Transforming the death sentence: elements of hope in women with advanced ovarian cancer

To describe the experience of hope in women with advanced ovarian cancer.

Grounded theory methodology with interviews.

Oncology clinics in the northeastern United States.

20 women aged 42-73 who had completed initial chemotherapy and had no evidence of recurrence.

A personal data form and focused interview guide supported data collection. The core variable and related themes were identified using the constant comparative process. Demographic and treatment information was analyzed using descriptive statistics.

The process of hope in women with advanced ovarian cancer.

Facing the death sentence emerged as the main concern. The core variable in dealing with the concern was transforming the death threat. The three phases of the trajectory were shock (reverberating from the impact), aftershock (grasping reality), and rebuilding (living the new paradigm). Healthcare provider communication and spirituality influenced women's abilities to transform the death sentence. Support and perceived control emerged as key dimensions of the core variable.

Women experience significant distress and trauma symptoms associated with a diagnosis of ovarian cancer. Hope was linked closely to the core variable and was necessary for finding meaning in the experience. Women with high support and perceived control seemed most hopeful and able to transform the death sentence.

Evidence-based interventions and strategies are needed to foster improved provider communication, symptom management, and peer support for women facing ovarian cancer. Future nursing research should focus on strategies that enhance support, perceived control, hope, and spirituality.