Hope, expectations and recovery from illness: a narrative synthesis of qualitative research

This paper is a report of a narrative literature review conducted to explore how expectations and wants are distinguished in empirical research on hope and illness and the related issues of realistic hope and temporality. Particularized hope has been identified as comprising wants and expectations. The distinction is important in relation to debates around 'realistic' hopes, the temporal dimension of hope and hope-sustaining strategies. A systematic search of the literature was undertaken for qualitative research papers published between January 1996 and July 2007 relating to hope and recovery in adults with physical ill health. Seven papers were identified. A narrative synthesis approach was adopted and the papers were appraised for quality using the Critical Appraisal Skills Programme method. Textual descriptions and tabulation were used to compare central themes and thematic analysis was used to explore the findings. A lack of conceptual clarity in relation to hope as a want or an expectation was identified. Healthcare professionals' role in encouraging 'realistic' hopes emerged as problematic because of the lack of understanding about the possible benefits of hope and difficulties in identifying 'realistic' hopes. There has been limited research exploring temporality and the impact of hope-sustaining activities. The lack of clarity about particularized hope, its dimensions, properties or different forms limits knowledge about the conditions under which hope is a positive force versus when it can be damaging. Distinguishing conceptually between hope as a want and hope as an expectation has potential value in improving healthcare practice and informing future investigations.