title: Staff and patient views of the concept of hope on a stroke unit: a qualitative study.
abstract: OBJECTIVE
  This study explores the experience of hope for patients and staff in the context of a British stroke unit.
  
  
  BACKGROUND
  Hope is identified as a useful concept for exploring how people find meaning in recovery from illness. Uncovering the experience of hope in acute stroke care has provided evidence that can be used to facilitate rehabilitation.
  
  
  METHODS
  The methodology drew on the principles of ethnography, undertaking unstructured qualitative interviews with ten patients, ten multidisciplinary staff and 21 hours of participant observation including informal discussions with staff and patients. Data collection took place between November 2007 and November 2008.
  
  
  RESULTS
  Four themes were identified: suffering, struggling with no hope and despair, hope for recovery and realistic hopefulness. Hope was experienced in the context of suffering a stroke demonstrated as loss of function, loss of mental capacity and dependency. Patients struggled to maintain a sense of hopefulness while feeling close to a slippery slope towards despair and death. Hope was expressed as a strong desire to recover, get back to normal and a time to reflect on their lives so far. Staff identified realistic hopefulness as focused on keeping things real while balancing giving hope and avoiding false hope.
  
  
  CONCLUSIONS
  Hope is placed within the emotional challenges of suffering and struggle inherent in recovery from stroke. The staff work with patients' hopes but offer realistic hopefulness as a practical strategy for recovery. Further interventions are required for working with feelings of despair or no hope.
authors.affiliation: RCN Research Institute, University of Warwick, UK. liz.tutton@warwick.ac.uk
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Tutton
authors.forename: Kate
authors.initials: K
authors.lastname: Seers
authors.forename: Deborah
authors.initials: D
authors.lastname: Langstaff
authors.forename: Martin
authors.initials: M
authors.lastname: Westwood
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009741:Nursing Staff, Hospital / Q000523:psychology*; D010361:Patients / Q000523:psychology*; D036301:Qualitative Research; D020521:Stroke / Q000523:psychology*; D000071939:Stroke Rehabilitation; D006113:United Kingdom