Balancing hope, realism and emotional boundaries: A qualitative study of healthcare providers working with individuals with spinal cord injury in Cyprus.

Spinal cord injury (SCI) affects far more than motor and sensory function, disrupting identity, mental health and relationships. Healthcare providers (HPs) delivering rehabilitation face systemic constraints and interpersonal challenges, especially around communication and relational dynamics with individuals with SCI. This qualitative study explored HPs' perspectives on their experiences of working with individuals with SCI. Semi-structured interviews were conducted with 12 HPs (physiotherapists, occupational therapists, general practitioners, nurses, and a physiatrist) working in SCI rehabilitation. Reflexive Thematic Analysis identified two intertwined themes: 1. 'Hope vs. realism' captured the ongoing tension of sustaining individuals with SCI's motivation while managing their expectations and 2. 'Connection vs. Detachment' illuminated deep, rewarding bonds of HPs with individuals with SCI that simultaneously generate emotional strain. Findings highlight the need for organisational support (e.g. reflective practice, peer debriefing) and targeted training to strengthen communication, foster empathetic interactions and enhance sustainable rehabilitation practice and outcomes.