A grounded theory study of parental caregivers who have children in treatment for cancer : Keeping hope possible

Purpose: The overall purpose of this qualitative research study was to gain a clear understanding of the experience of hope for parents who care for their child who was receiving treatment for childhood cancer. Specifically, the objectives were: (a) to gain an interpretive understanding of the hope experience and processes of hope for parents who have children who are undergoing treatment for cancer; (b) to describe and define parental hope and significant related concepts for parental caregivers of children undergoing treatment for cancer within their context; and, (c) to construct a tentative substantive theory that is grounded in the experiences of parents who care for their child with cancer. Research Design: Qualitative: Constructivist Grounded Theory. Sample and Setting: The study sample included 16 parents who were caring for their children in treatment for cancer at a Western Canadian Cancer Centre. Methods/Procedure: Using purposive theoretical sampling, 16 parents were invited to participate in this grounded theory study. Thirty three open-ended, in depth, face-to-face interviews were conducted using a flexible interview guide, and fourteen journals with daily entries over a two week period were collected. The interviews were audio-taped, and both the interviews and the journals were transcribed verbatim, organized and stored using ATLAS.ti software. Analysis of the data was conducted using Charmaz’s (2006) constructivist grounded theory approach. Findings: A developing, substantive grounded theory was constructed in which hope was identified as vital to parents of children who were in treatment for cancer. Parental hope was defined as an essential, powerful, deliberate, life sustaining, dynamic, cyclical process that was anchored in time, and was both calming and strengthening, and provided inner guidance through the challenging experience of preparing for the worst and hoping for the best. Parental hope helped parents to maintain a positive attitude and to seek growth during their experience of caring for their child who was in treatment for cancer. The parents’ main concern was ‘fearing the loss of hope’, and this was ameliorated by the basic social process of ‘keeping hope possible’ through accepting reality, establishing control, restructuring hope, and purposive positive thinking. Conclusions: Parents journey through numerous transitions related to the treatment phase of cancer that causes feelings of uncertainty, anxiety, stress, and loss of control. To minimize these adverse experiences, nurses can support parents’ ability to keep hope possible, and thus, to optimize their well-being by understanding, assessing, and supporting parental hope