Both for clinicians and patients, hope is a forceful emotional driver. The psychological benefits of hope are associated with improved physical and mental health, relationships, functional status, and coping. As with any type of emotion, extremes can be detrimental. Patients might become unrealistic, the same with clinicians.
So, the question becomes, what is the right amount of hope and how do we manage the polarity that surrounds it? Setting expectations surrounding what the goals are, is the first step. Are we wanting an improved quality of life and/or preventing death? Hope is also a contextual process and may transform over time as facts become more apparent and time passes. In addition, hope may be directed towards something and includes both motivation and a pathway or self-efficacy. Thus, hope consists of wanting something and believing one can achieve it.
Unfortunately, it is this latter component that causes issues. How do we handle the false perceptions that may occur because of hope? As clinicians, in our desire for hope as caregivers, what is our role in giving hope and living in the situation’s realism? Often, a patient has differing views than the clinician in both directions; meaning one may have more hope than the other and vice versa.
The role of a clinician is to help their patients with the context of the situation. Consequently, they work on defining goals and setting expectations of hope that match both the issue at hand and the desires of those we serve. Therefore, continued conversation and viewing hope as a positive part of treatment are crucial. Hope and realism do not need to be opposed to each other. They are both essential conceptual models, but also dependent on each other and contain positive and negative attributes.
One can position the conversations within the framework of setting the factual issues as part of the discussion, then pivoting to what we focus on from a hope perspective. Hence, it’s crucial to utilize emotion to offset the negative dynamics of a less than optimal situation.
Additionally, one can hold multiple hopes that seem incongruent. For instance, I hope to live longer, yet I also hope to spend quality time with family in my home, not the hospital. The goal for clinicians is not to create a situation where it is one or the other. Focusing on how we can define success within each sphere is what is crucial.
One must also be aware that occasionally hope is simply a misplaced emotional state when one has regrets or longing for things to have been different. Acceptance of the past is necessary to focus on hope for the future, regardless of the situation. Hope is highly complex and requires careful attention. We also must remember that clinicians need hope as well. Let our hope be the fulfillment of creating a life for those we serve rather than just states of non-death.