Delineating the concept of hope.

This description of the concept of hope was developed using interview data from four participant groups: patients undergoing heart transplant, spinal cord-injured patients, breast cancer survivors, and breastfeeding mothers intending to continue nursing while employed. Advanced techniques of concept analysis (using qualitative methods) enabled the delineation of the seven abstract and universal components of hope: a realistic initial assessment of the predicament or threat, the envisioning of alternatives and the setting of goals, a bracing for negative outcomes, a realistic assessment of personal resources and of external conditions and resources, the solicitation of mutually supportive relationships, the continuous evaluation for signs that reinforce the selected goals, and a determination to endure. Comparison of the various manifestations of these components in the four participant groups revealed unique and distinct patterns of hope. These were labeled: hoping for a chance, incremental hope, hoping against hope, and provisional hope. The implications for nursing practice are discussed.