Jean C Spencer

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The relationship between pregnancy wantedness and adverse pregnancy outcomes was studied using data from 2,828 mothers who participated in the Missouri Maternal and Infant Health Survey. The wantedness of a pregnancy was measured using traditional classifications of mistimed and unwanted, as well as additional measures gauging how the woman felt about the(More)
A naturalistic, ethnographic, phenomenological study of adaptation to wheelchair use was conducted with one key informant, a 30-year-old white man with acquired paraplegia who was undergoing acute rehabilitation. Primary staff members served as additional informants. It was found that adaptation to wheelchair use had both pragmatic and emotional components.(More)
The purposes of this article are (a) to examine cognitive, emotional, and spiritual aspects of hope as reflected in the literature; (b) to describe three clinical approaches that have been used in occupational therapy to engage clients in development of hopes for the future; and (c) to consider practical issues that have been raised by therapists seeking to(More)
OBJECTIVES The study objectives were to describe (a) adaptation trajectories of elderly persons treated on a transitional unit for deconditioning and tracked after their return to the community, (b) an individualized adaptation-based intervention provided to selected elderly persons in addition to protocol-based treatment for deconditioning, (c) goals and(More)
To study adaptive processes following spinal cord injury, unstructured audiotaped interviews were conducted on an almost daily basis with a 30-year-old divorced male during the first 3 months of his initial comprehensive inpatient rehabilitation. Analysis of the transcribed tapes identified a number of important themes, including the theme of social(More)
Many constructs of interest to occupational therapists can only be studied through qualitative methods. Such constructs include meaning of activity or the illness experience and the context in which these occur. The purpose of this paper is to describe how ethnographic methods used in research can be generalized and applied to clinical practice. Ethnography(More)
OBJECTIVES Most previous research on rehabilitation of patients after spinal cord injuries has dealt with the attainment of outcomes valued by staff members or with the prediction of successful outcomes based on sociodemographic characteristics of patients. This study examined the rehabilitation process from the insider's perspective of an individual(More)
OBJECTIVE To examine instrument reliability, validity, factor structure, and conceptual underpinnings of the Community Integration Measure (CIM) with the Community Integration Questionnaire Revised (CIQ-R) and the Satisfaction with Life Scale (SWLS). DESIGN A replication study. SETTING Community living. PARTICIPANTS Ninety-one participants: 51(More)
OBJECTIVES Objectives of this study were to examine similarities and differences in physical recovery and psychosocial adaptation, engagement in occupations and relationships, perceived outcomes and expectations, and adaptive issues and strategies of 5 participants from an ongoing longitudinal study of adaptation to hand injury. METHODS Participants were(More)
Narratives are gaining recognition as important ways occupational therapists and other clinicians can think about the life stories of clients. The purpose of this article is to examine a conceptualization of how changes from one chapter to another occur in life stories, using the metaphor of an adaptive repertoire, and to consider how this notion can be(More)