Learning to live with a hand nerve disorder: A constructed grounded theory

Introduction: The broader perspective of health offered by the World Health Organization’s Classification of Functioning, Disability and Health (WHO ICF), has had a significant bearing on how we view the measurement of health outcomes after surgical or therapy interventions for peripheral nerve disorders affecting the hand. The value of the patient’s perspective is now recognised and outcomes which reflect this are being advocated in the clinical management and support of this population. Purpose of the Study: This qualitative study sought to explore the lived experience of a hand nerve disorder and in particular the impact on body structure/function, activities and participation. Methods: In depth, one to one interviews with fourteen people with a range of hand nerve disorders were conducted. Constructivist grounded theory methods were used to collect and analyse the data. Patients were also given the option of taking photographs to visually represent what it is like to live with a nerve disorder, to bring with them for discussion during the interview. Results: The impact of hand nerve disorders forms part of a wider narrative on adaptation. A process of ‘struggling’ and then ‘overcoming’ was experienced. This was followed by an interior aspect of adaptation described as ‘accepting’. This gave rise to participants ‘transforming’; being changed as a result of the journey that they had been on. Conclusions: This study provides an explanatory theory on the adaptive process following a hand nerve disorder which may inform future patient-therapist interactions