Applying evidence-based hope interventions

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WORKSHOP
Applying Evidence-Based Hope
Interventions in Practice
Covenant Health
23rd Annual Palliative Care Conference
Education and Research Days
Fantasyland Hotel - West Edmonton Mall
October 29, 2012
Presenter:
Wendy Duggleby, PhD, RN, AOCN
Professor and Nursing Research Chair Aging and Quality of Life
Faculty of Nursing University of Alberta
[email protected]
Applying Evidence Based Hope Interventions in Practice
1. Can you describe a situation where you experienced hope?
2. In that situation, what was hope?
3. What influences your hope?
4. Is there anything that others can do to help you have hope?
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Applying Evidence Based Hope Interventions in Practice
Living with Hope Program for Palliative Care Patients
Description:
The Living with Hope Program for Palliative Care Patients consists of viewing the Living
with Hope Film and choosing to begin one of three hope activities: a) begin to write a letter
to someone, b) choose a hope symbol or c) begin “my story”.
Choose One of These:
1. Write or ask someone to help you write one or
more letters to someone:
 Choose people you want to write a letter to.
 Ask someone to help you
write the letter or letters.
 You can give the letter to
someone if you wish, but
you don’t have to.
2. Begin a Hope Collection:
 You can collect anything you want that
gives you hope.
 These may include poems, writings,
pictures, drawing, photographs, music,
stories etc.
 Place your collection in a special binder or
box.
3. Begin an “About Me” Collection
 Tell your life as a story.
 In your story tell about your ups and downs
beginning as young as you can remember.
 You can tell your story however you would
like to do this. Some
examples may be
collecting cards, pictures,
or writing a journal.
 You can put your story in
a scrapbook or you can audio or videotape
your story so others can learn about you.
Acknowledgement
This study was funded by the Saskatchewan Health Research Foundation.
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Applying Evidence Based Hope Interventions in Practice
Living with Hope Program for Family Caregivers
Description:
The Living with Hope Program consists of viewing the Living with Hope film featuring
caregivers of patients with advanced cancer describing their hope and a hope activity
“Stories of the Present”. Caregivers are instructed to take 5 minutes at the end of the day
and write about their thoughts, challenges and what gave them hope over a 2 week time
period. They can choose to use a journal, a computer or audiotape their “Stories of the
Present”.
Stories of the Present
Take 5 minutes near the end of the
day to reflect.
Every day, write in the journal,
try to focus on:
Challenges you faced today;
what gave you hope today;
what will give you hope tomorrow.
Remember to focus on your
experiences;
this is about you right now.
Write about your day in any way
you’d like;
use point form if you’d like.
Don’t worry about grammar or spelling.
www.nurs.ualberta.ca/livingwithhope
Acknowledgement
Funding for this study: Duggleby, W. (PI), Williams, A. (CO-PI), Popkin, D. (CI), ThomasHampton, M. (CI), Holtslander, L. (CI), Halstrom, L. (CI), & Cooper, D. (CI). Living with hope:
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Applying Evidence Based Hope Interventions in Practice
Developing a psychosocial supportive program for rural older women caregivers of
spouses with advanced cancer. CIHR Standard Operating Grant.
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Applying Evidence Based Hope Interventions in Practice
Case Study
Mr. R is an advanced lung cancer patient with liver metastasis receiving palliative home
care in a rural area. He is experiencing persistent nausea and is confused at times.
His primary caregiver is his daughter who has moved temporarily into his home to care
for him following his recent hospitalization. Her husband comes to stay with her and help
with caregiver when he can. She works full time, but has taken a temporary leave. With
the confusion of her father she is becoming more and more distressed and is experiencing
chest pain.
In talking with Mr. R., although he had attended church regularly, he does not believe in
life after death. He believes that when you are buried, that is the end. He says he has no
hope.
This is in contrast to the belief of the daughter, who does believe in life after death and
is very concerned about her father’s beliefs. She has hope that her father will be
comfortable and have peace at the end of life.
Discussion Questions:
1. What do you think Mr. R. means when he says he has no hope?
2. How do you think the daughter’s focus of hope may create conflict in their
relationship?
3. If unresolved what are the potential outcomes to this conflict?
4. How could you utilize the Living with Hope Programs to support Mr. R. and his
daughter?
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Applying Evidence Based Hope Interventions in Practice
Bibliography
Dufault, K. & Martocchio, B. (1985). Hope: It's spheres and dimensions. Nursing Clinics of
North America, 20(2), 379-391.
Duggleby, W., Williams, A., Thomas, R., Cooper, D, Holtslander, L. & Popkin, D. (2012).
Evaluation of the “Living with Hope Program” for Rural Women Caregivers of
Persons with Stage IV Cancer. Palliative Medicine, 26(4), 517-518.
Duggleby, W., Hicks, C., Nekolaichuk C., Holtslander, L., Williams, A., & Chambers, T. (2012)
Hope, older adults and chronic illness: a metasynthesis of qualitative research.
Journal of Advanced Nursing, 68(6), 1211-1223. Article first published online: 3 JAN
2012 | doi:10.1111/j.1365-2648.2011.05919.x
Duggleby, W., Williams, A., Holtslander, L., Cunningham, S. & Wright, K. (2011). The chaos of
caregiving and hope. Qualitative Social Work, published online 21 June 2011.
doi:10.1177/1473325011404622
Duggleby, W., Holtslander, L., Steeves, M., Cummings, S. & Wenzel, S. (2010). Discursive
meaning of hope for older persons with advanced cancer and their caregivers.
Canadian Journal of Aging, 29, 361-367
Duggleby, W., Kylma, J., Holtslander, L., Duncan, V., Hammond, C. & Williams, A. (2010).
Metasynthesis of the hope experience of family caregivers of persons with chronic
illness. Qualitative Health Research, 20(2), 148-158.
Duggleby, W., Cooper, D., & Penz, K. (2009). Hope, self-efficacy, spiritual well-being and job
satisfaction. Journal of Advanced Nursing, 65(11), 2376-2385.
Duggleby, W., & Wright, K. (2009). Transforming hope: How elderly palliative patients live
with hope. CJNR 40th Anniversary Edition, 41, 204-217 (reprint from 2005, 37(2), 7084).
Duggleby, W., Wright, K., Williams, A., Degner, L., Cammer, A., & Holtslander, L. (2007).
Developing a living with hope program for family caregivers of terminally ill cancer
patients. Journal of Palliative Care, 23, 24-31.
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Applying Evidence Based Hope Interventions in Practice
Duggleby, W. & Wright, K. (2007). The hope of professional caregivers caring for persons at
the end of life. Journal of Hospice and Palliative Nursing, 9, 42-49.
Duggleby, W., Degner, L., Williams, A., Wright, K., Cooper, D., Popkin, D., & Holtslander, L.
(2007). Living with hope: Initial evaluation of a psychosocial hope intervention for
older palliative home care patients. Journal of Pain and Symptom Management,
33(3), 247-257.
Holtslander, L. & Duggleby, W. (2009). The hope experience of older bereaved women who
cared for a spouse with terminal cancer. Qualitative Health Research, 19(3), 388400.
Holtslander, L. & Duggleby, W. (2008). Inner struggle for hope. International Journal of
Palliative Nursing, 14(10), 478-484.
Klyma, J., Duggleby, W., Cooper, D., & Molander, G. (2009). Hope in palliative care: An
integrative review. Journal of Supportive and Palliative Care, 7, 365-377.
Penz, K. & Duggleby, W. (2011). Harmonizing hope: A grounded theory study of the hope
experience of registered nurses who provide palliative care in community settings.
Palliative & Supportive Care, 9(3), 281-291. doi:10.1017/S147895151100023X
Rodin, G., Lo, C, Mikulincer, M., Donner, A., Gagliese, L. & Zimmerman, C. (2009). Pathways
to distress: The multiple determinants of depression, hopelessness and the desire
for hastened death in metastatic cancer patients. Social Science & Medicine, 68(3),
562-569.
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