Højgaard Nejst Camilla, Glintborg Chalotte
Neurorehabilitation Copenhagen, Municipality of Copenhagen, Copenhagen, Denmark.
Department of Communication and Psychology, Aalborg University, Aalborg, Denmark.
Front Rehabil Sci. 2024 May 14;5:1376895. doi: 10.3389/fresc.2024.1376895. eCollection 2024.
There has been an increasing interest in the concept of hope within the field of brain injury rehabilitation. Existing reviews have nevertheless focused on stroke, leaving out the broad population of people with acquired brain injury (ABI). Furthermore a majority of the included studies in those reviews excluded the subgroup of people with communication difficulties, thus primarily giving voice to a select group of people with ABI.
A qualitative systematic review was conducted with the purpose of systematically reviewing and thematically synthesise findings about hope as experienced by adults with ABI in a rehabilitation or recovery process. The search strategy included peer-reviewed qualitative studies published after 2000 in English or Scandinavian languages. Searches of EBSCO databases incorporating CINAHL, MEDLINE, and PsycINFO were conducted together with SocINDEX, Social Work Abstracts, Eric and Web of Science. Ten qualitative studies were included, and the Critical Appraisal Skills Program (CASP) was used for assessing the quality and relevance of the ten studies. Qualitative findings were synthesized using Thomas and Harden's methodology.
Through a thematic synthesis eleven subthemes were identified relating to experiences of hope. These were grouped into four analytical themes: (1) hope a two folded phenomenon; (2) time and temporality; (3) progress, goals and visibility and (4) the alliance; a balancing act requiring good communication skills.
This review has shown that even though hope has both a positive and negative side to it, it is necessary as a driving force for people with ABI in terms of supporting them to keep going and not give up. Rehabilitation professionals are advised to embrace the ambiguity of hope, customizing the support of hope to each person with ABI. Attention is needed on how to make progress visible for persons with ABI during their rehabilitation process just as rehabilitation professionals should acknowledge the alliance with the person with ABI as a core component of rehabilitation. This requires a focus on professionals' communication skills if hope promoting relationships between professionals and persons with ABI are to be achieved.
在脑损伤康复领域，人们对希望这一概念的兴趣与日俱增。然而，现有的综述主要聚焦于中风，忽视了广大的后天性脑损伤（ABI）患者群体。此外，这些综述中纳入的大多数研究都排除了存在沟通困难的亚组人群，因此主要反映的是特定的一部分ABI患者的观点。
进行了一项定性系统综述，旨在系统地回顾和主题性综合关于ABI成年人在康复或恢复过程中所体验到的希望的研究结果。检索策略包括2000年后发表的、以英文或斯堪的纳维亚语言撰写的同行评审定性研究。对包含CINAHL、MEDLINE和PsycINFO的EBSCO数据库进行了检索，并结合了SocINDEX、社会工作摘要、Eric和科学网。纳入了十项定性研究，并使用批判性评估技能计划（CASP）来评估这十项研究的质量和相关性。定性研究结果采用托马斯和哈登的方法进行综合。
通过主题综合，确定了与希望体验相关的11个子主题。这些子主题被归纳为四个分析主题：（1）希望是一种双重现象；（2）时间与时间性；（3）进展、目标与可见性；（4）联盟：一项需要良好沟通技巧的平衡行为。
本综述表明，尽管希望有积极和消极两个方面，但它对于ABI患者来说是一种驱动力，有助于支持他们坚持下去而不放弃。建议康复专业人员接受希望的模糊性，根据每位ABI患者的情况定制对希望的支持。在康复过程中，需要关注如何让ABI患者看到进展，同时康复专业人员应认识到与ABI患者的联盟是康复的核心组成部分。如果要实现促进专业人员与ABI患者之间关系的希望，就需要关注专业人员的沟通技巧。
