The trajectory of hope: Pathways to find meaning and reconstructing the self after a spinal cord injury

Abstract

Study design:This is a qualitative study.Objectives:To evaluate and track the importance and the continuum of hope, and its trajectory, from the point of view of the individual with a spinal cord injury (SCI) and a rehabilitation psychologist.Setting:This study was conducted in the Indian Spinal Injuries Centre, New Delhi, India, and in patients' homes in the National Capital Region, India.Methods:Twenty individuals with an SCI were interviewed for the study at intervals of 2 weeks, 6 months, 1 year and 2 years since the time of the injury. Semi-structured interviews were conducted, in which the following theoretical research questions were investigated: 'What is the meaning, relevance and significance of hope in the individual's life following an SCI? Does the meaning and subject of hope change at different points in time?'Results:Three distinctive themes markedly emerged in the trajectory of hope: (1) Hope for a complete recovery; (2) hope for self-reliance despite the injury; and (3) hope for an optimum quality of life. The make-up of each theme, its significance and contribution to recovery and/or rehabilitation, while tracking the influence of time since injury, family and friends, as well as other agencies and pathways, are discussed.Conclusion:After sustaining a life-altering injury, hope becomes the force that spurs individuals. Psychologists and rehabilitation counselors need to focus on instilling realistic hope, goal setting, sustaining motivation, enabling adaptive appraisals and problem-solving. Further recommendations include developing and testing interventions against the context of the continuum of hope.