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The purpose of this study was to explore, using grounded theory, the process through which adolescents with cancer move to achieve hopefulness. The sample, 58 adolescent oncology patients, had varying diagnoses and were in different stages of treatment. Data were collected through interviews, observations, and review of health care records. A subset of 11 adolescents was interviewed to validate study findings. Four sequential concepts (cognitive discomfort, distraction, cognitive comfort, and personal competence) emerged to represent the process adolescents experience to achieve hopefulness. The overall organizing construct, induced from the four core concepts, was labeled self-sustaining and defined as a natural progression adolescents who are experiencing serious health threats move through to comfort themselves and to achieve competence in resolving health threats. Results indicated adolescents are able to initiate effective and preferred strategies to achieve hopefulness and competence in resolving health threats.
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