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Keeping Hope Possible: A Grounded Theory Study of the Hope Experience of Parental Caregivers Who Have Children in Treatment for Cancer

Bally, Jill M. G. PhD, RN; Duggleby, Wendy PhD, RN; Holtslander, Lorraine PhD, RN; Mpofu, Christopher MBChB, MSc, FRCP(c); Spurr, Shelley PhD, RN; Thomas, Roanne PhD; Wright, Karen PhD, RN

doi: 10.1097/NCC.0b013e3182a453aa

Background: Hope has been found to support parents as they care for their child with a life-limiting or life-threatening illness. However, very little research focuses on the nursing care of parents of pediatric oncology patients, and therefore, nurses may have difficulty in understanding and supporting parental well-being.

Objective: The purpose of this qualitative study was to gain an understanding of the experience of hope for parents who care for their child in treatment for cancer.

Methods: Using purposive theoretical sampling, 16 parents participated in this study. Thirty-three open-ended, face-to-face interviews were conducted, and 14 parent journals were collected. Analysis of the data was conducted using Charmaz’s constructivist grounded theory approach.

Results: A developing, substantive grounded theory was constructed. Parental hope was described as an essential, powerful, deliberate, life-sustaining, dynamic, cyclical process that was anchored in time; was calming and strengthening; and provided inner guidance through the challenging experience of preparing for the worst and hoping for the best. Parents’ main concern was “fearing the loss of hope,” which was ameliorated by the basic social process of “keeping hope possible” through accepting reality, establishing control, restructuring hope, and purposive positive thinking.

Conclusions: Parents journeyed through numerous transitions related to the treatment of cancer that caused feelings of uncertainty, anxiety, stress, and loss of control. Hope was identified as vital to parents.

Implications for Practice: To minimize these adverse experiences, nurses can support parents’ ability to keep hope possible and thus to optimize their well-being by understanding, assessing, and supporting parental hope.

Author Affiliations: College of Nursing, University of Saskatchewan, Saskatoon (Drs Bally, Holtslander, Spurr, and Wright); Faculty of Nursing, University of Alberta, Edmonton (Dr Duggleby); Saskatoon Cancer Centre and University of Saskatchewan, Saskatoon (Dr Mpofu); and Faculty of Health Sciences, University of Ottawa, Ontario (Dr Thomas), Canada.

This study was funded by a grant from The Canadian Association of Nurses in Oncology (CANO/ACIO).

The authors have no conflicts of interest to disclose.

Correspondence: Jill M. G. Bally, PhD, RN, College of Nursing, University of Saskatchewan, 413 St Andrew’s College, 1121 College Dr, Saskatoon, SK, Canada S7N 0W3 (

Accepted for publication July 9, 2013.

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins