DIET & NUTRITION 
PATIENT EDUCATION 
OBESITY/WEIGHT MANAGEMENT 
EXERCISE/TRAINING 
LEGAL MATTERS 
GUIDELINES/RECOMMENDATIONS 
A survey of 60 bereaved parents whose children died from cancer revealed hope evolved as prognosis worsened—initially meaning cure, later shifting to quality of life, comfort, and small milestones like celebrating birthdays early. Some parents described hoping for “something other than a cure” as feeling like giving up, while others completely lost hope as cancer progressed, highlighting nurses’ critical role in reframing care transitions.
⚖️ CLINICAL CONSIDERATIONS
- Faith provided a lifeline for many parents but not all: wait for families to initiate faith discussions rather than imposing spiritual conversations
- Parents’ definition of hope is highly subjective and changes throughout the cancer journey, requiring ongoing assessment rather than one-time conversation
- Saying “There’s nothing more we can do” communicates abandonment and destroys hope; instead use “redirecting care” language when transitioning from curative to comfort-focused treatment
- False reassurance (“Everything will be okay,” “This treatment works most of the time”) hinders meaningful conversation and creates uncertainty or new worries for families
🎯 PRACTICE APPLICATIONS
- Ask “What does hope mean to you?” and “What do you hope for your child?” at different points in the cancer journey, recognizing answers will change
- Set small, achievable short-term goals (child participates in meal selection 3x/week, expresses interest in play once daily) and celebrate these wins with parents
- Use supportive language: “We’ll be here every step of the way” or “What matters most to you and your child right now?” paired with honest prognosis discussions
- Avoid phrases suggesting uncertainty: Instead of “This treatment works most of the time,” say “They’re receiving excellent care and every child reacts differently”
- Refer to pediatric palliative care teams early after diagnosis to help with symptom management, community resources, and quality of life support
- Include child in age-appropriate conversations—wait for child to ask questions, avoid offering information they don’t request
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