Background:
Hope is widely recognized as a crucial psychological resource for individuals facing life-limiting illnesses, supporting their emotional well-being and ability to cope. However, how hope relates to patients’ understanding of their prognosis remains insufficiently understood.
Aim:
This study seeks to examine how people living with advanced, incurable diseases experience and interpret hope, and how these experiences intersect with their awareness of prognosis.
Design:
We conducted a qualitative study grounded in phenomenological methodology, employing reflexive thematic analysis to explore data from semi-structured interviews.
Setting/participants:
Interviews were carried out with 24 individuals aged 30 to 99 years diagnosed with advanced, non-curable conditions (12 cancer, 12 other than cancer), recruited from both hospice and hospital settings in the Czech Republic.
Results:
Our analysis revealed four distinct patterns of relating to hope and prognostic awareness: Technical, Spiritual, Minimalist, and Pragmatic. These orientations differed in how participants processed information and managed emotional responses. While hope in the Technical and Minimalist groups tended to fluctuate in response to clinical updates, the Spiritual and Pragmatic orientations maintained a steadier sense of hope, less affected by changes in medical information.
Conclusions:
Understanding these varied approaches to hope can help clinicians tailor their communication and support strategies in palliative care. Aligning care with an individual’s orientation toward hope may improve emotional coping and the overall experience of end-of-life care. These findings highlight the complexity of how hope functions in the context of terminal illness and point to the value of personalized, psychologically attuned care.