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Case Studies
The following case studies of patients with spinal cord injuries show the manifold strengths of the Rehab Cycle in clincial practice. The individuals portrayed in these cases differ in regard to the nature and cause of their injuries and the height of the lesion.
1Goal Setting
2Independence
3Hope
4Health Behavior
5SCI in the Elderly
6Recovery after traumatic SCI
7Vocations
8Community Reintegration
9Sports in Rehabilitation
10Walking Recovery
11Care in Developing Countries
12SCI and Environmental Accessibility
13SCI in Adolescence and Peer Relationships
14Bowel and bladder management
15Psychological issues and SCI
16When more time is less
17Motivation and rehabilitation
 
Case Study 3:
Hope as an agent in the rehabilitation process
General Introduction

Intuitively, it can be said that hope plays a significant role in the process of rehabilitation. However, a central question is whether or not this emotion can be explicitly supported and integrated by a rehabilitation team to achieve better outcomes in the rehabilitation process.

This case study aims to illustrate the intersection of hope and rehabilitation, showing how one patient suffering from the debilitating Guillain-Barré Syndrome (GBS) and her hopes, both realistic and less realistic, were focused, adapted and integrated for effective rehabilitation management. The study offers one positive example of an intervention that both built upon a patient’s hopes and worked constructively with those hopes that were less realistic.

Hope: A Rehabilitative Opportunity

Hope: a state of being characterized by an anticipation of a continued good state, an improved state or a release from a perceived entrapment.1 

Hope is a multidimensional construct that provides comfort while enduring life threats and challenges. In general, it is future-oriented with a positive essence 2,3  and comprises an “essential state of mind,” having an impact upon a given individual’s attitudes towards both life and functioning.4

Overall, hope may support goal-directed training particularly when focused on realistic expectations. It may carry patients through struggle and lead to personal growth as a motivational factor promoting positive outcomes.5  A person’s willpower provides the energy and strength in the hoping process and is the basis of an individual’s “power of hope.”

Qualitatively, hope can be thought of as being comprised by two forms: generalized hope that is an intrinsic quality of an individual and may serve as a positive coping strategy, and particularized hope that refers to the substance of hoping and contains specific expectations which may be realistic or unrealistic.

Additionally, people hope in negatively experienced situations, hoping for things or conditions that are important to them but have a low likelihood of being realized.7

Box 1:

Guillain-Barré Syndrome – A complex disease and its long road to recovery                                                                    

 

Integrating Hope Into Rehabilitation Management for GBS

Given the uncertainty surrounding the progression of GBS, rehabilitation management should be based on a dynamic procedure that can be continuously adapted and adjusted to a patient’s actual stage. 18,19 Both health professionals and patients are constantly searching for new possibilities within the experience of illness and suffering.20 Given an uncertain and insecure condition such as GBS, hope contributes by inspiring and stimulating the process of recovery and works against a patient’s desire to “give up.” Hope also motivates patients to persevere with their training, which may stimulate improvements.

Thus there is a reinforcing feedback cycle: hope and the hoping process drive training, which leads to improvements that result in more hope.21  Health professionals should therefore work to integrate a patient’s hopes into the rehabilitation approach, promoting those that are realistic and minimizing those that are not.

 

 

 

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