Hope during the first months after acute spinal cord injury

Background. According to the general literature on hope, individuals who are hopeful live more positive lives than those who experience hopelessness. Hope has been defined as a positive orientation toward future improvements, and is associated with health and well-being. Aim. This paper reports a study that explored patients' experiences of hope following spinal cord injury. Method. Data were collected by personal interviews (n = 10) at a rehabilitation institution in Norway. A phenomenological-hermeneutic approach was used to extract the meaningful content of patients' experiences. The analysis was performed as a spiral process that included a reading to gain a sense of the whole, followed by identification of meaningful parts and a comprehensive and understandable interpretation of the whole. Findings. Two themes emerged: 'images of the past and future', and 'balancing between inner emotional dichotomies' that were, mainly, related to experiences of courage/uncertainty and patience/restlessness. Discussion. All participants experienced hope. The substance of hope - being able to walk again and hoping for recovery - was a universal experience among participants and was comprehended in terms of positive expectations. The process of hope involved continuous 'ups and downs'. Patients were in need of skilled nursing care to enable and foster hope during the first months following acute spinal cord injury. Conclusion. In conclusion, patients hoped for recovery and every improvement stimulated hope. The process of hope was future-oriented, characterized by dichotomies. Nurses need the skills to foster hope and enable recently injured patients to look beyond the immediate situation and direct their energies appropriately.