Hope-Oriented Care in Palliative Care: Relational and Organizational Perspectives From Nurses

Objectives Hope is a dynamic, relational dimension of palliative care; little is known about how nurses themselves perceive and navigate hope-oriented practice. This study aimed to explore experienced palliative care nurses’ perceptions of the relational and organizational barriers, facilitators, strategies, and practices involved in supporting hope. Methods A qualitative, exploratory, descriptive study was conducted using a single online focus group with 8 nurses experienced in palliative care. Data were analyzed using inductive content analysis following Bardin's approach. Results Four interconnected categories emerged: challenges in supporting hope (symptom control, limited time and availability, environmental and organizational constraints, and documentation limitations); facilitators of hope-oriented care (preserving autonomy, honest communication, family involvement, and genuine presence); organizational and team-level strategies (teamwork, nurse case management, and standardized instruments); and person-centered hope-promoting practices (personalized goals and dignity and meaning oriented care). Findings indicate that hope-oriented care depends not only on relational competencies but also on organizational conditions that enable continuity, documentation, and coordination. Conclusions Supporting hope in palliative care should be understood as both a relational and an organizational responsibility.