Degree Of Hope Research Articles

Abstract 12687: Race, Resilience, and Health Literacy Are Important to Medication Adherence in Those With Heart Failure

Background: Personal and psychological factors, such as depression, have a considerable influence on nonadherence to medications and self-care in those with heart failure. More evidence, however, is needed about positive personal factors that motivate adherence to medications and self-care in those with heart failure. Objective: The purpose of this study was to investigate whether there was a consistent and predictable relationship between the personal resources of resilience, hope, health literacy, social support, and self-care activation and adherence to medications and HF self-care and whether race impacts adherence. Methods: This study used a prospective, cross-sectional design. Correlation and multiple regression analyses were used to estimate associations between study variables. A nationwide, diverse sample was recruited for this study. Results: Of the 174 participants, 51% were female, 48% were persons of color (POC) and the mean age was 62 years. Medication adherence and health literacy were significantly lower among POC compared to Whites. POC were more likely to be under 65 years, single, and have a lower income. Following adjustment for differences in age and depressive symptoms, a predictive relationship remained between resilience (B = -0.049, p < 0.001), health literacy (B = -0.258, p = 0.003) and medication adherence. A high level of perceived social support (B = 5.359, p < 0.001) was a predictor of better HF self-care. Conclusion: Persons with heart failure may have better medication adherence and overall self-care if sufficiently resilient, health literate, and supported regardless of their degree of hope or activation. Race and age may be important factors to consider. More research is needed to understand the relationship between resilience and medication adherence.

The Impact of Resilience, Health Literacy, and Social Support on Medication Adherence and Self-care Among Adults With Heart Failure.

Personal and psychological factors, such as depression, have a considerable influence on nonadherence to medications and self-care in those with heart failure. More evidence is needed about positive personal factors that motivate adherence to medications and self-care in those with heart failure. The purpose of this study was to investigate whether there was a relationship between the personal resources of resilience, hope, health literacy, social support, and self-care activation and adherence to HF self-care and medications and whether race impacts adherence. This study used a cross-sectional, correlational design. Stepwise regression was used to test whether resilience, hope, health literacy, self-care activation, and race significantly predicted medication adherence and self-care. A diverse sample was recruited for this study. Of the 174 participants, 51% were female, 51.7% were White, and the mean age was 62 years. After adjustment for differences in age and depressive symptoms, a predictive relationship remained between resilience, health literacy, and medication adherence. Hope, activation, and race were not selected in the final regression model. A high level of perceived social support was the only predictor of better HF self-care. Persons with heart failure may have better medication adherence and overall self-care if sufficiently resilient, health literate, and supported regardless of their degree of hope or activation. Race and age may be important factors to consider. More research is needed to understand the connection between resilience and medication adherence.

Separatist Presbyterianism in 20th Century Scotland

This essay aims to give an account of separatist Presbyterian denominations in the context of Christianity in Scotland in the 20th century. After a brief introduction, attention is first given to the circumstances in which the denominations concerned were birthed. A second section looks at their current place within the wider Scottish context. In the third section, further attention is paid to the two most recent, late 20th century, divisions, those of 1989 and 2000. Concluding reflections seek to view the scene, thus sketched, through a wider lens and to look to the future with a degree of hope for reconciliation and healing. This paper is indebted to the invaluable insights, particularly in regard to the content of its third section, of the Revd Archie McPhail. Sincere thanks are also due to the Revd Martin Keane, Principal Clerk of the United Free Church, and the Revd David Meredith, Mission Director of the Free Church of Scotland, for their gracious and helpful responses to specific queries about their respective denominations. Any errors of fact or judgement are of course those of the author. In writing on a subject as difficult—and painful—as this, one inevitably brings personal perspectives to bear. Those of this writer have inevitably been formed, at least in part, in the context of an unusual ecclesiastical journey within the territory of three denominations—the Free Presbyterian Church, the Associated Presbyterian Churches and the Church of Scotland. Personal involvement in the history and denominational transfers of recent decades, together with long service as a parish minister and experience as a former Moderator, lend to the paper its distinctive angle of approach.

‘The Troubles’ and the Peace Process in Northern Ireland in Seamus Heaney’s "The Cure at Troy"

Based on "Philoctetes", the tragic play by Sophocles, the poet Seamus Heaney creates his own version in "The Cure at Troy" to present the political and social problems in Northern Ireland during the period that became known euphemistically as ‘the Troubles’. This paper aims to highlight the significance of Heaney’s play in the final years of the conflict. Heaney uses the classical Greek play to bring to light the plight and suffering of the Northern Irish people as a consequence of the atavistic and sectarian violence between the unionist and nationalist communities. Nevertheless, Heaney also provides possible answers that allow readers to harbour a certain degree of hope towards peace and the future in Northern Ireland.

Humiliated Consciousness in Ronnie Govender’s The Lahnee’s Pleasure and Ben Okri’s In Arcadia

Ronnie Govender entitled both his major play (Johannesburg: Ravan Press, 1977) and his later novel (Johannesburg: Jacana, 2008) The Lahnee’s Pleasure, articulating that life was, and still is, a pleasure ground for a privileged minority in South Africa. Over a period of three decades, spanning both the periods before and after apartheid, his assessment of political conditions in the country of his birth remains as valid. Lao, in Ben Okri’s In Arcadia, reveals how much of life in Europe today remains a “fairground for the favoured” (London: Head of Zeus, 2014, 108) and how little pampered and privileged people such as Jim, the director of the film project in this novel, see or comprehend of what is so often a secret ordeal for a person of colour. Okri writes of conditions and perceptions in contemporary Britain, while Govender writes of South Africa up to the present time; yet despite the many differences in their social contexts, their delineation of conditions that surround a person of colour living in British or South African society shows that interracial equality and brotherhood are still distant ideals in both countries. Both writers, however, do hold out a measured degree of hope in their depiction of Wordsworthian figures of humble labour: Mothie in Govender’s novel and the train driver in Okri’s.

Application of positive behavior management in patients after breast cancer surgery.

BACKGROUNDAs a radical treatment, breast cancer surgery has a positive psychological impact on most patients. However, some patients do not have a clear understanding of the disease, which requires a more scientific and comprehensive consideration during clinical intervention and are based on cognition. The positive behavior management model is based on this kind of background-derived new interventions, which can better serve the clinical rehabilitation process of patients. The positive behavior management model based on cognitive architecture is a new type of intervention derived from this background, which can better serve the clinical rehabilitation process of patients.AIMTo analyze the influence of a positive behavior management model based on cognitive framework on the degree of hope and self-efficacy of patients with breast cancer surgery.METHODSEighty-four patients with breast cancer who underwent surgical treatment in our hospital from August 2016 to December 2018 were included in the study. The patients were divided into the experimental group (n = 42) and control group (n = 42) by random number table grouping. The control group received traditional nursing intervention, while the experimental group received a positive behavior management model based on cognitive framework based on the traditional intervention of the control group. General Self-efficacy Scale, Herth Hope Scale, Self-Rating Anxiety Scale, Self-Rating Depression Scale and Cancer Patient Specific Scale were used to evaluate the two groups before and 1 wk after intervention.RESULTSAfter the intervention, self-efficacy and hope level of the experimental group were significantly higher than those of the control group (P < 0.05). The Self-Rating Anxiety Scale and Self-Rating Depression Scale scores in the experimental group were significantly lower than those in the control group (P < 0.05). There was no significant difference in the quality of life scores between the two groups before intervention (P > 0.05). The quality of life scores in all aspects in the experimental group after intervention were significantly higher than those in the control group (P < 0.05).CONCLUSIONThe positive behavior management model based on cognitive framework applied to patients with breast cancer surgery improved hope for treatment and self-efficacy, reduced negative emotion, and improved quality of life.

Impact of emotion-based nursing on the degree of hope and the quality of life of patients with hepatocellular carcinoma

Objective To explore the impact of emotion-based nursing on the degree of hope and the quality of life of patients with hepatocellular carcinoma. Methods A total of 100 patients who had undergone liver-cancer surgery in the department of General surgery of our hospital between March 2014 and October 2015 were selected as the research objects.They were divided into an observation group and a control group according to the random table method, with 50 cases in each group.Patients in the control group received routine nursing, whereas those in the observation group were given the emotion-based nursing. The degree of hope, quality of life, depression, quality of sleep and the satisfaction of the two groups were compared before and after nursing. Results After intervention, the scores of hope level of the two groups were both improved, and the scores of the observation group were higher than that of the control group, and the difference was statistically significant (P<0.05). Besides, the scores of physical function, cognitive function, social function and emotional function of patients of the observation group were shown to be significantly higher than that of the control group, and the differences were statistically significant (P<0.05). After intervention, the scores of depression of the two groups were both reduced, and the reduction of the observation group was significantly higher than that of the control group, and the difference was statistically significant (P<0.05). After nursing intervention, the satisfaction rate of the control group was shown to be significantly lower than that of the observation group, and the difference was statistically significant (P<0.05). Conclusion Compared with the conventional General surgery nursing, the emotion-based nursing was shown a better application effect, which can significantly improve the quality of life and sleep of patients, alleviate their negative emotion, and increase their confidence in treatment.Therefore, it has high value in clinical application. Key words: Emotion-based nursing; Liver cancer; Level of hope; Quality of life; Negative emotion

The Determinants of Happiness in Turkey: Evidence from City-Level Data

This paper analyses the determinants of happiness in Turkey between 2004 and 2013 by relying on TURKSTAT’s Life Satisfaction Surveys. It contributes to the literature by employing a set of novel variables and a larger dataset which became representative at city-level in 2013. Some of the interesting findings are as follows: degree of hope is found to be the strongest estimator of happiness which was neglected in previous studies; job satisfaction is as important as being employed. Similarly, being married makes people happier only if they are satisfied from their marriage. Education brings more happiness only if it helps to increase income. Moreover, our results support Easterlin Paradox (Nations Househ Econ Growth Essays Honor Moses Abramovitz 1974. doi: 10.1016/B978-0-12-205050-3.50008-7 ). We have shown that happiness and income share a potent and positive relationship when yearly or pooled micro datasets are analysed, which has not been observed in macro data.

The relationship between alliance ruptures and hope for change through counseling: A mixed methods study

The negative impact of alliance ruptures on clients’ experiences within the therapeutic process is well documented. One such negative influence may include clients’ hope for counseling as a helpful process. This study used a mixed methods design to explore how alliance ruptures are related to hope for change through counseling. Quantitative data (N = 105) indicated that those who experienced ruptures reported lower levels of the components of hope for change through counseling, (a) pathways and agency, and (b) goal identification. More frequent ruptures and rupture repairs were significantly related to participants’ (n = 35) pathways and agency. Phenomenological analysis of qualitative participants’ (N = 5) experiences elicited 218 meaning units grouped into four themes: disengagement and mistrust in therapy, deepened distress, questioning one’s hope for and belief in therapy, and resilience for therapy. Qualitative and quantitative data indicate that alliance ruptures are related to lower degrees of hope for change through counseling. Results suggest that clients’ perceptions of ruptures fostered disengagement and mistrust of therapists. However, when therapists act to repair ruptures, they may effectively re-engage some degree of hope for change through counseling in clients. Lastly, the role of clients’ persistence in therapy despite experiencing ruptures is discussed.

Hope Maintenance in People Living Long‐term with HIV/AIDS

Background: The introduction of antiviral agents, most particularly ‘highly active antiretroviral therapy’ (HAART), has changed the very nature of the care for persons with HIV and/or AIDS, from preparing patients to die to assisting patients with living with a chronic illness. Despite this dramatic turnaround in prognosis, the limited literature available indicates that these individuals often do not have a high degree of hope for the future. Accordingly, this study seeks to explain how hope might be inspired and maintained in people living long‐term with HIV/AIDS (the so‐called ‘Lazarus Syndrome’). Design: The study used a modified Glaserian grounded theory method and was conducted in the United States of America. A total of 10 participants were selected by means of theoretical sampling. Methods: The study adhered to the principal features of Glaserian Grounded Theory, namely: (a) theory generation, not theory verification; (b) theoretical sampling; (c) the constant comparative method of data analysis; and (d) theoretical sensitivity (searching for/discovering the core variable, one which identifies the key psychosocial process and contains temporal dimensions or stages). Further, the authors ensured that the study was concerned with generating conceptual theory, not conceptual description. Findings/conclusion: The findings indicate that the key psychosocial problem (i.e. the maintenance of hope) is addressed through the core variable, ‘Turning from death to life: finding new meaning’. This parsimonious theory describes and explains a four‐stage process of hope maintenance consisting of the subcore variables: ‘Losing the Ontological Self’, ‘Turning from Death to Life’, ‘Finding Acceptance and Reconciliation’, and ‘Finding New Meaning’.

Germany and Neoconservatism: A Tragedy of Errors?

Abstract This article analyzes how neoconservatism is perceived in Germany and elsewhere in Old Europe, contrasts the misperceptions of the tenets of neoconservatism with its actual political and ideological substance, formulates a basic definition of contemporary neoconservative thought on foreign policy, and concludes that Germans and Americans have drawn fundamentally different lessons from history and therefore face the challenges of the twenty-first century with completely different mind-sets. Finally, the author offers some degree of hope for achieving a revitalized and sustainable transatlantic relationship by providing an outline of possible ways to achieve that objective.

The Role of Hope in the Psychological Adjustment of Gastropareutic Patients Receiving the Gastric Pacemaker: A Longitudinal Study

Hope, depressive symptoms, anxiety, and physical quality of life (QOL) were assessed in three subgroups of patients receiving the gastric pacemaker. Patients (n = 22) completed questionnaires prior to pacemaker implantation and at 3 and 6 months post-surgery. The idiopathic subgroup reported a significantly greater degree of hope and less anxiety at 6-month follow-up, compared to the diabetes patients. The idiopathic patients also reported significantly less anxiety at 6 months than the postsurgical patients. Across all subgroups, there was an increase in hope and physical QOL, and decrease in depressive symptoms and anxiety, from baseline levels. There was a significant negative relationship between hope and both depressive symptoms and anxiety at baseline and 3- and 6-month follow-up. Presurgical hope level did not significantly predict depressive symptoms or anxiety after implantation. This study provides evidence that the pacemaker improves the physical and psychological health of gastropareutic patients; hope appears to play a role in the psychological adjustment of these patients.

A Strategy for Hope: A Commentary on Necessary Collusion

In the past, people with an incurable cancer were not informed of the reality of their condition—a charade of “don’t tell/ don’t ask” was played by physician and patient. Now, we work under the assumption that patients and their families deserve the truth. How can hope be sustained without elision or fabrication? Helft believes that this is possible through “collusion.” He builds an argument that it is ethical, indeed beneficial, to communicate with patients in a metered way, gradually adding or subtracting a degree of hope based on unfolding clinical events. This collusive approach is rooted in the paradox of uncertainty. Everyone with illness, but most squarely those with severe and lifethreatening disease, faces the fact that nothing in medicine is absolute. On the one hand, this is a source of anxiety, because there are no guarantees that a drug or procedure will succeed one hundred percent of the time. On the other hand, the absence of absolute certainty provides a basis for hope. Even the worst disorders have the potential for an unexpected outcome. Yes, their outcomes statistically cluster around a median and a mean, but there also can be cases at the far end of the distribution. After years in practice, most oncologists encounter these extended limits of the curve. There is the unusual case of a patient with advanced malignancy whose remission lasted years instead of months, or the even rarer case who completely defied the odds and entered a sustained complete remission. I still care for a woman, who more than 20 years ago, presented with inflammatory carcinoma of the breast and an underlying 8 cm primary mass; her tumor has waxed and waned with no significant clinical morbidity on treatment with a series of hormonal agents. A physician colleague of mine with metastatic gastric carcinoma has no evidence of disease 17 years after surgery, chemotherapy, and radiation. One woman with multiple cerebral metastases from breast cancer had 5 years of quality of life before relapsing and dying. And patients I saw as a consultant later died of “natural causes,” following many years in remission from CNS lymphoma or metastatic non–small-cell carcinoma of the lung. Some are critical of doctors who refer to such rare cases and the uncertainty that they illustrate. These critics assert that rarities are a wellspring of false hope for people who should squarely face their imminent demise. They further contend that raising the specter of a positive outcome manipulates patients and their families into pursuing therapies that are toxic and clinically worthless, therapies that cost society large sums. The strategy of collusion largely deflects such criticisms, since the approach is sculpted to the clinical course of the individual. If the initial period of treatment proves terribly toxic and ineffective against the malignancy, then this result serves as a platform for reassessment of the therapeutic plan and focuses the patient and his family on the more certain negative outcome. But if the tumor regresses and the patient can enjoy some quality of life with the particular treatment, then it becomes more probable that the person’s own biology and the biology of the tumor may move him further along the outcome curve, away from the median and mean. Helft convincingly argues it is From the Harvard Medical School, Division of Experimental Medicine, Beth Israel Deaconess Medical Center, Boston, MA.

DISTRIBUTIVE JUSTICE AND VOCATIONAL EDUCATION

ABSTRACT: This paper considers the relationship between distributive justice and vocational education. It examines both the way that the very notion of a vocational education carries implications for distributive justice and how the meaning of justice itself might be shifting towards one of inclusion. The argument, which is based on the recent work of Bernard Williams (2002), may have some general explanatory and predictive power particularly relevant to the educational uses of certain terms. ‘Vocational’ is used in the paper as an exemplar. It is argued that consideration of what is just in any liberal society involves weighting the application of principles in ways that respect the shared values of that society. These values are communicated partly through hopeful myths that enable social cohesion. One such set of myths currently serves to sustain some degree of hope that emphasis on the vocational in education will enable distributive justice. Increasingly however experience of and research within vocational education reveals some truths that challenge these myths. Neither myth nor truth floats free of structure, however, and the paper also includes discussion of the ways that structure, truth and myth are related.

Forholdet mellom håp og smerte hos menneske med revmatoid artritt!

Hope is an expression of motivation, and is individual in both sick and healthy. In chronically ill this difference is made visible by the many who seem to have a high morale and the others who seem to give up, experience hopelessness. The aim of this study is to investigate to which extent hope is present in people with arthritis, and if there is a relationship between self-reported hope and pain. The study is a descriptive survey. Hope is measured with Nowotny Hope Scale (NHS) and pain is measured with (one of the nine dimensions) in Arthritis Impact Measurement Scale (AIMS). Results reveal that most respondents indicate a moderate degree of hope. Regarding pain many reports a lot with high intensity. There is no significant correlation between degree of hope and frequency and intensity of pain. Results indicate that pain may not directly affect degree of hope. One can speculate that hope then may be a more person dependent variable, and as such less changeable. However, a challenge to nurses is further...

Nueva Granada: Paul Horgan and the Southwest by Robert Franklin Gish

Reviews 187 conceived graduate thesis that proves the scholar’s fam iliarity with the stan­ dard literary and critical works without contributing significant new interpre­ tation of Carver’s fiction. Introducing the study, N esset places Carver in the tradition of Hemingway, Anderson, O’Hara, Cheever, Kafka, Turgenev, and Chekov, claim ing for Carver’s fiction a moral center w hile it explores the disenchantments of post­ modern humanity. Chapter One, “ ‘This Word L ove’: Sexual Politics and Silence in Will You P lease Be Quiet, P lease ?” explores particularly the force o f love and the issue of the lim itations of language as they appear in Carver’s first volum e of fiction. Characters find that love com plicates and dominates their lives, often com ­ pelling them to engage in sexual politics that further encumber them and lead them to ineffectual use of language or to silence. Even so, these characters usu­ ally continue their struggles rather than surrender to them. In the second chapter, “The Power o f Style in What We Talk A bout When We Talk About L ove,” N esset responds to the labeling of Carver as a m inimal­ ist w hile claim ing that Carver consistently “affords his characters liberty to act as they might . . . in a fictive universe . . . fundamentally lacking in individual freedom s.” N esset calls Carver’s style hyperextended realism and his treatment sympathetic. “Insularity and Self-Enlargem ent in C athedral” explores the stories that suggest the ability of man to insulate him self or to expand outward through gained awareness o f self. N esset focuses upon sym bols and metaphors Carver em ploys both as thematic matter and signature in the stories critics have called “affirm ative.” “ ‘Things Clearly Within My Pow er’: Communication and Control in the Last Stories” claim s that Carver renewed his original interest in characters who “struggle, mainly unsuccessfully, to comprehend the bleak realities o f their liv es,” and who “not only recognize freedom but typically articulate their recognitions, even if only to vent dismay at how im possible such freedom seem s in relation to their lives.” N esset states that these last stories are “more com prehensive, fuller rhetorically and thematically, while at the same time lighter in tone than the earlier work.” Characters persist, som etim es moving toward a crossroads, a better life, helped along by a degree of hope. DELORES W ASHBURN Hardin-Simmons U niversity Nueva Granada: Paul Horgan and the Southwest. By Robert Franklin Gish. (C ollege Station: Texas A&M University Press, 1995. 139 pages, $22.50.) Number Two in the Tarleton State University Southwestern Studies in the Humanities, Nueva Granada is a collection of eight essays on Paul Horgan and 188 Western American Literature two interviews with Robert Gish. The essays are reprints and revisions of papers which have previously appeared in scholarly journals over a period of some fourteen years (1979-1993). One interview is printed here for the first time. The essays address different aspects of Horgan as a writer of short fiction, novels, and historical-biographical works over more than fifty years. Each essay is com plete in itself, presenting a different dimension of a “remarkable but unfortunately neglected talent,” in the words of Lawrence Clayton. Several concentrate on his evocation of the Southwest, others on his historical writings with an emphasis on his comprehensive approach to presenting history, similar to the “omnidirectional history of Parkman.” Given his lengthy career and the number of his publications, this collection underlines the thematic unity that characterizes Horgan’s work— in Anaya’s words, the “magic realism of place.” Like W illa Cather, Horgan never fails to project the dynamics of the interaction between the character and his space, or as Gish phrases it, Horgan’s sympathy for “humanity and the places of its liv ­ ing.” M exico Bay, W hitewater, The Common H eart evoke powerfully this sense of people, place, and time. M ost of the essays, in one way or another, and parts of the two interviews address the theme of Horgan as a regionalist writer, a label Horgan him self does not seem to find particularly endearing— a non...

Pontine Glioma-Reply

In Reply.— Dr. Milhorat's case report is indeed of great interest, and it is unfortunate that the finding of a cystic astrocytoma, such as his patient had, is so extremely rare when one looks at the usual course and classification of brain stem tumors in children. 1 The purpose of our article was not to add confusion to the diagnosis and treatment of this very grave disease, but merely to point, with some degree of hope, to the fact that other treatments are being developed at major cancer centers that some day may be combined with the initial treatment of surgery and radiation therapy, which to date have offered only palliative treatment for the overwhelming majority of patients with solid astrocytomas of the brain stem. The patient that we reported did have computerized transaxial tomography (CTT) with intravenous contrast performed at our institution. It disclosed a large, solid mass; however,