Ameliorating the tension: use of forgiveness for healing

To generate a grounded substantive theory of the process of forgiveness in patients with cancer.

Qualitative approach, grounded theory.

Inpatient hospice, cancer support groups, homecare patients.

25 adult patients with cancer between the ages of 35 and 88 (X = 62.4 years): 13 men and 12 women receiving active, palliative, or terminal treatment.

Using grounded theory methodology, open-ended interviews were transcribed verbatim and analyzed using constant comparative analysis and expert and participant validation.

Forgiveness as reflected in participants' past and current experiences.

Participants described hurtful events that initially caused severe negative emotional responses. Participants also described attempts to focus on living out priority values prompted by their cancer diagnosis. An escalating tension ensued between maintaining negative emotions and acting on personal values. Forgiveness was used to relieve this tension. Using several methods to gain perspective allowed resolving these negative emotions and living out priority values to various degrees.

A cancer diagnosis promotes the rethinking of life priorities regardless of the stage of disease. For these participants, forgiveness was used to help clarify personal values and to help eliminate negative emotions from an inflicted hurt.

Nurses can facilitate the healing process by helping patients to identify and clarify priority values, recognizing appropriate definitions of forgiveness, using active listening or referral to help patients analyze their situations, encouraging active approaches to forgiving, and encouraging perseverance in the process.