[Helping a terminal cancer patient establish hope]

Cancer patients who feel a sense of hopelessness concerning the prospects of long-term treatment success may defeat all efforts to stop their diseases. The authors present a case study of a breast cancer patient, a former nursing instructor, who suffered from passiveness, depression, resistance to communication, blunted affect, lack of participation in self-care, and refusal to eat--all resulting from a lack of treatment-related progress. One of the authors established a continuing and active care relationship with the patient. As part of her nursing care plan, she enacted encouraging social interactions, provided medical treatment information, assisted with self-care procedures, and attempted to maintain a constant level of psychological calm. Outcomes included an improved positive attitude toward treatment, enhanced self-control, active participation in self-care, and improved social interaction. The patient was also better able to adapt to her illness and to face an uncertain future.