Life histories of adult survivors of childhood polio

Chronic illness is a major health problem in this country. This research addresses the need for increased understanding of physically disabling illness across the life span, long-term outcomes, and variables that shape illness and biographical trajectories. Fifteen adult survivors of childhood polio were recruited from a support group, the community, and long-term care facilities. Subjects were interviewed to obtain life histories: to describe biographical experiences, identify long-term outcomes, adaptational patterns and illness courses, and determine life span themes and patterns, context, and meaning. Interview data were collected on physical, psychosocial, and sociocultural dimensions and adaptational patterns using an unstructured interview schedule. Mandelbaum\u27s life history framework, Strauss\u27s trajectory concept, and the constant comparison method were used for analysis. One major pattern emerged in the illness trajectories, unanticipated late effects and further functional decline following a long plateau. Two biographical patterns emerged. The dominant pattern was cultural and developmental normalcy. Normalization was the most common adjustment style. Three individuals, with lengthy hospitalizations as children, defined a second pattern, underachievement, chronic emotional stress, dependency and unending struggle. Psychosocial response patterns were internalization of childhood experiences and a late stage, psychosocial transition process. Metaphors were used to interpret experience and promote coherence in the life history. Caring family relationships and normalized social life support normal development. Long separations and inconsistent parental substitutes increase the risk of problematic outcomes. There is a need to anticipate future cohorts of children who will age with a disability. Early identification of high-risk families and emotionally vulnerable children, and interventions that limit family separation and attend to the child\u27s psychosocial needs are critical. Metaphors that express individual interpretations key into coping dynamics. Research with adult survivors or longitudinal research with children who have chronic conditions will further define trajectory courses and long-term outcomes, explicate relevant conditions for management, and develop a chronicity model. Increased knowledge in this realm has the potential to reduce disability level, ameliorate the negative effects of chronic illness and enhance the quality of life