Hope in orthopaedic trauma: a qualitative study

Background: Hope is identified as an important aspect of life and recovery from illness and injury but less is known about how hope is constructed within an acute trauma care environment. An understanding of what hope means would help to identify its therapeutic potential and the challenges that exist regarding its use in practice.

Objective: The objective of the study was to ascertain experiences of hope on a Trauma Unit from both people living with trauma and health care professionals.

Design: The study drew on the principles of ethnography undertaking in depth qualitative interviews with 10 patients and 10 multidisciplinary members of staff, 21 h of participant observation followed by observation interviews and informal discussion with patients. Two focus groups with health care professionals were held to explore and expand initial findings. Data collection took place between March 2007 and November 2007.

Results: The findings identified three themes: (a) moving forward, (b) finding a future and (c) realistic hopefulness. Moving forward identified hope as a dynamic and purposeful force that was important for recovery but also connected to the meaning life had for participants. Finding a future identified the challenges that exist within the process of recovery from injury. Health care professionals identified the importance of finding an acceptable future and people living with injury struggled to be hopeful whilst feeling frustrated with the process of treatment and recovery. Realistic hopefulness was the process by which health care professionals facilitated the emotional and physical progression of people living with injury through recovery.

Conclusions: Health care professionals construct hope as a fundamental aspect of their work in trauma care and people living with injury focus on suffering in the present and frame their hopes on their immediate future and the context of their lives prior to injury.