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'.