H. Herrestad & S. Biong light of this theory, these informants did not entertain hopes about what they would achieve by ingesting an overdose of medication because such hoping requires a high-level interpretation of the situation. It is also possible that the expressions of indefinite hopes are reflecting such mental moves to escape an interpretation of oneself as a failure and to preserve a feeling of self-worth. Implications for research A number of measures were taken to ensure validity and transparency during and following the analysis. The researcher’s pre-understanding is stated, and reflections are made about the context and the influence of the researcher. According to Malterud (2001), subjectivity arises when the effect of the researcher is ignored, and thus forms a threat to scientific principles of knowledge production. After the initial analysis, the authors discussed the devel- oping explanations and interpretation of the findings on several occasions to determine whether the sub- themes and themes represented what they actually were supposed to. Efforts were made to identify data that were inconsistent or that challenged the com- prehensive understanding. The presentation of the findings is as detailed and complete as possible, allowing the reader to view the material on which the statements rest. A possible limitation of the method used in this study is that the construction of the whole, the comprehensive understanding, should cover the na¨ıve reading and all the parts of the structural analysis. This could lead the researcher to overlook and not present contradictory findings in order to follow the method in a rigorous way. Clinical implications Life as text, that is the researcher’s interpretation and presentation of the stories, does not represent life as lived or experienced. Hence, our interpretation is not established truth, but verisimilitude (Bruner, 1986). Drawing on the ideas of Ricoeur (1991), we argue that the focus should be more on the kind of reflections and actions that the findings of the present study create in the reader when assessing transfer- ability. This notion represents a naturalistic and analytic way of generalization. The clinician must make the final judgment about whether the descrip- tions and interpretations we have given in the present study are sufficiently analogous to be used as a precedent for cases she or he is engaged in. Contrary to the view that suicidal behavior indicates an extinction of relational hopes and withdrawal from social relations, our interpretation of the hopes expressed by our informants indicate that they are deeply occupied with relational concerns. This knowledge may be of clinical im- portance to professionals who seek to help patients who have been hospitalized after acts of intentional self-harm. The discussion of why our informants predominantly express indefinite hopes may also be of clinical relevance as the clinician should be aware that disappointment can be avoided either by fulfilling a hope or by maintaining an unfulfilled hope. Sometimes a person may find it more important to maintain hope than to see the hope fulfilled. Conclusions The lived experience of hope in patients hospitalized for intentional self-harm could be understood as definite and indefinite relational hopes for life and death. This comprehensive understanding was informed by the na¨ıve reading leading to an understanding that hope is relational, and a synthesis of the three themes found in the structural analysis of the meaning of hopes for life, of hopes for death, and of the act of hoping. That their hopes for both life and death are relational hopes may have clinical implications as this indicates that they are deeply occupied with relational concerns. Our interpretation of the lived experience of hope has led us to the distinction between definite and indefinite hopes which we see as more useful than the model of the various distinctions and aspects of hope that informed our pre-understanding. On the basis of the discussion we have gained the under- standing that expressing indefinite hopes may serve the function of protecting the informant against experiencing failure and disappointment. Clinicians should be aware that sometimes maintaining hope may be more important to the patient than seeing hope fulfilled. Acknowledgements The authors would like to thank the following for their contributions to this project: The 12 informants for their willingness to be interviewed. Trond Jørgensen, Svein Staff, Ellen Munthe-Kaas, Synnøve Fougner (psychiatric liaison ofﬁce Aker University Hospital), Trine Jensen, Mads Friberg (transcriptions), Helge Svare (assistance in preliminary analysis), Latha Nrugham, and the research forum of National Centre for Suicide Research and Prevention (iterated draft discussions). 8 (page number not for citation purpose) Citation: Int J Qualitative Stud Health Well-being 2010, 5: 4651 - DOI: 10.3402/qhw.v5i1.4651