Should palliative care patients' hope be truthful, helpful or valuable? An interpretative synthesis of literature describing healthcare professionals' perspectives on hope of palliative care patients

Abstract

Background: Healthcare professionals' perspectives on palliative care patients' hope influence communication. However, these perspectives have hardly been examined.

Aim: To describe healthcare professionals' perspectives on palliative care patients' hope found in the literature.

Design: The interpretative synthesis consisted of a quality assessment and thematic analysis of included articles.

Data sources: Literature search of articles between January 1980 and July 2011 in PubMed, CINAHL, PsycINFO and EMBASE and references of included studies.

Search strategy: (palliat* or hospice or terminal* in title/abstract or as subject heading) AND (hope* or hoping or desir* or optimis* in title or as subject heading).

Results: Of the 37 articles, 31 articles were of sufficient quality. The majority of these 31 articles described perspectives of nurses or physicians. Three perspectives on hope of palliative care patients were found: (1) realistic perspective - hope as an expectation should be truthful, and healthcare professionals focused on adjusting hope to truth, (2) functional perspective - hope as coping mechanism should help patients, and professionals focused on fostering hope, and (3) narrative perspective - hope as meaning should be valuable for patients, and healthcare professionals focused on interpreting it.

Conclusions: Healthcare professionals who are able to work with three perspectives on hope may improve their communication with their palliative care patients, which leads to a better quality of care.

Keywords: Palliative care; behaviour and behaviour mechanisms; communication; nurse–patient relations; physician–patient relations; terminal care.