Hope dies last ... A qualitative study into the meaning of hope for people with cancer in the palliative phase

Palliative patients may have strong hope, even hope for a cure, despite knowing their prognosis. Health professionals do not always understand patients who have this kind of hope. The aim of this article was to explore the meaning of hope among patients with cancer in the palliative phase. A secondary analysis was conducted including a constant comparative analysis to uncover the processes underlying the maintenance of hope, of previously collected interview data (n = 76). The meaning of hope is related to the importance of the object it is attached to, rather than to a real chance of achieving this object. Hope has a dual function: patients hope because they cannot forsake it and because they benefit so much from it. Hope can spring from many sources and is influenced by various factors. If there are fewer potent sources to tap into, people create hope themselves and this type of self-created hope takes more effort to maintain. Patients use different strategies to increase their hope, described as the 'the work of hope'. A better understanding of the work of hope can lead to better psychosocial support by health professionals. Health professionals convey many messages that affect the work of hope.