The concept of hope in nursing 5: hope and critical care nursing.

This article is the fifth of a series of six that explores the nature of hope, reviews the existing theoretical and empirical work in several discrete areas of nursing, and provides case studies to illustrate the role that hope plays in clinical situations. In this article we focus on hope within the formal area of critical care nursing. The article points out that there is a distinct paucity of theoretical and empirical work on hope in this formal area. A very limited empirical literature exists, and this work has produced some preliminary findings on the nature and range of interventions for inspiring hope in this client group. Interestingly, while the nature of critical illness appears to indicate the need for the individual to draw upon all his/her intra- and interpersonal sources of help and support, and thus similarly draw upon his/her internal and external hope, the substantive issue of hope inspiration in this client group is not well researched. There exists, no doubt, a range of explanations for this disparity and this article outlines two and introduces a third. Yet hope and hope maintenance/inspiration may just be equally relevant and important to people with critical problems as they are to individuals with chronic problems; this view is supported by the limited empirical work in this area. Consequently, there is a clear need for future qualitative and quantitative research, some of which needs to explore the experiences of hope/hoping/hopelessness for people with a range of critical care needs. Furthermore, despite the apparent emphasis on 'high-tech', overt, and tangible practices within some critical care settings, this article would urge practitioners to remain open to the value of the more subtle, less visible, implicit, approaches to inspiring and maintaining hope in these clients.