外傷性在宅頸髄損傷者の個人誌の混乱にみる困難の特徴と概念構造の検討

抄録

This study aims to investigate characteristics as well as relationships between the factors of the difficulties, of persons who experienced biographical disruption after sustaining cervical spinal cord injury. Authors conducted semi-structured interviews with 29 participants and developed the following four core categories based on the grounded theory approach : 1) difficulties of locomotor disorders, 2) difficulties in physical health management, 3) difficulties of psychological and emotional conditions as well as mood, and 4) difficulties in socioeconomic factors. Physical difficulties of the participants were attributed to not only locomotor disorders but also the constant need to manage concomitant chronic health symptoms. Moreover, the objective aspects of such physical difficulties influenced the occurrence of participant psychological and social difficulties. Finally, psychological distress derived from the stigma of persons with a disability negatively influenced the frequency of going out, whereas the loss of an occupational role related to an increase in psychological difficulty. These overlapping difficulties were related to prolonged suffering of biographical disruption. Especially, the achievement of participants' identity reconstruction might be difficult because of internalized social norms that value able-bodied persons, and important others' influence. Therefore, it was considered essential to provide long-term support for participants to cope with their psychological distress.