Transforming the death sentence: elements of hope in women with advanced ovarian cancer.
OBJECTIVE
To describe the experience of hope in women with advanced ovarian cancer.


METHODS
Grounded theory methodology with interviews.


METHODS
Oncology clinics in the northeastern United States.


METHODS
20 women aged 42-73 who had completed initial chemotherapy and had no evidence of recurrence.


METHODS
A personal data form and focused interview guide supported data collection. The core variable and related themes were identified using the constant comparative process. Demographic and treatment information was analyzed using descriptive statistics.


METHODS
The process of hope in women with advanced ovarian cancer.


RESULTS
Facing the death sentence emerged as the main concern. The core variable in dealing with the concern was transforming the death threat. The three phases of the trajectory were shock (reverberating from the impact), aftershock (grasping reality), and rebuilding (living the new paradigm). Healthcare provider communication and spirituality influenced women's abilities to transform the death sentence. Support and perceived control emerged as key dimensions of the core variable.


CONCLUSIONS
Women experience significant distress and trauma symptoms associated with a diagnosis of ovarian cancer. Hope was linked closely to the core variable and was necessary for finding meaning in the experience. Women with high support and perceived control seemed most hopeful and able to transform the death sentence.


CONCLUSIONS
Evidence-based interventions and strategies are needed to foster improved provider communication, symptom management, and peer support for women facing ovarian cancer. Future nursing research should focus on strategies that enhance support, perceived control, hope, and spirituality.
Reb
Anne M
AM
The Henry M. Jackson Foundation, United States Military Cancer Institute, Washington, DC, USA. areb@comcast.net
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D003643:Death; D018450:Disease Progression; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000523:psychology*