Why health expectations and hopes are different: the development of a conceptual model.
BACKGROUND
In the literature, 'hope' has often been thought of as an ideal expectation. However, we believe the classification of hope as a type of expectation is problematic. Although both hopes and expectations are future-oriented cognitions, expectations are distinct in that they are an individual's probability-driven assessment of the most likely outcomes, while hopes are an assessment of the most desirable - but not necessarily the most probable - outcomes.


OBJECTIVE
This paper presents a conceptual model of the factors that may serve as common antecedents of hopes and expectations, and a mechanism that may mediate their differentiation.


METHODS
Ovid Healthstar and PsycINFO database searches from January 1967 to October 2008 were conducted. An integrative literature review, synthesis and conceptual model development were carried out. Outcome Our model envisages the differentiation of hope from expectation as a dynamic, longitudinal process consisting of three phases: appraisal of possible outcomes, cognitive analysis for achieving hopes and goal pursuit. Key variables such as temporal proximity, controllability, external resources, goals, affect, agency and pathways may moderate the extent of divergence by influencing the perceived probability of achieving desired outcomes.


CONCLUSIONS
Hopes and expectations are distinct, but linked, constructs. This preliminary conceptual model presents how hopes and expectations develop, become differentiated and how social-cognitive factors may moderate this relationship. A better understanding of hopes and expectations may assist health professionals in communicating illness-related expectations while maintaining the integrity of patient hopes.
Leung
Karen K
KK
Primary Care Research and Development Group, Department of Family Medicine, University of Calgary, AB, Canada.
Silvius
James L
JL
Pimlott
Nicholas
N
Dalziel
William
W
Drummond
Neil
N
D003258:Consumer Behavior; D006296:Health Services; D006801:Humans; D008960:Models, Psychological; D011593:Psychology, Social
Int J Qual Health Care. 1995 Jun;7(2):127-41
7655809
J Consult Clin Psychol. 2000 Oct;68(5):875-82
11068973
BMC Med Res Methodol. 2006 Jul 26;6:35
16872487
Field methods. 2008;20(1):3-25
18677415
Soc Sci Med. 1999 Mar;48(5):591-605
10080361
J Natl Med Assoc. 1980 Jan;72(1):67-9
7373668
Health Educ Q. 1988 Summer;15(2):175-83
3378902
Camb Q Healthc Ethics. 2005 Spring;14(2):235-9
15887817
J Gen Intern Med. 2002 Nov;17(11):817-24
12406352
Qual Health Res. 2006 Mar;16(3):318-36
16449684
J Clin Oncol. 2003 Feb 1;21(3):570-4
12560453
Soc Sci Med. 2004 Sep;59(6):1329-37
15210103
J Clin Oncol. 2005 May 1;23(13):3146-50
15860876
Pers Individ Dif. 2004 Jun;36(8):1945-1952
18985169
Bioethics. 2004 Sep;18(5):428-47
15462025
Am Psychol. 2002 Sep;57(9):677-89
12237978
Am J Psychiatry. 1953 Dec;110(6):417-21
13104684
Eur J Cancer Care (Engl). 2005 May;14(2):132-40
15842460
J Clin Oncol. 2005 Feb 20;23(6):1278-88
15718326
Ultrasound Obstet Gynecol. 2002 Jan;19(1):5-6
11851961
Milbank Mem Fund Q. 1966 Jul;44(3):Suppl:94-127
5967464
Am Psychol. 1989 Sep;44(9):1175-84
2782727
Nurs Clin North Am. 1985 Jun;20(2):379-91
3846980
Pers Individ Dif. 2003;35(2):399-409
20390044
Sch Inq Nurs Pract. 1991 Spring;5(1):39-51; discussion 53-6
2063043
Health Psychol. 1985;4(3):219-47
4029106
Bioethics. 2005 Jun;19(3):215-31
16167402
Am J Psychother. 1985 Oct;39(4):515-24
4083371
Neurology. 1999 Nov 10;53(8):1622-7
10563602
BMC Med Res Methodol. 2007 Jan 15;7:4
17224044
Br J Nurs. 2002 Jun 27-Jul 10;11(12):832-40
12131834
J Pers Soc Psychol. 1991 Apr;60(4):570-85
2037968
J Epidemiol Community Health. 2008 May;62(5):427-34
18413456
Res Sch. 2006 Spring;13(1):29
20098638
Am Psychol. 2002 Sep;57(9):705-17
12237980
Health Expect. 2006 Mar;9(1):37-48
16436160
Am Psychol. 2003 Oct;58(10):820-2; authors' reply 823-4
14585003
Scand J Caring Sci. 2002 Sep;16(3):240-7
12191035
Oncol Nurs Forum. 1989 Jan-Feb;16(1):57-61
2911528
J Gen Intern Med. 1998 May;13(5):289-95
9613883
Int J Palliat Nurs. 2004 Jul;10(7):352-9
15365488
Palliat Med. 2005 Apr;19(3):234-40
15920938
Med Care Res Rev. 1996 Mar;53(1):3-27
10156434
J Altern Complement Med. 2005;11 Suppl 1:S23-30
16332183
Arch Gen Psychiatry. 1974 Jun;30(6):779-85
4832186
Annu Rev Psychol. 1996;47:593-620
15012489
J Clin Psychol. 2002 Sep;58(9):1003-22
12209861
JAMA. 1999 Mar 17;281(11):1019-21
10086437
J Palliat Med. 2002 Dec;5(6):883-94
12685535
Ann Fam Med. 2004 Jul-Aug;2(4):356-61
15335136
Holist Nurs Pract. 2006 May-Jun;20(3):137-46
16672814
Fam Pract. 2002 Aug;19(4):333-8
12110550
J Pers Soc Psychol. 2000 Apr;78(4):620-34
10794370
Behav Res Ther. 1979;17(4):287-304
486033