Hope and hopelessness are important psychological constructs that physiotherapists should consider when working with patients who have experienced a stroke. The view of hope in rehabilitation is often focused around the concept of goals and how hope works within this framework. However, the current paper proposes a broader framework for hope and the importance of a more generalised view of understanding why a certain hope exists or is identified by a patient. A narrative review using an a priori thematic analysis was undertaken to consider how more generalised hopes are expressed by individuals who have suffered a stroke. An electronic search of 4 databases from inception until April 2014 was undertaken. Qualitative articles were included if they considered the concept of hope for patients who had suffered a stroke. The results identified three themes which included (1) consideration of the patient’s identity/identities, (2) meaningful activities, experiences, and interactions, and (3) the experience of suffering and need for relief. An awareness of patients’ generalised hopes should be a priority for HCPs. Detailed implications for HCPs are identified within the discussion. 1. Introduction The most accepted definition of hope within positive psychology [1] is generated from Snyder et al. [2] which states that hope is “a positive motivational state that is based on an interactively derived sense of successful (a) agency (goal directed energy), and (b) pathways (planning to meet these goals)” (page 287). Hope can be seen as an essential part of recovery for patients with a chronic illness [3] and is a very important concept for individuals who have suffered a stroke [4, 5]. However, there are several factors which challenge the hope of an individual following their stroke [6]. For instance, hope is severely challenged at times of disease onset, during change [7], or uncertainty [8]. It is particularly important if progress through rehabilitation is slow [9] or if individuals do not achieve what they had expected [10] and it is also severely challenged by individuals feeling dependent on others [11]. Importantly, if hope is lost, it can render patients vulnerable to severe consequences such as major depression [4] and, as reported in other neurological conditions, can end in suicide [12]. Whilst there has been an increase in research considering hope in individuals with a stroke, there is a lack of clarity in how the concept is understood in this population [5]. Goals are used by health care professionals as a key way of managing which is important to
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