Going Back to Civvy Street: a historical account of the impact of the Everest and Jennings wheelchair for Canadian World War II veterans with spinal cord injury

In February 1945, the Canadian government agreed to provide the Everest and Jennings folding, self-propelled wheelchair to all World War II veterans with spinal cord injury. These wheelchairs replaced wooden and wicker invalid wheelchairs that were usually assigned to hospital wards rather than to individuals. Veterans with spinal cord injury were among the first group of Canadians to use these wheelchairs to participate in community life. By 1947, Canadian veterans had demonstrated that it was possible to return to education, employment and leisure activities using a wheelchair. Drawing on oral history interviews and archival research, this paper provides an account of the introduction of folding, self-propelled wheelchairs into Canada following World War II. It discusses the impact of these wheelchairs on the life experiences of veterans, and outlines the strategies used by these early pioneers to live and work in communities that had neither expected nor planned for individuals using wheelchairs.     

A voice in the chorus: perspectives of young men of color on their disabilities, identities, and peer-mentors

With the rise of violence during the 1990s, the number of persons who acquired a spinal cord injury as a result of gunshot trauma increased dramatically in the United States. This qualitative study examined disability, race, and contribution of peer-mentors to the development of identity. Six men with a violence-related spinal cord injury participated in a focus group. They were injured for at least two years, making positive gains in their lives, and training to become peer-mentors at a rehabilitation hospital. In addition, 16 men with a newly-acquired spinal cord injury from gunshot trauma participated in an individual interview. These sixteen participants were all mentees (or recipients) of the peer-mentor program. Principles of grounded theory were used to code and analyze data. Data converged on three main themes: (1) disability viewed as a wake-up call or blessing, (2) disability viewed as a turning point, and (3) disability viewed as identity transforming.     

'Working at Disability': a qualitative study of the meaning of health and disability for women with physical impairments

Seven women with cerebral palsy and one woman with a spinal cord injury were interviewed about the meaning of health and disability in their lives. The most compelling feature of their narratives was the pressure to define their health by able-bodied standards. These women 'worked at' fitting their bodies and experiences into the limited societal understanding of a body. Paradoxically, the women seemed to come to a deeper personal understanding of disability and themselves through this work. The women's stories of health, impairment and disability, as told in the interviews, blended into rich chapters of their life stories.     

Spinal Cord Injury

ABSTRACT

This article provides an overview of spinal cord injury (SCI) that is useful and informative for social workers and other health care professionals who work with this population. Social workers new to the specialty of spinal cord injury must expand their knowledge base of this chronic injury. Social workers contribute to the rehabilitation process through assessment, education, and discharge planning. This article also may be used to inform persons with spinal cord injury and their families and to encourage them to engage in dialogue about SCI in the earliest stages of treatment and rehabilitation.     

'Doing Motherhood': some experiences of mothers with physical disabilities

In this paper, we discuss the experiences of physically disabled mothers. We interviewed 30 women in the age group 28-49 with medical diagnoses such as: multiple sclerosis, neuromuscular diseases, cerebral palsy and spinal cord injury Becoming a mother implied for many 'capturing' a gender or 'recapturing' a lost gender. They women felt they had to go to great lengths to 'present' themselves and their children as managing 'normally' in order to be accepted as 'ordinary' mothers. Eventually, they feared that their children might be taken away from them if they did not live up to other people's expectations. One possible explanation for what they experienced as other people's scepticism might be that disabled people on the whole are primarily still looked upon as being dependent on other people's help and care. In short, they are often looked upon by professionals and lay people as receivers, and not as carers.     

Images of self and spinal cord injury: exploring drawing as a visual method in disability research

This article describes the use of drawings in a research project aimed at understanding the personal experience of spinal cord injury. The article briefly reviews the use of visual methods in disability research, and then describes the specific procedures used to elicit and analyze two sets of drawings: ‘draw your self’ and ‘draw how you see spinal cord injury in your mind’. The drawings were a small but essential part of a larger study focused on the community integration and participation of adults (n = 160) with spinal cord injury. Despite the challenges posed by this method for research participants with paralysis, the drawings provided unique insight into the personal meanings of spinal cord injury and how this injury is understood and represented to others. Using examples of participants' own drawings, we show how elicited drawings are a useful adjunct to traditional interview methods in studies of disability.     

How do men with paraplegia choose activities in the light of striving for optimal participation? A qualitative study,based on a phenomenological–hermeneutical method

The objective of this study was to explore the experiences of men with paraplegia with regard to how they choose activities. The study involved a qualitative research design, based on a phenomenological–hermeneutical method. The findings revealed that the activities participants were choosing could be on a continuum between the individual’s self and the influence from their environment. On this continuum, the choice to perform activities was influenced by two mediating factors: the individual’s activities performed during their life-history, and their activity challenges for the future. We conclude that choosing activities is an individually constructed internal process of negotiation. Feelings of resignation and revolt appear in combination with feelings of justice and injustice when balance is not found. This knowledge provides a better understanding of the impact of spinal cord injury, sheds light on the development of distress after spinal cord injury and sheds new light on individuals’ feelings of participation.     

The Caring Wife: The Experience of Caring for a Severely Disabled Husband in the Community

Modern medicine has dramatically increased the chances of survival following major trauma such as a severe head injury or high level injury to the spinal cord. Greater numbers of seriously disabled people are thus returning to live in the community. This article examines the situation of the wife who assumes a caring role following the onset of severe disability in her husband. The study examines community care for people with traumatic disabilities and the social expectations of women's role in the provision of that care. Reference is made to the British situation although similar experiences are shared by women in other developed countries. As health care and social service professionals seek to serve the needs of their physically disabled client it is recommended that they view also the needs of their other client-the carer.     

Meditations on a Bullet: Violently Injured Young Men Discuss Masculinity, Disability and Blame

Violently-acquired spinal cord injury (VASCI) has recently emerged as a significant disability category. Identity formation following such a serious injury is important for psychosocial recovery. However, research examining individuals with VASCI is largely limited to epidemiological work prior to the injury and rehabilitation outcomes following the injury. This article details the results from a qualitative study to understand how young men with violently-acquired spinal cord injuries integrate the injury into their sense of self, as well as how the disability interacts with other aspects (e.g., racial/ethnic, gender, etc.) of their identity. Eleven men in this study were all former or current gang members, paralyzed because of their activities. Throughout the interviews four major themes emerged: environmental effects, making sense of the injury, living life on a split-screen, and challenges to masculinity. For the men in this study, the negative associations between disability and dependency affected their ability to integrate their injury positively into their identity.

Men, sport, and spinal cord injury: an analysis of metaphors and narrative types

This article draws upon life history data from a small group of men who have experienced spinal cord injury (SCI) through playing the sport of rugby union football and now define themselves as disabled. The salient and most common metaphors used by the men in telling their stories post SCI, and the manner in which this is shaped by three narrative types, is focused upon in detail. The implications of this dynamic process for their identity reconstruction as disabled men are considered.     

The Life Rope: a transactional approach to exploring worker and life role development

The Model of Human Occupation offers a framework for analyzing occupational roles including that of worker; however, it does not describe the dynamics of role change after a traumatic injury. This paper reports a qualitative study of sixteen individuals who experienced a traumatic spinal cord injury in the midst of their occupational career development. The study examined their role change processes involved in redeveloping the worker role. Data were collected across 24 months of the participant's lives and triangulated via participant observations, guided interviews, mapping, and archival document review. Results showed that individuals formed multiple strands within their role repertoires at any point in time. After a traumatic injury, the worker role became an optional, elective role strand, one that often unraveled first as they encountered breakdowns in more basic survival roles, such as home manager, assistive technology user and attendant care employer. The metaphor of a Life Rope emerged as a useful conceptual framework for explaining life role development, including that of worker.     

Working with parents of spinal cord injured adolescents: A family systems perspective

Concepts from family systems theory are used to facilitate understanding of the needs of families coping with the spinal cord injury of an adolescent. Five assumptions derived from systemic principles are discussed as related to assessment and family functioning. Related suggestions are given for assisting parents in dealing with this non-normative stressor and its long-range effects on the adolescent and family.     

‘It takes two to tango …’ revisited: a qualitative study on integration and participation of people living with spinal cord injury in Switzerland

We aimed to examine how integration and participation are understood by persons with spinal cord injury. A qualitative study was carried out where we analysed 14 interviews with persons with spinal cord injury living in Switzerland. Integration was more often understood in terms of social acceptance and inclusion, while individual activities were more often highlighted in definitions of participation. Environmental factors were seen as the most important determinants. Applied strategies comprised pre-arrangements, open communication, asking for help and optimism. Common ground appears to be autonomous functioning and freedom of choice while major determinants are seen in the environment.     

When identities collide: masculinity,disability and race

This study is part of a larger project that examined the impact of violently acquired spinal cord injuries (VASCI) on identity among racial and ethnic minority men living in a major American metropolis. Like other individuals who sustain a disabling injury, individuals with a VASCI often struggle with the consequences of the injury vis‐à‐vis redefining their identities and their role in society. For the men in this study the negative association between disability and dependency affected the integration of the injury into their sense of self. The injury and resulting disability violated social understandings of what it means to be a man in their environments. The men noted the injury’s impact on their sense of safety, sexual encounters, body image and choice of intimate partners. Their social context shaped what it meant to be a man, played a role in their injuries and increased the challenges inherent in a life‐changing event.     

Modern times: an ethnographic study on the quality of life of people with a high support need in a Flemish residential facility

This ethnographic study shows the impact of the care system on clients' and staff's life experiences, with the clear distance between these two groups as one of the core issues. Together with a dominant care approach and a well established but subtile system of control, it makes them function in systems that are characterized by an oppressing care culture. Learned helplessness prevents both groups of acting upon quality of life outcomes. The idea of supporting a life of good quality through merely improving these traditional care systems should therefore be considered with caution, and real alternatives should be considered to open this barrier of the oppressing care culture.     

I'm going back to work: back injured clients' perceptions and experiences of their worker roles

This study aimed to elicit perceptions and experiences of facilitators and barriers that affected individuals who received back rehabilitation and their ability to resume their worker roles. Qualitative research methods were used in order to explore the research question. Participants were selected by means of simple random sampling and the data were collected by means of semi-structured focus groups. Some factors that were seen as facilitatory in maintaining the worker role of an individual who received back rehabilitation included injury management strategies, a positive work culture and having meaningful/satisfactory work experiences. Factors or barriers that prevented individuals from resuming their worker roles included physical and psychosocial stressors of the job, a lack of education by the employer and inadequate workplace policy. The results indicated that occupational therapists need to reassess their role within the wider context of the helping professions where they should become more involved in on-the-job evaluations, work placements and training of individuals who received back rehabilitation.     

Barriers to returning to work for people with spinal cord injuries: a focus group study

The rate of employment for people with spinal cord injuries is relatively low, especially among Asians. To help individuals with spinal cord injuries return to work or retain employment, rehabilitation professionals must understand the barriers to employment and intervene to reduce or remove them. Hence, a focus group study was administered to 16 people with spinal cord injuries to explore return to work barriers. Various ideas, beliefs, responses, and values at different stages of work resettlement were elicited from both employed and unemployed participants, and then summarized. According to the results, several modifications of existing forms of rehabilitation intervention are necessary, as are further research directions.     

Women and Migration in Albania: A View from the Village

Since the fall of communism in the early 1990s, Albania has experienced migrations of epic proportions: 17 years later almost one in four Albanians has emigrated and lives abroad, primarily in Greece and Italy. Albanian emigration has by and large represented a typically male‐dominated model, whereby men have “led the way” and women have followed as family members. Despite the considerable participation of Albanian women in this migration, their roles and experiences remain under‐researched. Based on in‐depth interviews with rural migrant women and their families, as well as additional ethnographic material collected from 2004 to 2006 in Albania and Greece, this paper aims to fill this knowledge gap. The findings demonstrate the various ways in which Albanian rural women participate in the migratory process. They are often the most important pillar for supporting the family migration strategy through their productive and reproductive labour when remaining behind. They are also closely involved in decision‐making about the migration of other family members. Furthermore, they have been among the pioneers of the early 1990s migration themselves, including taking the long and risky journeys across the mountains to Greece. Overall, their contribution to the migrant household is beyond their presumed reproductive role and includes a strong economic component. While some “traditional” norms and values persist and are reinforced during migration, change does take place, albeit at a slow and gradual pace. However, for the emancipatory benefits women could accrue through migration to be enhanced, immigration policies need adjusting to address their position as fully autonomous economic and social actors, thus reducing their dependency on male “bread‐winners.” Albanian women’s particular migratory experiences, combined with their increasing numbers as migrants, make a compelling case for further attention from researchers and policymakers.     

An outsider in my own home: attachment injury in stepcouple relationships

This multiple-case study explored women's relational experiences as attachment injury patterns in distressed stepcouple relationships and how these experiences might be attributable to stepcouple status. The first author interviewed five stepmothers with biological children, using open-ended interview questions developed from attachment theory and existing research regarding attachment injury and stepfamily formation. Data analysis using the pattern-matching method derived and explored markers of attachment injury in the women's stepcouple relationships. The four categories of attachment injury showed significant attribution to stepfamily issues. This supports past stepfamily research suggesting that stepcouples face unique challenges. Further, these findings suggest that the language of attachment injury accurately describes stepcouples' problems and the usefulness of conceptualizing and addressing these problems in an attachment injury framework.