"What Do We Know about Hope in Nursing Care?": A Synthesis of Concept Analysis Studies. — TEI-tagged view

Mónica AntunespersName, Carlos LaranjeirapersName, Ana QueridopersName, Zaida CharepepersName (2023date). “"What Do We Know about Hope in Nursing Care?": A Synthesis of Concept Analysis Studies..” Healthcaretitle·j.

Object of study — concept analysisterm studies of hopeterm·dom in the context of nursing careterm·key

Research question — which attributesterm, antecedentsterm and consequencesterm define the concept of hopeterm·dom in nursing careterm·key

Contribution — a proposed new definition of the hopeterm·dom diagnosis for the ICNPterm

Full text — tagged

"What Do We Know about Hopeterm·dom in Nursing Careterm·key?": A Synthesis of Concept Analysisterm Studies.

Abstract Hopeterm·dom is a central concept within the nursing literature, which is crucial towards the development of nursing knowledge. Nursing teams play a crucial role in exploring the meaning of hopeterm·dom and promoting hopeterm·dom among patients and their families. This study aims to synthesize concept analysisterm studies of hopeterm·dom in the context of nursing careterm·key and to propose an evidence-based update of the definition of hopeterm·dom in the International Classification for Nursing Practice (ICNPterm ® ). Method: This is a literature review, involving the synthesis of studies concerning the concept analysisterm of hopeterm·dom in nursing practice. Peer-reviewed articles with fully accessible Portuguese or English text were considered. As we aimed to include a historical perspective of the concept, no restriction upon the time of publication was set. Articles were selected in March 2022 and updated in July 2023 using the Medline, CINAHL, and Scopus databases. The search terms used were “hopeterm·dom” AND “concept” AND “analysis” AND “nurs*”. Only articles written in English or Portuguese were included. Two reviewers conducted the research synthesis and report independently to minimize the risk of bias in the included studies. This paper adheres to the PRISMA checklist. To clarify the concept of hopeterm·dom as perceived by patients and develop hopeterm·dom as an evidence-based nursing concept, 13 studies were reviewed. The concept of hopeterm·dom, its attributesterm, antecedentsterm, and consequencesterm, as well as similar concepts, were studied by nurses and synthesized into a definition. The identified antecedentsterm include pivotal life events, stressful stimuli, and experiencing satisfaction with life. The analysis of its attributesterm, antecedentsterm, and consequencesterm has contributed to understanding its relevance in nursing careterm·key and provided a proposed update of hopeterm·dom in the ICNPterm ® . This review provides conceptual clarity on how hopeterm·dom is defined and used in nursing practice and the potential factors that may impact the promotion of hopeterm·dom to provide opportunities for future nursing research.

Keywords: holistic health, hopeterm·dom, nursing diagnosisterm·key, nursing theory, review literature, nurse-patient relations, therapeutical approaches 1. Introduction Hopeterm·dom is an integral part of being human and a dynamic and multidimensional phenomenon with numerous meanings. The concept of hopeterm·dom has been studied extensively in many academic fields, including philosophy, psychology, and medicine, although it only appeared in the nursing literature in the 1980s, which defined the concept for specific populations and inspired the first strategies. Since then, hopeterm·dom research and its inclusion in nursing careterm·key have become a priority [ 1 ]. Hopeterm·dom has become an important and crucial factor in the care of people with health problems and their families [ 2 ], with three main focuses: (a) hopeterm·dom as an inner power that facilitates transcending the present situation and conceiving a reality-based expectation of a better future for oneself or others; (b) hopeterm·dom as a state of being, characterized by the anticipation of a good and improved state, or a release from perceived entrapment or a human experience [ 1 , 3 ]; (c) hopeterm·dom as a personal experience, centered on personal responsibility and convictions about the world and our chances of achieving what we want [ 4 ].

Scholars agree on describing hopeterm·dom as an idiosyncratic complex process that is essential to life, future-oriented, deliberate, and highly personalized [ 2 , 5 ]. It also entails the presence of substantial goals that are both desired and achievable, as well as the motivation and capacity to make judgments and choices [ 6 ].

Dufault and Martocchio provide the most extensive analysis of hopeterm·dom in the nursing literature [ 7 ]. They define hopeterm·dom as a dynamic process, a multidimensional “life force” that anticipates achieving a practically attainable and personally relevant good, with some degree of confidence despite marked uncertainty. Within the hoping process, the authors differentiate between generalized hopeterm·dom (a more global longing for some positive, yet undefined, future) and particularized hopeterm·dom (focused on a specific goal) [ 7 , 8 ].

Farran et al. [ 9 ] conceptualized hopeterm·dom as a psychological and cognitive process that can possess spiritual or transcendent dimensions. It involves the formation of positive expectations and optimistic beliefs about future outcomes [ 9 ]. These positive expectations are influenced by various factors, including self-belief (confidence in one’s abilities and potential), trust in others (confidence in the reliability and support of others), and adherence to a religious doctrine (faith in a higher power or spiritual principles) [ 9 ].

Hopeterm·dom emerges as a forward-looking process that involves a dynamic interplay among cognition, action, emotions, and interpersonal connections. This process is oriented toward the pursuit of future accomplishments that hold personal significance [ 10 ].

The International Classification of Nursing Practiceterm (ICNPterm ® ) defines hopeterm·dom as “the feeling of having possibilities, a trust in others or in the future, a zest for life, an expression of reasons and will to live, and inner peace and optimism, associated with setting goals and mobilizing energy” [ 11 ] (p. 1), which can constitute a nursing diagnosisterm·key (despair), intervention (promoting hopeterm·dom), or outcome (hopeterm·dom). The continuous updating of this classification ensures its usefulness, relevance, and ongoing quality, as well as supporting future health models and nursing. Regarding the definition of the diagnosis of hopeterm·dom proposed by the ICNPterm ® , recent scientific findings point to a better clarification of the concept. In this way, nurses can consider this focus more easily, considering its attributesterm when making the initial assessment and monitoring nursing careterm·key in this area.

Hopeterm·dom research in nursing careterm·key has focused on different populations, life spans, and stages of the health–disease transition process [ 1 , 12 ], varying according to the experienced events and cultural environments [ 13 ]. Several studies on hopeterm·dom are grounded in nursing’s totality paradigmterm·dom. In this paradigm, nurses view individuals not just as a collection of isolated symptoms or medical conditions but as whole beings with physical, emotional, psychological, social, and spiritual dimensions. Nurses consider the interplay of these various aspects of a person’s life when providing care, aiming to address the individual’s needs in a comprehensive and integrated manner and are frequently developed to promote healing and quality of life through interventions with specific individuals or certain health conditions [ 2 ]. Some examples include elders [ 14 ], individuals with chronic medical conditions [ 15 , 16 ], children and adolescents [ 13 , 17 ], caregivers and spouses [ 17 , 18 ], homeless people [ 19 ], and people with mental health disorders [ 20 , 21 ].

Recently, there has been an increased interest in the promotion of hopeterm·dom in advanced clinical nursing practice to aid and support clients in managing the complexity of physical and emotional suffering. The nurse’s ability to foster hopeterm·dom necessitates a deliberate approach and the establishment of circumstances for therapeutic interaction through interpersonal engagement. This occurs in response to situations characterized by suffering, uncertainty, or emotional distress, ultimately leading to mutual personal growth for both the nurse and the client [ 22 ]. Some of the hope-promoting strategies included making a meaningful impact on their patients’ lives, establishing deep connections with them, accompanying them on their journey, and gradually building trust over time. Additionally, the nurses emphasized that the way they approached their tasks and interactions was more important than the specific actions they took [ 23 ]. In this regard, the nursing team plays a crucial role in exploring the meaning of hopeterm·dom and promoting hopeterm·dom in patients and their families. Promoting hopeterm·dom is a professional responsibility and a moral and ethical obligation, which is foundational to all nursing careterm·key [ 24 ].

There is extensive research on the topic of hopeterm·dom, including several concept analyses, justifying our need to synthesize the evidence, allowing the discipline to attain a clearer comprehension of the concept and contributing to illuminating what “hides in veiled shades of obscurity” [ 2 ]. A concept analysisterm is a valuable approach used in nursing to bring clarity to concepts that are often used with ambiguity. By subjecting these concepts to thorough examination, nurses can achieve a heightened level of insight and a more refined delineation of their role and significance within the scope of their profession. A better understanding of the attributesterm of a concept makes it possible to increase the accuracy of nursing diagnoses and to target nursing interventions to human responses in health and disease processes. The primary objective of a concept analysisterm is to identify and explore the essential properties of a concept within the nursing field. Through this process, the aim is to achieve a clearer and more comprehensive understanding of the concept’s meaning and its inherent characteristics, thereby providing a more precise and explanatory framework for its application in nursing practice [ 25 ]. A concept analysisterm, in essence, involves the methodical deconstruction and examination of a particular phenomenon or concept. Undertaking this analytical process allows us to gain a more profound understanding of the concept’s intricacies and nuances, thereby enhancing our comprehension of the essential aspects and significance of quality in bedside nursing careterm·key [ 26 ].

Therefore, our aims were: (1) to synthesize the research regarding concept analyses of hopeterm·dom in the context of nursing careterm·key; (2) to propose an update for the definition of hopeterm·dom in the ICNPterm ® .

2. Materials and Methods This focused literature review ultimately aimed to provide an updated definition of hopeterm·dom based on articles that use concept analyses to characterize the concept of hopeterm·dom. This review was conducted and reported independently by two reviewers following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines [ 27 ].

2.1. Review Question The question of this review is what are the attributesterm, antecedentsterm, and consequencesterm that define the concept of hopeterm·dom in nursing careterm·key?

2.2. Inclusion and Exclusion Criteria This literature review uses theoretical–methodological models describing the concept of hopeterm·dom in nursing practice. Peer-reviewed articles with fully accessible Portuguese or English text were considered. As we aimed to include a historical perspective of the concept, no restriction upon the time of publication was set. We included concept analyses covering all ages, settings, contexts, and study designs. No filters were established for the year of publication. The exclusion criteria were as follows: (a) grey literature sources, such as theses, dissertations, and conference proceedings; (b) papers on hopeterm·dom or hoping of nurses or other allied healthcare professions, since one of the aims was to contribute to the nursing taxonomy, which requires a patient-centered approach.

2.3. Search and Selection Strategy In March 2022, the authors (M.A., Z.C.) searched four databases: Medline (Medical Literature Analysis and Retrieval System Online), CINAHL (Cumulative Index to Nursing and Allied Health Literature), and Scopus. We updated the search in July 2023. The key Medical Subject Headings (MeSH) terms used included ‘hopeterm·dom’ combined with the free-text keywords ‘concept’ and ‘analyses,’ as well as the truncations ‘nur*’ and ‘hopeterm·dom*’ with the Boolean operator AND. The terms were searched in the title field. The bibliographies of selected articles were searched manually to improve the retrieval of relevant articles. The process of study selection is summarized using a PRISMA flow chart [ 27 ] in Figure 1 .

PRISMA flow chart of the study selection [ 27 ] (adapted to https://www.equator-network.org/reporting-guidelines/prisma/ , accessed on 1 June 2023).

2.4. Data Extraction To eliminate duplicates and aid each reviewer with independent screening, reference manager software was employed. Two reviewers independently read the titles and abstracts of the papers chosen for inclusion. When there was a disagreement or an abstract met the inclusion criteria, it was retrieved for full-text reading. A spreadsheet was shared among the reviewers that included the article’s authors, year of publication, and context; the antecedentsterm, consequents, and definition or attributesterm of the hopeterm·dom concept; and the empirical referents ( Table 1 ).

A narrative synthesis was used as a methodological strategy to clarify and construct a conceptual model of hopeterm·dom [ 28 ].

The synthesis of concept analysisterm studies on hopeterm·dom.

2.5. Data Analysis The studies were synthesized separately by two researchers while considering the main categories needed for the synthesis—antecedentsterm, consequents, and attributesterm. To ensure the study’s validity and reliability, the procedure was overseen by researchers acquainted with this method of analysis.

3. Results A total of 322 articles were initially identified. After removing duplicates, 218 titles or abstracts were excluded were deemed irrelevant, resulting in 17 articles whose full text was read. Four of these articles were excluded as they did not comply with the inclusion criteria; specifically, they did not use a conceptual analysisterm·mth or evaluate other concepts (e.g., hopelessness, resilience, spirituality). In total, 13 articles were included after data extraction.

Those articles were published from 1991 to 2021 in English. The theoretical–methodological model used most often was Walker and Avant’s [ 40 ] concept analysisterm model [ 29 , 30 , 31 , 32 , 33 , 36 , 37 , 38 , 39 ]. Among other models used were the evolutionary approach of Rodgers [ 35 , 41 ], Wilson and Norris’ method [ 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 ], and Morse’s concept analysisterm [ 26 ].

Different populations and clinical settings were included in this analysis: palliative care from Portugal [ 29 ] and the United Kingdom [ 33 ]; patients with a terminal illness from New Zealand [ 41 ] and Nigeria [ 30 ]; adolescents with cancer from the USA [ 37 ]; parents of critically ill newborns [ 31 ]; psychiatric population [ 35 ]; patients with early-stage dementia [ 32 ]; families and pediatric caregivers during a child’s serious illness [ 26 ]; orthopedic and trauma settings from the United Kingdom [ 25 ]; elderly adults with chronic heart failure from the USA [ 39 ] ( Table 1 ).

Some authors [ 36 , 38 , 39 ] have elucidated the concept of hopeterm·dom with a review of definitions and conceptual uses. Additionally, another author provided mutually exclusive theoretical definitions of four concepts simultaneously—spirituality, hopeterm·dom, acceptance, and self-transcendence—highlighting their interrelationships and distinguishing characteristics [ 34 ]. In the process of result formulation, we conducted a review of the antecedentsterm, attributesterm, and consequencesterm of hopeterm·dom ( Figure 2 ). For the antecedentsterm, we identified variables that precede or influence hopeterm·dom, such as life events, personal characteristics, or environmental factors. Regarding the attributesterm, we established clear definitions and quantified the constituent elements or features that comprise the construct of hopeterm·dom, including agency, pathways of thinking, and emotional experiences. The consequencesterm of hopeterm·dom determined the outcomes and effects associated with hopeterm·dom, encompassing both positive and negative manifestations [ 22 ].

The synthesis model of hopeterm·dom.

Figure 2 illustrates the link between antecedentsterm, attributesterm, and consequencesterm in a synthesis model, resulting in two main dimensions: “hopeterm·dom is a dynamic emotional state” and “hopeterm·dom is central to the process of adaptation”. These dimensions highlight that hopeterm·dom is not a static emotion (dynamic emotional state); it changes over time and plays a central role in how individuals adapt to and navigate the challenges and uncertainties of life (adaptative process). For this reason, it serves as a motivating and adaptive force that can help people persevere and thrive in various situations.

3.1. The Antecedentsterm of Hopeterm·dom The data indicate that hopeterm·dom is a comprehensive concept that requires support to achieve positive outcomes [ 39 , 42 ]. Antecedentsterm of hopeterm·dom may consist of a pivotal life event or a stressful stimulus, such as loss, major decisions, hardship, suffering, pain, despair, and uncertainty due to illness, chronic diseases, or terminal illness. Antecedentsterm of hopeterm·dom may also include a predicament or threat [ 29 , 30 , 31 , 33 , 34 , 36 , 38 , 39 , 41 ], such as an uncertain prognosis, experience of a trusting and loving relationship [ 26 , 29 , 41 ], a successful learning experience, reaching a goal [ 32 , 35 , 37 ], and connectedness with others and God or spirituality [ 29 , 30 , 32 , 34 ]. Antecedentsterm such as “trust, interpersonal relationships, effective communication, and relationships with health professionals” underline the importance of holistic care [ 30 , 41 ] (p. 1029). It is crucial to consider and prioritize these aspects, as they play a vital role in the overall well-being and satisfaction of patients or individuals receiving healthcare services.

3.2. The Attributesterm of Hopeterm·dom Hopeterm·dom was defined and described in several ways: an expectation of positive outcome [ 25 , 29 , 31 , 33 , 36 , 37 , 38 , 41 ]; an orientation towards the present and future [ 26 , 36 ]; a multidimensional and dynamic process of goal identification [ 25 , 26 , 29 , 31 , 33 , 34 , 36 ]; a personal quality [ 35 , 36 , 37 , 38 , 41 ]; a cognitive decision-making process [ 25 ]; spirituality [ 26 , 41 ]; a feeling of comfort and safety [ 30 , 41 ]; an interpersonal relationship and feeling of belonging and being needed [ 36 , 41 ]; a legacy [ 41 ]; an energy–action towards the future [ 26 , 31 , 34 , 36 ]; an ongoing adjustment to personal and observed experiences during illness and loss to daily living [ 32 , 33 , 35 ]; a sense of limitation [ 39 ]; a coping strategy [ 26 , 29 , 37 , 38 ]; mutuality experiences [ 41 ]; a positive social support [ 37 ].

These attributesterm frame a more pragmatic view (see the Supplementary File ) and can help understand how nurses might identify hopeterm·dom in the continuum of care.

3.3. The Consequencesterm of Hopeterm·dom Possible consequencesterm of the concept indicated in the literature included the following: returning to a more stable life, with better physical health and quality of life [ 26 , 30 , 31 , 32 , 33 ]; finding hopeterm·dom and meaning in life [ 29 , 34 , 37 , 38 ]; overcoming a difficult situation and obtaining greater healing and satisfaction [ 29 , 38 ]; facing uncertain future constructively [ 29 , 36 , 38 , 41 ]; accepting a health condition [ 29 , 30 , 34 , 36 , 38 , 41 ]; coping with pain and suffering [ 29 , 30 , 34 , 36 , 38 ]; promoting a sense of renewal, peace, and legacy, and developing new strategies and a positive outlook for family and friends [ 29 , 36 , 38 ]; survival [ 29 , 35 , 36 , 38 ]; positive changes in self-concept and growth opportunities [ 29 , 30 , 32 , 34 ]; developing new feelings of safety or comfort, formulating new and realistic goals, and promoting confidence in the future and trust in the support from others [ 30 , 34 , 37 , 39 , 41 ]; faith and spirituality [ 35 ]; a winning position [ 34 ]. Faith and the perception of the transcendent emerge as consequencesterm, as they become resources for individuals, particularly in times of uncertainty and vulnerability.

3.4. Updating the Definition of Hopeterm·dom The authors compared classifications (NANDA international diagnoses, ICNPterm ® axis, and similar terms) and proposed a new definition for the hopeterm·dom diagnosis and a new term for the ICNPterm ® ( Table 2 ).

Proposed update of the definition of hopeterm·dom in the ICNPterm ® .

The data suggest that is possible to update the definition of hopeterm·dom in nursing practice in the ICNPterm ® [ 11 ], providing a new insight into the relationship between hopeterm·dom and nursing practice and focusing on how people endure and sustain a positive outlook on life, despite their difficulties. Compared to the ICNPterm ® definition, which is more concise and emphasizes certain emotional aspects of hopeterm·dom, our proposed definition of hopeterm·dom is more detailed, multidimensional, and contextually flexible. Our proposed definition also explicitly includes a cognitive element and highlights the connection between hopeterm·dom and the present, as well as the future.

4. Discussion This analysis supports the theory that hopeterm·dom is a multidimensional concept, described as an emotion, state, and experiential process [ 10 ]. Based on the concept’s antecedentsterm, attributesterm, and consequencesterm, some authors formulated a conceptual definition. From a chronological perspective, several definitions have arisen: (a) hopeterm·dom as the anticipation of a positive possible future, accompanied by desire and expectation [ 38 ]; (b) hopeterm·dom as an energetic cognitive state, an action-oriented expectation of a positive future aim or outcome [ 25 ]; (c) hopeterm·dom as dynamic, multidimensional energy that promotes positive expectations, motivating actions to attain personally significant and realistic future goals [ 43 ]; (d) hopeterm·dom as the reassuring or life-sustaining, realistic belief in a positive future for self or others [ 31 ]; (e) “it is a belief in something positive without any guaranteed expectation that it will occur” [ 25 ] (p. 410); (f) hopeterm·dom in terminal illness represents “a calm, emotional, global focus on the hopesterm·dom of loved ones” [ 42 ] (p. 458); (g) hopeterm·dom is “a multidimensional construct arising from our memories, beliefs, and values”, which permeates all our activities and thoughts, strengthening the spirit and facilitating behavior that promotes the desired outcome or level of comfort, while impacting life quality [ 44 ]; (h) hopeterm·dom is an expectation of a sustained good and improved state, or a release from perceived entanglement [ 45 ]; (i) hopeterm·dom is crucial to the adjustment processes in health–illness transitions [ 34 , 39 ].

Hopeterm·dom is a process with individual value derived from lived experiences [ 2 ]. Some authors report behaviors highlighting aspects such as self-therapy [ 34 ], medication adherence, a sense of well-being, a positive attitude, and self-management despite physical limitations [ 34 ]. The findings from studies indicate that hopeterm·dom plays a crucial role in sustaining determination and resilience, even in the absence of tangible positive evidence. Additionally, hopeterm·dom can broaden an individual’s perspective, opening new possibilities and potential pathways for coping and achieving positive outcomes [ 46 ]. Consequently, these findings would provide valuable empirical support, offering caregivers the opportunity to refine their abilities in fostering and strengthening hopeterm·dom in individuals during their routine interactions and experiences.

The empirical referents identified in six studies are helpful for decision-making in nursing careterm·key. Hopeterm·dom has been measured both qualitatively and quantitatively. From a qualitative perspective, the interview is the most used method to understand the experience of hopeterm·dom in different populations. From a quantitative perspective, the research has used relevant hopeterm·dom assessment instruments, including the Hopeterm·dom Communication Tool, Beck Hopelessness Scale, Snyder Hopeterm·dom Scale, Hopelessness Assessment in Illness, Children’s Hopeterm·dom Scale, Stoner Hopeterm·dom Scale, Hopeterm·dom Assessment Guide, Beck Depression Inventory-II, Hospital Anxiety and Depression Scale, and Hopefulness Scale for Adolescents.

The instruments used most often in the analyzed studies were the Herth Hope Indexterm·key, Miller Hopeterm·dom Scale, and Nowotny Hopeterm·dom Scale. It should be noted that some of these instruments do not meet the gold standards of psychometric evaluation [ 45 ]. For that reason, is required to improve the quality of available hopeterm·dom scales and adapt them to different cultural scenarios.

The obtained results build upon evidence from conceptual analyses to clarify the concept of hopeterm·dom. This approach should be applied further in nursing research, contributing to a clearer understanding of how to improve hopeterm·dom in vulnerable people in clinical settings. In this sense, advocating and fostering hopeterm·dom might be a useful resource that allows people to maintain or regain their well-being [ 47 , 48 ].

This review contributes to advancing the comprehension of the concept of hopeterm·dom. This study’s antecedentsterm, critical attributesterm, and consequencesterm of hopeterm·dom offer valuable insights that can benefit nurses working in diverse healthcare environments. By utilizing this knowledge, nurses can more effectively recognize and grasp the experience of hopeterm·dom in their patients, thereby enhancing their ability to provide optimal care and support.

4.1. Strengths and Study Limitations The narrow focus of the topic, the exhaustive search for evidence, the criterion-based selection of relevant evidence, and the objective summary offered for the conceptual hopeterm·dom map are all strengths.

The review was not conducted using a systematic approach, and the gray literature, unpublished academic articles, and editorials were not included. Additionally, a small number of databases were used to identify suitable research.

The results obtained need to be framed with caution, even though they provide important information for clarifying the concept of hopeterm·dom. Building a synthesis matrix to represent an ever-expanding and complex set of literature requires some degree of simplification and subjectivity. Therefore, this overview may evolve for new insights and should serve as the first step toward a more complete and comprehensive understanding of hopeterm·dom.

The presence of hopeterm·dom, even in stressful and life-changing events, often leads to a sense of controlterm·dom, optimism, and a new purpose in life. However, having false hopeterm·dom about possible outcomes and denial of reality as a coping mechanism because one cannot accept reality is an unrealistic way to improve the situation. It is, therefore, vital to learn to distinguish between potentially feasible and impossible goals of self-change to avoid overconfidence and false hopesterm·dom that ultimately lead to failure and suffering. In some of the studies reviewed, unrealistic hopeterm·dom is essential to consider when evaluating hopeterm·dom, requiring further research through a more widespread understanding. Additionally, it could be worthwhile to offer an interdisciplinary overview of different perspectives of hopeterm·dom across the different scientific disciplines.

4.2. Implications for Nursing Practice and Research Applying this review’s results to real-life decision-making in care management is of central importance. This may result in specific nursing procedures to assess the existence or absence of hopeterm·dom in distinct groups. Thus, nurses might help clients discover and build successful hope-inspiring strategiesterm·key [ 6 ], as well as achieve their desired abilities and goals. Nurses can take advantage of reflection on their clinical practice to identify their viewpoints on hopeterm·dom and how they incorporate hope-inspiring approaches into their professional work. These reflections could play a vital role in fostering fresh or enriched perspectives on hopeterm·dom through descriptive analyses, self-awareness, emotional examination, critical thinking, syntheses, and evaluations.

The significance of hopeterm·dom in nursing practice is well-established, extending beyond a professional responsibility to a moral and ethical obligation for all nurses. Nursing curriculums should include teachings on hopeterm·dom, its assessment, and how to integrate hope-inspiring strategiesterm·key into patient care plans. Clinical experiences should focus on empathetic connections with diverse clients, using the term “hopeterm·dom” comfortably. The proposed hopeterm·dom process model can serve as a framework for assessing hopeterm·dom and selecting appropriate nursing strategies based on the client’s phase of hoping [ 49 ]. In advanced nursing education, a comprehensive approach to promoting hopeterm·dom should be adopted. This could involve incorporating hopeterm·dom intervention programs into clinical practicums and program evaluation courses to assess their effectiveness. Additionally, conducting doctoral research on the phenomenon of hopeterm·dom could yield valuable insights for future studies, contribute to the development of knowledge, and enhance evidence-based nursing practices.

This hopeterm·dom synthesis review is also a significant subject for nursing research. Despite the small number of studies analyzing the concept of hopeterm·dom, the knowledge already developed around its attributesterm, antecedentsterm, and consequencesterm is relevant. For this reason, it is important to conduct clinical trials to evaluate the effectiveness of interventions and activities that promote hopeterm·dom [ 6 ]. The synthesis of the various components of the concept of hopeterm·dom raises the opportunity to construct assessment instruments that measure its attributesterm. The continuity of research about the concept of hopeterm·dom in nursing careterm·key and the increase in its conceptual understanding will influence methodological decisions, as well as the boundary variables, in experimental clinical studies. These studies will validate the proposed conceptual model.

The research should also focus on hopefulness mediators, such as general well-being, social support, spiritual well-being, coping responses, gender differences, and cultural issues. Given that most studies occurred in so-called “Western” countries [ 8 ], future studies should examine unexplored contexts and consider how different aspects of hopeterm·dom have a role in different settings, cultures, and groups (e.g., obstetric care settings, prison contexts, community settings, and ghettos).

5. Conclusions This study’s primary purpose was to synthesize prior research components on concept analyses of hopeterm·dom in nursing and provide an updated definition, broader and more contemporary antecedentsterm and attributesterm, and more specific consequencesterm of hopeterm·dom in nursing than earlier concept analyses. This synthesis has provided detailed information regarding the causes, characteristics, and effects of hopeterm·dom, as well as vital insights into the needs of various groups and a deeper understanding of the idea of hopeterm·dom.

Overall, the review emphasizes hopeterm·dom as a multifaceted construct with emotional, cognitive, motivational, social, and identity-related components, bringing consolation when facing life’s challenges.

A better operationalization of the concept of hopeterm·dom can be achieved from the synthesis of concept analyses. Reducing ambiguity regarding its understanding will allow nurses to progress in measuring and selecting activities within the promoting hopeterm·dom intervention. Studying the activities and interactions between patients and healthcare professionals and how hopeterm·dom is experienced in healthcare settings could help clinicians understand what is currently happening in healthcare practice and show how this relates to the identified aspects of hopeterm·dom. This, in turn, could help the nurses improve healthcare workers’ abilities to preserve and foster hopeterm·dom in others. By employing evidence-based research, nurses could effectively anticipate potential outcomes and use appropriate interventions to nurture and bolster patients’ hopeterm·dom during nursing careterm·key.

Hopeterm·dom is a central concept in nursing, directly affecting nursing practice in patient care and nursing education. Although considered alongside other adjacent concepts, hopeterm·dom has its theoretical structure and measurement instruments and is definable based on knowledge in the scientific nursing literature. This review provides a better grasp of how hopeterm·dom is defined, actualized, and employed in nursing practice and the possible circumstances that may provide opportunities and promote hopeterm·dom.

Supplementary Materials The following supporting information can be downloaded at: https://www.mdpi.com/article/10.3390/healthcare11202739/s1 .

Click here for additional data file.

Author Contributions Conceptualization, Z.C. and M.A.; methodology, Z.C. and M.A.; software, M.A.; validation, Z.C. and M.A.; formal analysis, Z.C., C.L., A.Q. and M.A.; investigation, Z.C., C.L., A.Q. and M.A.; resources, Z.C. and M.A.; data curation, Z.C. and M.A.; writing—original draft preparation, Z.C., C.L., A.Q. and M.A.; writing—review and editing, Z.C., C.L., A.Q. and M.A.; visualization, Z.C., C.L., A.Q. and M.A.; supervision, Z.C.; project administration, Z.C.; funding acquisition, Z.C. All authors have read and agreed to the published version of the manuscript.

Institutional Review Board Statement Not applicable.

Informed Consent Statement Not applicable.

Data Availability Statement Materials are available from the corresponding author upon request.

Conflicts of Interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Funding Statement This research was funded by Universidade Católica Portuguesa—Center for Interdisciplinary Research in Health (CIIS) and by National Funds through FCT—Fundação para a Ciência e a Tecnologia, I.P., under the project UIDP/04279/2020. The study us also supported by national funds through FCT—Fundação para a Ciência e a Tecnologia, I.P. (UIDB/05704/2020 and UIDP/05704/2020), and under the Scientific Employment Stimulus—Institutional Call—(CEECINST/00051/2018).

Footnotes References Associated Data Supplementary Materials Click here for additional data file.

Data Availability Statement Materials are available from the corresponding author upon request.