Exploring the Experiences of Chronic Patients in Sustaining Treatment Adherence Amid Hopelessness: A Qualitative Phenomenological Study

Abstract

This study aimed to explore the lived experiences of patients with chronic illnesses in sustaining treatment adherence under conditions of hopelessness and to identify key factors influencing their therapeutic persistence. This qualitative study adopted a phenomenological approach. Eighteen chronic patients residing in Tehran were selected through purposive sampling until theoretical saturation was achieved. Data were collected using semi-structured interviews and analyzed through thematic analysis with the aid of NVivo 12 software. Thematic analysis revealed three main categories: (1) Lived experiences of hopelessness, including perceived therapeutic inefficacy, lack of social support, financial burdens, fear of the future, and distrust in the healthcare system; (2) Hidden motivators for treatment adherence, such as meaning-making, emotional support from close individuals, hope for change, family responsibility, and religious faith; and (3) Coping strategies like active illness acceptance, emotional regulation, lifestyle modification, and engagement in support groups. Patient narratives demonstrated the complex and dynamic nature of maintaining treatment amidst psychological adversity. The experiences of chronic patients in adhering to treatment despite hopelessness are shaped by intertwined psychological, social, and cultural factors. Recognizing these dimensions is essential for developing human-centered, integrative interventions aimed at enhancing resilience and treatment adherence.