, our opinion of
  ourselves and others, and our sense of control
  over the events and directions of our lives.

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What is Hope

• Hope is sense of the possible, the best resource
  of man, always there in the inside making
  everything possible, waiting to be illuminated.
• Pandoras story hope is there when all else is
  gone

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Optimism vs Hope

• Optimism - things are going to be all right
• Hope looks at threats in a realistic way sees
  a potential path to a better future

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He who has health has hope, and he who has hope,
has everything Arabian Proverb
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Literature

• Supports hope as a factor in coping with a
  variety of illnesses
• Evidence to support hope in MS
• Implicated in survival rates for cancer patients
• Supports presence of hope regardless of age or
  gender.

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Hope in MS

• Hope promotes adherence to Copaxone in
  relapsing/remitting patients (Fraser,C. 2002)
• Hope exists for patients with relapsing/remitting
  MS (Miller,C., 2000)

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Factors that support hope

• Strong self-esteem
• Feeling competent, and in control
• Underpinning of faith manifested by religious
  beliefs, or feeling connected to a higher being
  spirituality

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Fighting Spirit
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Instruments to measure hope

• Herth Hope Index
• Miller Hope Scale

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Behaviors that reflect hope

• Verbalizes future goals
• Shows motivation to achieve goals
• Imagines a brighter tomorrow
• Reminisces about past successes
• Sees options for self
• Maintains a sense of control

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Behaviors cont.

• Anticipates positive outcomes, and expects to
  accomplish goals
• Relates to family, friends, or caregivers in
  supportive and reciprocal ways
• Feels connected to a higher being spirituality

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USES HUMOR
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Nursing measures

• Establish realistic expectations
• Help to maximize abilities
• Educate, counsel, refer, advocate
• Use humor
• Provide distraction

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NURSES ARE A HEALING PRESENCE
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Nursing measures

• Reframe the experience
• Help to savor the moment
• Encourage socialization
• Teach relaxation modalities

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Relaxation modalities
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Relaxation modalities

• Deep breathing
• Tachi
• Massage
• Beauty parlor
• Shopping

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Simple pleasures

• Snowflakes
• Stars
• Flowers
• Poems
• Songs
• Stories
• Sunsets

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Personal Hope

• Nurses inspire hope when they feel hopeful.
• Patients rely on the hopeful attitudes of the
  healthcare provider (Miller, C., 2000).
• Fill yourself up with hope, and allow others to
  borrow from your wellspring.

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Thank You