Exploring nurses' and patients' perceptions of hope and hope-engendering nurse interventions in an eating disorder...

WHAT IS KNOWN ON THE SUBJECT?: Individuals with eating disorders (EDs) experience hopelessness, suicidal thoughts and behaviours at elevated rates compared to the general population. Current knowledge of recovery from EDs does not address nurse engendered hope. This study aimed to explore differences between patients' and nurses' perceptions of hope-engendering nurse actions and the relationship actions have with patients' perception of hope. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This is the first study to explore differences between patients' and nurses' perceptions of hope-engendering nurse actions in an inpatient ED facility and find significant differences; nurses' scores were higher than patients' scores. The study explored the relationship perceived self-reported nurse hope-engendering actions have with patients' and nurses' perception of hope. There were no significant relationships. This study provides additional evidence to support that there are common patient needs for nurse hope-engendering practices such as caring and providing for patients; supporting and encouraging patients' connection to others; facilitating patients' adaptive belief systems; and helping to set goals and attain resources for patients. WHAT ARE THE IMPLICATIONS FOR MENTAL HEALTH NURSING PRACTICE?: Nurses who work with patients who have EDs should be prepared to work with patients who are feeling hopeless about their future. Thus, nursing continuing education should focus on strategies that enable nurses to deliver care that reduces hopelessness, improves connection, and inspires hope in those who are recovering from EDs. The results revealed that nurses perceived that they offered patients with EDs hope-engendering actions more often and effectively than patients believed; this finding pinpoints a future direction for research that may improve care for patients. Patient feedback identified ways nurses may improve care to engender hope: providing an open caring environment, nurse presence, comfort/pain relief, and involving patients in their care. Actions by nurses aimed to enhance interpersonal connection and nurse presence could facilitate hope in patients with ED. ABSTRACT: Introduction Individuals with eating disorders (EDs) experience suicidal thoughts and behaviours at elevated rates compared to the general population. Hope-engendering nursing actions may increase patients' levels of hope for the future, improve coping self-efficacy, and possibly reduce suicidality. Although nursing staff are integral ED treatment team members, little is known about nursing actions targeting hopefulness. Aim Explore differences between patients' and nurses' perceptions of hope-engendering nurse actions and the relationship actions have with patients' perception of hope. Methods Descriptive, cross-sectional, comparative, correlational research design was used. Responses for 97 ED patients and 10 nurses were entered into analysis. Hope-engendering nurse intervention and hope questionnaires were administered and analysed. Results Nurses' total hope-engendering nurse intervention and hope scores were higher than patients' scores. Discussion Patients reported that the most effective nursing actions were providing an open caring environment, comfort/pain relief, and involving patients in their care and treatment. Nurses perceived that they offered patients hope-engendering actions more often and effectively than the patients believed. Implications for Practice Findings indicate that patients with EDs have low levels of hope. Nursing educators should further develop strategies that enable nurses to deliver care that inspires hope and improves connectedness in those who have EDs.