Editing Hope (section)

== In healthcare ==

=== Major theories ===
Of the countless models that examine the importance of hope in an individual's life, two major theories have gained a significant amount of recognition in the field of [[psychology]]. One of these theories, developed by [[Charles R. Snyder]], argues that hope should be viewed as a cognitive skill that demonstrates an individual's ability to maintain drive in the pursuit of a particular goal.<ref>{{cite book|last1=Snyder|first1=C.R|title=The Psychology of Hope|url=https://archive.org/details/psychologyofhope00snyd|url-access=registration|date=1994|publisher=Free Press|location=New York, NY|isbn=9780029297155 }}</ref> This model reasons that an individual's ability to be hopeful depends on two types of thinking: agency thinking and pathway thinking. Agency thinking refers to an individual's determination to achieve their goals despite possible obstacles, while pathway thinking refers to the ways in which an individual believes they can achieve these personal goals.

Snyder's theory uses hope as a mechanism that is most often seen in [[psychotherapy]]. In these instances, the therapist helps their client overcome barriers that have prevented them from achieving goals. The therapist would then help the client set realistic and relevant personal goals (i.e. "I am going to find something I am passionate about and that makes me feel good about myself"), and would help them remain hopeful of their ability to achieve these goals, and suggest the correct pathways to do so.

Whereas Snyder's theory focuses on hope as a mechanism to overcome an individual's lack of motivation to achieve goals, the other major theory developed by Kaye A. Herth deals more specifically with an individual's future goals as they relate to coping with illnesses.<ref>{{cite journal|last1=Weis|first1=Robert|last2=Speridakos|first2=Elena|title=A Meta-Analysis of Hope Enhancement Strategies in Clinical and Community Setting|journal=Psychology of Well-Being: Theory, Research and Practice|date=2011|volume=1|page=5|doi=10.1186/2211-1522-1-5|doi-access=free}}</ref> Herth views hope as "a motivational and cognitive attribute that is theoretically necessary to initiate and sustain action toward goal attainment".<ref name=Herth>{{cite journal|last1=Herth|first1=K.A.|title=Enhancing hope in people with a first recurrence of cancer|journal=Journal of Advanced Nursing|date=2000|volume=32|issue=6|pages=1431–1441|doi=10.1046/j.1365-2648.2000.01619.x|pmid=11136411}}</ref> Establishing realistic and attainable goals in this situation is more difficult, as the individual most likely does not have direct control over the future of their health. Instead, Herth suggests that the goals should be concerned with how the individual is going to personally deal with the illness—"Instead of drinking to ease the pain of my illness, I am going to surround myself with friends and family".<ref name=Herth />

While the nature of the goals in Snyder's model differ with those in Herth's model, they both view hope as a way to maintain personal motivation, which ultimately will result in a greater sense of optimism.

=== Major empirical findings ===
Hope, and more specifically, particularized hope, has been shown to be an important part of the recovery process from illness; it has strong psychological benefits for patients, helping them to cope more effectively with their disease.<ref>{{cite journal|last1=Wiles|first1=R.|last2=Cott|first2=C.|last3=Gibson|first3=B.E.|title=Hope, expectations, and recovery from illness: A narrative synthesis of qualitative research|journal=Journal of Advanced Nursing|date=2008|volume=64|issue=6|pages=564–573|url=https://www.ncbi.nlm.nih.gov/|doi=10.1111/j.1365-2648.2008.04815.x|pmid=19120569}}</ref> For example, hope motivates people to pursue healthy behaviors for recovery, such as eating fruits and vegetables, quitting smoking, and engaging in regular [[physical activity]]. This not only helps to enhance people's recovery from illnesses but also helps prevent illness from developing in the first place.<ref name="Enayati 2013" /> Patients who maintain high levels of hope have an improved prognosis for life-threatening illness and an enhanced quality of life.<ref>{{cite web|last1=Simonik|first1=T.|title=Reflections on hope and recovery|url=http://nedic.ca/|publisher=National Eating Disorder Information Centre|access-date=April 20, 2015}}</ref> Belief and expectation, which are key elements of hope, block pain in patients suffering from chronic illness by releasing endorphins and mimicking the effects of morphine. Consequently, through this process, belief and expectation can set off a chain reaction in the body that can make recovery from chronic illness more likely. This chain reaction is especially evident with studies demonstrating the [[placebo effect]], a situation when hope is the only variable aiding in these patients’ recovery.<ref name="Enayati 2013" />

Overall, studies have demonstrated that maintaining a sense of hope during a period of recovery from illness is beneficial. A sense of hopelessness during the recovery period has, in many instances, resulted in adverse health conditions for the patient (i.e. depression and anxiety following the recovery process).<ref>{{cite web |title=How to Spot and Overcome Hopelessness in Recovery |url=https://www.newhoperanch.com/blog/overcoming-hopelessness/ |website=New Hope Ranch |date=July 2021 |access-date=Nov 19, 2022}}</ref> Additionally, having a greater amount of hope before and during cognitive therapy has led to decreased PTSD-related depression symptoms in war veterans.<ref name="Phillips 2012" /> Hope has also been found to be associated with more positive perceptions of subjective health. However, reviews of research literature have noted that the connections between hope and symptom severity in other mental health disorders are less clear, such as in cases of individuals with [[schizophrenia]].<ref name="Schrank et al. 2008" />

Hope is a powerful protector against chronic or life-threatening illnesses. A person’s hope (even when facing an illness that will likely end their life) can be helpful by finding joy or comfort. It can be created and focused on achieving life goals, such as meeting grandchildren or attending a child’s wedding. Hope can be an opportunity for us to process and go through events, that can be traumatic. A setback in life, an accident, or our own final months of living can be times when hope is comfort and serves as a pathway from one stage to the next.<ref>{{cite web |last1=Stern |first1=Adam |title=Hope: Why it matters |date=16 July 2021 |url=https://www.health.harvard.edu/blog/hope-why-it-matters-202107162547 |access-date=November 19, 2022}}</ref>

Hope is a powerful emotion that drives us to keep working and moving forward. It gives us the power to survive. In a study conducted by Harvard, Curt Richter experimented with 12 wild rats and 12 domesticated rats. The wild rats, known for their great swimming abilities, survived for only about two minutes when placed in a glass container of water with no way of escape. In contrast, the domesticated rats survived for days.<ref>{{cite web |last=Richter |first1=Curt |title=On the Phenomenon of Sudden Death in Animals and Man |date=July 1957 |url= https://journals.lww.com/psychosomaticmedicine/abstract/1957/05000/on_the_phenomenon_of_sudden_death_in_animals_and.4.aspx |access-date=December 1, 2024}}</ref> Curt attributed this difference to hope. The domesticated rats hoped to be saved from drowning, but the wild rats had no such hope, as they had never experienced rescue.

Curt decided to run another experiment with 12 wild rats. He placed them in water, and when they were about to drown, he took them out and held them briefly, creating an experience of hope. He then returned the rats to the water to observe how long they would tread water. Remarkably, they survived just as long as the domesticated rats—about 60 hours. With hope, the rats went from surviving for 2 minutes to treading water for 60 hours.

Hope is a powerful emotion. It drives us to move faster, further, and longer than we thought possible. But for hope to thrive, it must be anchored in something more powerful than ourselves. The rats had hope that a saving hand would come and lift them out of the water. <ref name=":1" />

=== Applications ===
The inclusion of hope in treatment programs has potential in both physical and mental health settings. Hope as a mechanism for improved treatment has been studied in the contexts of PTSD, chronic physical illness, and terminal illness, among other disorders and ailments.<ref name="Phillips 2012">{{cite web|last1=Phillips|first1=Suzanne|title=Does Hope Really Make a Difference? Scientific Findings|url=http://blogs.psychcentral.com/healing-together/2012/07/does-hope-really-make-a-difference-scientific-findings/|website=PsychCentral|access-date=20 April 2015|date=August 2012|archive-date=21 April 2015|archive-url=https://web.archive.org/web/20150421220612/http://blogs.psychcentral.com/healing-together/2012/07/does-hope-really-make-a-difference-scientific-findings/|url-status=dead}}</ref><ref name="Schrank et al. 2008">{{Cite journal|last1=Schrank|first1=Beate|last2=Stanghellini|first2=G|last3=Slade|first3=M|title=Hope in psychiatry: a review of the literature|journal=Acta Psychiatrica Scandinavica|volume=118|issue=6|pages=421–33|doi=10.1111/j.1600-0447.2008.01271.x|pmid=18851720|year=2008|s2cid=205802998|url=https://kclpure.kcl.ac.uk/portal/en/publications/hope-in-psychiatry-a-review-of-the-literature(d22cdded-f92e-4240-9e94-868928a538f6).html|type=Submitted manuscript}}</ref> Within mental health practice, clinicians have suggested using hope interventions as a supplement to more traditional [[Cognitive behavioral therapy|cognitive behavioral therapies]].<ref name="Schrank et al. 2008" /> In terms of support for physical illness, research suggests that hope can encourage the release of [[endorphins]] and [[enkephalin]]s, which help to block pain.<ref name="Enayati 2013">{{cite news|last1=Enayati|first1=Amanda|title=How hope can help you heal|url=http://www.cnn.com/2013/04/11/health/hope-healing-enayati/|website=CNN|access-date=20 April 2015}}</ref>

=== Impediments ===
There are two main arguments based on [[Decision-making|judgment]] against those who are advocates of using hope to help treat [[Catastrophic illness|severe illnesses]]. The first of which is that if physicians have too much hope, they may aggressively treat the patient. The physician will hold on to a small shred of hope that the patient may get better. Thus, this causes them to try methods that are costly and may have many side effects. One physician noted<ref>{{cite web|last1=Jarrett|first1=Christian|title=Is it ethical to instill false hope?|url=http://digest.bps.org.uk/2013/09/is-it-ethical-to-instil-false-hope-in.html|website=Research Digest|access-date=2 April 2015}}</ref> that she regretted having hope for her patient; it resulted in her patient suffering through three more years of pain that the patient would not have endured if the physician had realized recovery was unfeasible.

The second argument is the division between hope and [[wish]]ing. Those that are hopeful are actively trying to investigate the best path of action while taking into consideration the obstacles. Research<ref name="Enayati 2013" /> has shown though that many of those who have "hope" are wishfully thinking and passively going through the motions, as if they are in denial about their actual circumstances. Being in [[denial]] and having too much hope may negatively impact both the patient and the physician.

=== Benefits ===
The impact that hope can have on a patient's recovery process is strongly supported through both empirical research and theoretical approaches. However, reviews of literature also maintain that more longitudinal and methodologically sound research is needed to establish which hope interventions are actually the most effective, and in what setting (i.e. [[Chronic condition|chronic illness]] vs. [[terminal illness]]).<ref name="Schrank et al. 2008" />