title: Spiritual issues associated with traumatic-onset disability.
abstract: OBJECTIVE
  The present study used a qualitative approach to discover the concepts used by people with a sudden-onset disability to express issues of spirituality. Using a cross-sectional time frame, the study sought to understand how spiritual issues were experienced at the onset of a disability from the perspective of the disabled person him or herself. The study also compared the perceptions of brain injury respondents to spinal cord injury respondents.
  
  
  METHODS
  The qualitative approach was chosen to capture a detailed understanding of perceptions about spirituality, and the relationship of the disability to the disabled person's spiritual beliefs. The sample consisted of 16 individuals, all of whom had experienced a spinal cord injury or a brain injury.
  
  
  RESULTS
  The main findings of the study were as follows: (1) Participants recovering from a disability described spiritual issues relating to five themes which arose directly from the data (awareness, closeness, trust, purpose, vulnerability) and relating to three relationships found throughout the literature on spirituality (intrapersonal, interpersonal and transpersonal). These eight dimensions can be combined to form a matrix, which serves as a framework for considering spiritual issues associated with disability; and (2) There were differences in the spiritual concepts described by the participants with brain injury compared to those with spinal cord injury. In particular, those with brain injuries seemed to place greater emphasis on the importance of their families, and to be more aware of the need for trust in view of their memory deficits.
  
  
  CONCLUSIONS
  These results represent one of the earliest attempts to take an empirical approach to the development of theory in the area of spirituality and disability. Building on theory developed in other populations (palliative care and ageing), the study offers a theoretical model for clinicians, educators and researchers to better understand spirituality in the context of disability.
authors.affiliation: School of Rehabilitation Therapy, Queens University, Kingston, 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: D000208:Acute Disease; D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D001930:Brain Injuries / Q000523:psychology*; D003430:Cross-Sectional Studies; D006233:Persons with Disabilities / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D012069:Religion and Psychology; D012649:Self Concept; D013119:Spinal Cord Injuries / Q000523:psychology*; D011795:Surveys and Questionnaires