Abstract
BackgroundHope is a critical resource for people with aphasia after stroke, sustaining people though times of distress and uncertainty and providing motivation. In the first months after stroke, hope is vulnerable to different influences, and people can struggle to identify and work towards hopes for the future. We have little knowledge about how people with aphasia experience hope in the longer term after stroke.ObjectivesTo identify how people with aphasia experience hope 1 year after stroke and how hope may change in the year after stroke.MethodsThe study used an Interpretive Description methodology. Interviews were conducted with four people with aphasia who had been interviewed 1 year previously. These were analysed using content analysis.ResultsAll people reported a broad sense of hope for the future. They described an active process of recalibrating their early poststroke hopes through a process of reflecting on past progress, current function and what they considered might be possible and desirable in the future. People were able to develop ‘new’ hopes that were meaningful and seemingly achievable when they had a sense of a possible, desirable future. Those who struggled to see a possible future maintained a hope that things will be good. Social supports, a sense of progress, engagement in meaningful activities and interactions appeared crucial in helping people (re)develop hopes for their future.ConclusionsHope and hopes for the future gradually changed after stroke. Hope, identity and social connectedness were closely entwined and could enable people to both dwell in the present and move towards desired futures. This research suggests clinicians should prioritise creating hope‐fostering environments which support people to develop hope for their future.
Highlights
Hope is a critical resource for people who have experienced a stroke [1,2]
This was present in both the postacute and chronic stages of recovery. They reported a future-oriented form of hope. They indicated an active process of recalibrating their hope for the future in the time since their stroke, revising hope in the light of their progress to date and their changing views and desires of their possible future
Active and growing hopes for the future were evident in the narratives of those who were actively engaged in reconstructing their life, had a strong sense of identity and were developing a sense of their possible future
Summary
People commonly struggle to maintain or develop hope, perhaps reflecting the significant emotional consequences experienced by up to 70% of stroke survivors and the significant life changes that result [3,4,5,6]. While people could hope for particular outcomes (for example, to return to work) in the postacute period after stroke, they did not consistently prioritise these nor expect them to be realised within the episode of rehabilitation. People were able to develop ‘new’ hopes that were meaningful and seemingly achievable when they had a sense of a possible, desirable future. Those who struggled to see a possible future maintained a hope that things will be good. This research suggests clinicians should prioritise creating hope-fostering environments which support people to develop hope for their future
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