The burden of the 'RA RA' positive: survivors' and hospice patients' reflections on maintaining a positive attitude to serious illness.
OBJECTIVE
This article seeks to make a contribution to fostering work on the neglected area of research about how individuals maintain a positive outlook during their confrontation with serious illness. Insights are presented from both haematology survivors and hospice patients about the factors that hinder and facilitate their capacity to 'be positive'.


METHODS
Open-ended interviews with 14 hospice patients and 12 haematology survivors on their construction of meaning in the face of serious illness were audio-recorded, transcribed verbatim and thematically analysed. The findings on the topic of maintaining a positive outlook are presented in this article.


RESULTS
Although the participants affirmed the value of a positive perspective on their illness experience, they were critical of unwanted pressure from others to be positive: a phenomenon they called the 'RA RA' positive. Such pressure interfered with the natural process of continually having to re-negotiate a positive outlook through exploring the fullness of feeling, both positive and negative. The participants indicated that at times of relapse or worsening physical condition they had to cycle through a process of despair/negativity and re-adjustment before they were able to find the positive. The process could not be rushed and required freedom from an imposed pressure to be positive.


CONCLUSIONS
The essential message is that a positive outlook cannot be imposed but requires a nurturing orientation that allows the expression of a full range of feelings in a supportive environment.
Centre for Social Science Research, Central Queensland University, 4702 Rockhampton, Queensland, Australia. pam_mcgrath@bigpond.com
Pam
P
McGrath
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001293:Attitude to Death; D017281:Cost of Illness; D004644:Emotions; D005260:Female; D017051:Hospice Care; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D033262:Narration; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy; D017060:Patient Satisfaction; D011446:Prospective Studies; D011788:Quality of Life; D012944:Social Support; D029181:Spirituality; D013315:Stress, Psychological / Q000209:etiology*; D017741:Survivors / Q000523:psychology*