Patients suffering from chronic illnesses are likely to fare better without false hope for recovery, according to a recent study done by researchers at the University of Michigan Health System.

Published in this month’s edition of Health Psychology, the study looked at two groups of post-operative patients all of whom received colostomies — a medical procedure in which the colon is rerouted through an opening made in the abdomen.

As a result of undergoing the surgery, colostomy patients in both of these groups are forced to collect the products of their bowel movements in an external pouch.

One group consisted of patients who were told by their doctors that, after six months, a follow-up operation would be possible to reattach their colons. Patients in the other group were informed that their colostomies were irreversible.

Dr. Peter Ubel, a George Dock collegiate professor of medicine and one of the study’s authors, said the differing circumstances had a profound effect on each patient’s perceived satisfaction with life.

“By six months, most of the people in this permanent (colostomy) group bounced back to normal because they really adapted to their situations,” Ubel said. “The other group didn’t.”

The disparity in satisfaction level between the two groups appeared to depend on how quickly each patient accepted the situation, Ubel said. Colostomy patients who had expectations of a complete recovery were found to often postpone dealing with their present issues.

“While hope in most circumstances might be a good thing that promotes action and well-being, there may be times when it could backfire,” Ubel said.

Ubel, director of the University’s Center for Behavioral and Decision Sciences in Medicine, said he and his team sought to coordinate a study centered on factors of decision-making and hopefulness in context of participants’ reported levels of happiness.

“We looked for a natural experiment where people had very similar circumstances with one key difference in that one group saw no way out and another group could hold onto hope,” he said.

Colostomies, Ubel said, represented the sort of hurdle in which they were interested. Patients often feel embarrassed or stigmatized by the condition. It is, therefore, in a physician’s best interest to consider on a case-by-case basis when to give hope to chronic illness patients and when to rein it in, he said.

“We clinicians often think of hope as something that we can give to patients because it will boost their spirits and it’ll keep them fighting,” said Ubel. “We hate to take away their hope.”

Ubel said the negative impact of hope, however, can transcend clinical situations and maintain relevance to all aspects of life.

“A prisoner who is sentenced to life without parole is less likely to try to escape from prison than someone who has six months left on their sentence,” Ubel said as an example the connection between hope and decision-making.

“The person who is coming near the end of his sentence thinks about how much better life is going to be and can’t wait for that life to happen,” he said. “They’re miserable and have to get out.”

Ubel said the correlation between clinging on to hope and diminished quality of living has significant consequences for people who cannot resolve themselves to accept a situation and make the best of it.

“I think this is a phenomenon that goes way beyond healthcare,” said Ubel. “There are always times when people find themselves in challenging circumstances.”

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