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      Trajectory of parental hope when a child has difficult-to-treat cancer: a prospective qualitative study.

      Psycho-Oncology
      Adolescent, Attitude to Health, Child, Child, Preschool, Disease Progression, Female, Humans, Interviews as Topic, Male, Neoplasms, psychology, therapy, Pain, Parents, Professional-Family Relations, Prognosis, Prospective Studies, Qualitative Research, Severity of Illness Index

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          Abstract

          This prospective and longitudinal study was designed to further our understanding of parental hope when a child is being treated for a malignancy resistant to treatment over three time points during the first year after diagnosis using a qualitative approach to inquiry. We prospectively recruited parents of pediatric cancer patients with a poor prognosis who were treated in the Hematology/Oncology Program at a large children's hospital for this longitudinal grounded theory study. Parents were interviewed at three time points: within 3 months of the initial diagnosis, at 6 months, and at 9 months. Data collection and analysis took place concurrently using line-by-line coding. Constant comparison was used to examine relationships within and across codes and categories. Two overarching categories defining hope as a positive inner source were found across time, but their frequency varied depending on how well the child was doing and disease progression: future-oriented hope and present-oriented hope. Under future-oriented hope, we identified the following: hope for a cure and treatment success, hope for the child's future, hope for a miracle, and hope for more quality time with child. Under present-oriented hope, we identified hope for day-to-day/moment-to-moment, hope for no pain and suffering, and hope for no complications. For parents of children with a diagnosis of cancer with a poor prognosis, hope is an internal resource that can be present and future focused. These views fluctuated over time in response to changes in the child's well-being and disease progression. Copyright © 2013 John Wiley & Sons, Ltd.

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