title: Changes in spiritual beliefs after traumatic disability.
abstract: OBJECTIVE
  To discover the effect of sudden-onset disability on spirituality, specifically, to investigate changes following the onset of disability in spiritual concepts and to outline a theoretical framework consisting of relationships with the self, others, the world, and a supreme power.
  
  
  METHODS
  The study used a cross-sectional, qualitative approach to understand changes in spirituality from the perspective of the disabled person. Intensive semistructured interviews were conducted with 16 participants, each of whom had either a spinal cord injury or brain injury, within the 2-year period after discharge from rehabilitation. Changes in spiritual concepts were explored in relation to 3 types of relationships (intrapersonal, interpersonal, and transpersonal) and 5 themes (awareness, closeness, trust, purpose, and vulnerability).
  
  
  RESULTS
  Specific changes in spirituality described by sample members were: greater awareness of the self; a change in their view of their own independence; a sense of purpose in life that was not present before the onset of the disability; greater awareness of their own mortality and vulnerability; a new understanding of trust, especially when depending on others; loss of some significant relationships; greater appreciation and closeness with others and the world; and greater understanding of other disadvantaged groups.
  
  
  CONCLUSIONS
  The interviews portrayed a significant ability to conceptualize issues in a spiritual context in the 2-year period after discharge from rehabilitation. Further, the changes reported suggest a positive effect of spirituality in the adjustment period following onset.
authors.affiliation: School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada.
authors.forename: M A
authors.initials: MA
authors.lastname: McColl
authors.forename: J
authors.initials: J
authors.lastname: Bickenbach
authors.forename: J
authors.initials: J
authors.lastname: Johnston
authors.forename: S
authors.initials: S
authors.lastname: Nishihama
authors.forename: M
authors.initials: M
authors.lastname: Schumaker
authors.forename: K
authors.initials: K
authors.lastname: Smith
authors.forename: M
authors.initials: M
authors.lastname: Smith
authors.forename: B
authors.initials: B
authors.lastname: Yealland
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001364:Awareness; D001930:Brain Injuries / Q000523:psychology* / Q000534:rehabilitation; D003430:Cross-Sectional Studies; D004644:Emotions; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D012067:Religion; D013119:Spinal Cord Injuries / Q000523:psychology* / Q000534:rehabilitation; D011795:Surveys and Questionnaires