title: Modes of hoping: understanding hope and expectation in the context of a clinical trial of complementary and alternative medicine for chronic pain.
abstract: This article explores the role of hope in participants' assessments of their expectations, experiences and treatment outcomes. Data analysis focused on semi-structured, open-ended interviews with 44 participants, interviewed 3-5 times each over the course of a study evaluating Traditional Chinese Medicine (TCM) for temporomandibular disorders (TMD), a form of chronic orofacial pain. Transcripts were coded and analyzed using qualitative and ethnographic methods. A "Modes of Hoping" (Webb, 2007)(1) framework informed our analysis. Five modes of hoping emerged from participant narratives: Realistic Hope, Wishful Hope, Utopian Hope, Technoscience Hope, and Transcendent Hope. Using this framework, hope is demonstrated as exerting a profound influence over how participants assess and report their expectations. This suggests that researchers interested in measuring expectations and understanding their role in treatment outcomes should consider hope as exercising a multi-faceted and dynamic influence on participants' reporting of expectations and their experience and evaluation of treatment.
authors.affiliation: Department of Family and Community Medicine, University of Arizona, Tucson, AZ; School of Anthropology, University of Arizona, Tucson, AZ. Electronic address: emerye@email.arizona.edu.
authors.forename: Emery R
authors.initials: ER
authors.lastname: Eaves
authors.affiliation: Department of Family and Community Medicine, University of Arizona, Tucson, AZ; School of Anthropology, University of Arizona, Tucson, AZ.
authors.forename: Cheryl
authors.initials: C
authors.lastname: Ritenbaugh
authors.affiliation: Department of Family and Community Medicine, University of Arizona, Tucson, AZ; School of Anthropology, University of Arizona, Tucson, AZ; College of Public Health, University of Arizona, Tucson, AZ.
authors.forename: Mark
authors.initials: M
authors.lastname: Nichter
authors.affiliation: Department of Family and Community Medicine, University of Arizona, Tucson, AZ.
authors.forename: Allison L
authors.initials: AL
authors.lastname: Hopkins
authors.affiliation: Group Health Research Institute, Seattle, WA.
authors.forename: Karen J
authors.initials: KJ
authors.lastname: Sherman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059031:Anticipation, Psychological; D059350:Chronic Pain / Q000628:therapy*; D032882:Comprehension; D005157:Facial Pain / Q000628:therapy*; D005260:Female; D065026:Hope; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008516:Medicine, Chinese Traditional / Q000523:psychology*; D008875:Middle Aged; D036301:Qualitative Research; D013705:Temporomandibular Joint Disorders / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Hope; TCM; TMD; expectation; qualitative