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 wendy.duggleby@ualberta.ca 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? 1|Page 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. 2|Page 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: 3|Page 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. 4|Page 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? 5|Page 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. 6|Page 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. 7|Page