How does information influence hope in family members of traumatic coma patients in intensive care unit?

AIMS: To assess the interplay between hope and the information provided by health care professionals.

BACKGROUND: Earlier research learned that hope is crucial for relatives of traumatic coma patients. Also it has been reported that the need for information is extremely important for relatives of critically ill patients.

DESIGN: A qualitative approach according to the 'grounded theory' method with constant comparison was used.

METHOD: We held 24 in-depth interviews with 22 family members of 16 patients with traumatic coma. Data processing and data analysis took place in a cyclic process wherein the induction of themes was alternated by confrontation with new material.

RESULTS: Family members of traumatic coma patients want information that is as accurate as possible, provided by doctors and nurses in an understandable manner and leaving room for hope. At first, family members can do no more than passively absorb the information they receive. After some time, they actively start working with information and learn what to build their hope on. In this way, concrete hope evolves and seems to be strongly determined by information. Information that is more positive than warranted is not appreciated at all. It leads to false hope and once its real nature becomes apparent, to increased distress and loss of trust in the professionals.

CONCLUSION: The process of hope is crucial in coping with traumatic coma and information can facilitate this process.

RELEVANCE TO CLINICAL PRACTICE: If professionals, especially nurses, keep the process in mind that family members go through in handling information, they can not only facilitate this process but also help them to establish realistic hope.