Table 1 Categories, subcategories, and meaning units of the factors related to hope in the patients under hemodialysis

Hope as particular things to happen

Having positive thoughts

Thinking about positive events, thinking about future and ignoring the renal failure, seeing the future clearly, having good dreams

Expectation and desire for future things

Being healthy after hemodialysis, coming back home after hemodialysis, being recipient of kidney transplantation, being a healthy person, and having a good life without any disease complication

Having goal-oriented thoughts, developing strategies to achieve goals, and being motivated to expand effort to achieve goals

Having goals in the life, thinking about buying a house, getting a job in future, waiting for the children go to the university, being successful in the family functions, job, social relationship and life in spite of renal failure and undergoing hemodialysis

Having family support in future

Having a family that understand, love, care and accept the patients with all of their disease limitations, and living with the husband and children at the same home

Opportunities and threats to achieve hope

Physical challenges

Changes in appearance like turning pale, swelling under the eyes, dark spots on the face, and skin color changes may affect the patients’ hope

Challenges in social interactions

Dialysis ward environment, presence of other patients, seeing other patients’ problems while communicating with them, restrictions for choosing a place to travel, challenging trips may affect the patients’ hope

Educational failure

Inability to continue education, physical and mental problems in the classroom may be correlated to hope

Economic challenges

Losing one’s properties for treating the disease, cost of referral to the hemodialysis center and transplantation, financial problems for following up the treatment process

Occupational limitations

Job restrictions for patients, obligation for choosing specific jobs, quitting job due to the disease, impatience for finishing works may affect the patients’ hope

Familial conflicts

Challenges for choosing a spouse, being rejected by the family, inability to fulfill one’s role in the family affect the hemodialysis patients’ hope

Spirituality

Belief in a supreme power named God as the source of hope, belief in the purposefulness of the world and creation of living things, belief in God as the creator of life, belief in the fact that being thankful leads to blessing in life, and considering the disease as a divine destiny may increase the patients’ hope

Negative emotions as barriers to achieve hope

Depression

Impatience in doing personal and social activities, being intolerant and unmotivated, considering nothing as important in life, being isolated, feeling alone, crying, tendency to die are barriers to achieving hope

sadness

Being sad due to physical and social limitations are barriers to achieving hope

uncertainty

Lack of confidence in being ready for transplantation and transplant rejection are barriers to achieving hope

Anger and hate

Being nervous, getting angry by even simple stimulants, showing aggressive behavior, hatred of dialysis barriers to achieve hope

Positive coping strategies to achieve hope

Positive solution-oriented strategies

Modification of goals, using positive and solution-oriented strategies are to achieving hope

Staying motivated

Making attempts, listening to music, grooming oneself, banishing negative emotions, taking part in recreational activities to achieve hope

Positive psychological constructs

Positive thinking, positive expectations, cheering oneself up, comforting oneself, being thankful to achieve hope

Supportive exchanges

Emotional, informational, instrumental, and spiritual supports to achieve hope

Connection to transcendence

Talking to God, praying, hope in God, complaining to God to achieve hope

Growth and excellence as outcomes of hope

Improvement of well-being

Optimism, happiness, vitality, being energetic, gaining tranquility, health, building better social relationships with others, promotion of self-efficacy, acceptance of the disease as outcomes of hope

Finding the meaning of life

Purposefulness in life, finding order in life, following goals in life, being interested in life, recognition of oneself and God, self-care, adherence to treatment, understanding life, love for continuation of life as outcomes of hope