title: Dynamics of hope in adults living with HIV/AIDS: a substantive theory.
abstract: OBJECTIVE
  The aim of this paper was to discuss a substantive theory on the dynamics of hope in adults living with the human immunodeficiency virus/acquired immune deficiency syndrome.
  
  
  BACKGROUND
  Existing literature describes how the dynamics of hope have profound connections with human essence and life, wellbeing and health, suffering and illness, and nursing care, in general as well as in the context of human immunodeficiency virus/acquired immune deficiency syndrome.
  
  
  METHODS
  The data consisted of five original articles describing the dynamics of hope in people living with human immunodeficiency virus/acquired immune deficiency syndrome and their significant others in Finland. Meta-synthesis was adapted to synthesize the original studies into a substantive theory.
  
  
  RESULTS
  The core category that emerged was the dynamically alternating balance between interconnected hope, despair and hopelessness based on folding (closing down of) and unfolding (opening up of) possibilities with regard to the dynamics of hope in dealing with the changing self and life with human immunodeficiency virus/acquired immune deficiency syndrome. The dynamics of hope include the subprocesses of hope, despair and hopelessness.
  
  
  CONCLUSIONS
  The dynamics of hope in adults living with human immunodeficiency virus/acquired immune deficiency syndrome is an important phenomenon in nursing practice and nursing science. In taking care of people living with acquired immune deficiency syndrome, factors contributing to folding possibilities should be minimized, if possible, and factors contributing to unfolding possibilities should be nourished. The present study adds to the knowledge-base of nursing science about the dynamics of hope in people living with acquired immune deficiency syndrome. Future research should focus on testing this theory in people living with acquired immune deficiency syndrome.
authors.affiliation: Department of Nursing Science, University of Kuopio, Kuopio, Finland. jari.kylma@uku.fi
authors.forename: Jari
authors.initials: J
authors.lastname: Kylma
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001294:Attitude to Health; D005387:Finland; D015658:HIV Infections / Q000451:nursing / Q000523:psychology*; D006801:Humans; D009013:Morale; D015404:Nursing Methodology Research; D011795:Surveys and Questionnaires