The battle between hoping and suffering: a conceptual model of hope within a context of spinal cord injury.

The aim of this longitudinal study was to explore 10 patients' experiences of the meaning they attribute to the substance of hope and the process of hoping during the first 3 to 4 years following a spinal cord injury. This qualitative study is a synthesis of three empirical studies of hope and the overall aim was to deepen the understanding of the phenomenon of hope, based on the text representing the main contextual findings, to develop a theoretical framework on hope within a context of spinal cord injury, illustrated in the conceptual model. In correspondence with Ricoeur, this conceptual model, which was developed from a new understanding, based on a new text of the phenomenon of hope, develops a new and deeper understanding of the meaning of hope. Findings revealed 9 themes: universal hope, uncertain hope, hope as a turning point, the power of hope, boundless creative and flexible hope, enduring hope, despairing hope, body-related hope, and existential hope. The conceptual model was derived from these themes, illustrated as The Battle between Hoping and Suffering and The Road of Hope. The interpretations also revealed a distinction between being in hope and having hope, and having a hope of improvements was the main focus at the early stage of rehabilitation, whereas being in hope as being just fine was the main focus after 3 to 4 years of rehabilitation.