The process of maintaining hope in adults undergoing bone marrow transplantation for leukemia

The purpose of this qualitative study was to explore the processes of hoping in adults undergoing bone marrow transplantation (BMT) for leukemia. Grounded theory methodology was used to elicit the experience of hoping in 10 men and 10 women, ages 20-58, who had undergone BMT. The central process described by participants was that of maintaining hope. The core categories used to describe this process were Dealing With It and Keeping It in Its Place. Dealing With It is defined as the process of confronting the negative possibilities inherent in the illness experience and allowing the full range of thoughts, behaviors, and emotions resulting from this confrontation. Keeping It in Its Place is defined as the process of managing the impact of the illness by controlling or limiting one's response to the disease and therapy. The relationship between these two contradictory core categories is explained by The Dialectic of Maintaining Hope. This dialectic is defined as the synthesis of the antithetical strategies of Dealing With It and Keeping It in Its Place in which people are able to transcend each strategy and sustain hope. The findings provide a nascent, explanatory model and information for nurses regarding an important adaptive process.