Guillain Barré Syndrome is a debilitating disease that can strike unexpectedly at any age and result in serious neuromuscular paralysis, including different degrees of tetraplegia.7 GBS presents certain specific challenges and opportunities that are well illustrated in Helen’s case.
The intersection of a patient's hope and rehabilitative management can be a significant factor in driving recovery.
For Helen, as with many GBS patients, a significant challenge to rehabilitation involves the uncertainty of the prognosis: Individuals progress at different rates through the phases of the disease and reach different levels of recovery.9 As is evident in Helen’s final evaluation, this uncertainty makes accurately predicting these outcomes difficult. However, minor goals can be set and adjusted for the short term, giving her a true sense of progress.
Helen’s hopeful personality demonstrated some of the opportunities and potential pitfalls of hope as it relates to GBS. It has been shown that hope can play a critical role in patients with GBS when it is focused on attainable goals and that it is influenced by a variety of factors. 32
In Helen’s case, she struggled against dependence and sought autonomy. Her knowledge about the disease, her personality and the degree to which health care professionals involved in the rehabilitation were able to support her hope all played a role in her achievements, as her health care team helped to set realistic goals and refocused those that were less realistic (such as her strong desire to improve her hand use).
Importantly, without demoralizing Helen, they were able to refocus and encourage her in those areas where she could most improve. Helen’s hopefulness of achieving recovery and independence was strengthened and reinforced as many of her intervention targets gradually improved and milestones were met.
The intersection of a patient’s hope and his or her rehabilitative management can be a significant factor in driving his or her recovery. While it is certainly true that a shift from a pessimistic to an optimistic personality is likely to be difficult, if not impossible, it is the health professional’s obligation as best possible to help support, guide and focus a patient’s hopes, assisting him or her in avoiding the pitfalls of setting unrealistic goals.
Reliable information and attainable, short-term milestones for a GBS patient will work to encourage hope. In Helen’s case, the goals established were reached beyond all expectations. Despite the fact that her personal aims fell short, her health team helped to ensure that her hopes and optimism were in no way diminished – and showed her that independence remained very much in reach.