Hope in action—facing cardiac death: A qualitative study of patients with life-threatening disease

Coping with existential challenges is important when struck by serious disease, but apart from cancer and palliative care little is known about how patients deal with such issues and maintain hope. To explore how patients with life-threatening heart disease experience hope when coping with mortality and other existential challenges, we conducted a qualitative study with semi-structured interviews. We made a purposive sample of 11 participants (26–88 years) who had experienced life-threatening disease: eight participants with serious heart disease, two with cancer, and one with severe chronic obstructive pulmonary disease. Analysis was by systematic text condensation. The findings showed that hope could enhance coping and diminish existential distress when patients were confronted with mortality and other existential challenges. Hope was observed as three types of dynamic work: to shift perception of mortality from overwhelming horror toward suppression or peaceful acceptance, to foster reconciliation instead of uncertainty when adapting to the new phase of life, and to establish go-ahead spirit instead of resignation as their identity. Meaning of life could, hence, be sustained in spite of serious threats to the persons' future, everyday life, and self-conception. The work of hoping could be supported or disturbed by relationships with family, friends, and health care professionals. Hope can be regarded as an active, dynamic state of existential coping among patients with life-threatening disease. Physicians may support this coping and thereby provide personal growth and alleviation of existential distress by skillfully identifying, acknowledging, and participating in the work of hoping performed by the patient

The influence of menstrual cycle phase on skeletal muscle contractile characteristics in humans

The influence of the different phases of the menstrual cycle on skeletal muscle contractile characteristics was studied in 19 regularly menstruating women. Muscle function was measured when (i) oestrogen and progesterone concentrations were low (menstruation), (ii) oestrogen was elevated and progesterone was low (late follicular phase), and (iii) oestrogen and progesterone were both elevated (luteal phase).Maximal isometric quadriceps strength, fatiguability and electrically stimulated contractile properties were measured. Isokinetic knee flexion and extension strength and fatiguability were also assessed as well as handgrip strength. Menstrual cycle phases were confirmed through measurement of oestrogen, progesterone, follicle stimulating hormone and luteinising hormone.No significant changes were found in any of the muscle function parameters throughout the menstrual cycle (n = 15). The muscle function measurements showed no significant correlations with any of the female reproductive hormone concentrations.These results suggest that the fluctuations in female reproductive hormone concentrations throughout the menstrual cycle do not affect muscle contractile characteristics