Health Management and Time-Use With Tetraplegia: A Narrative Inquiry

Little is known about time-use related to health management of individuals with tetraplegia (motor and/or sensory loss originating in the cervical spine) and the influence on participation in occupations. The purpose was to explore the time-use of an individual with tetraplegia to understand factors that contributed to changes in health-management routines over time. Narrative inquiry was used to collect data via observation, time-use log, and interviews. Five interpretive stories emerged: Caregivers, Relationships, and Learning Self-Efficacy; Framing the Morning Routine with Positive Thinking; Caregivers Become My Hands: The Art of Doing; Discovering Meaning and Life-Purpose; and Schedules and Waiting: Disability Shaping Occupation and Time-use. The stories illustrated how situational contexts disrupted his engagement in routines and reliance on caregivers. These findings may help clinicians better understand the lived experience of clients with tetraplegia to design interventions that appreciate the changing nature of disability over time.