Learning Objective #1: Identify the major themes identified that describe the experience of adolescent women with a physical disability

Learning Objective #2: Describe the methodology used in this study and the strategies that increased trustworthiness of the findings

---

Compared to adolescents without disabilities, social relationships are considerably more complex for those with disabilities. This qualitative component of a larger mixed-method study of adaptation examined peer relationships in 31 adolescent women with spina bifida. The theoretical framework for this study integrates the Ecological Model of Spina Bifida Adaptation with the Middle-Range Theory of Inner Strength in Women living with chronic health conditions. These theories describe a process of response and adaptation to a chronic condition. The participants were interviewed, and content analysis was conducted for common themes. Ages of the participants ranged from 12-21 years, with a mean age of 15.84 years. The levels of lesions spanned all levels of the spinal cord in a fairly equal distribution: thoracic/high lumbar (25.81%), lumbar (32.26%), lumbosacral (22.58%) or sacral (19.35%) lesion. The six major themes identified were: Peers without Disabilities, Peers with Disabilities, Normalization, Challenges in Peer Connectedness, Peer Connectedness with Adults, and Romantic Connectedness. While some participants voiced close connections with peers, other stories highlighted prejudices, stereotyping, and limited dating experiences. In the sample 34% had been on an individual date, includes those in committed relationships and those who had chaperoned dates; 30% reported group dates, while 36% had never dated at all. These adolescents overwhelmingly reported that that they had sexual feelings similar to their peers. Implications for nursing include integrating social development data into universal screening for all adolescents with spina bifida. A progression to intervention studies testing strategies to improve social and sexual development is needed. Interventions need to initiate in preadolescence and include those youth with and without disabilities. Results of future intervention studies need to be readily translated into policy with school and social programs to enhance the connectedness and health of young women living with SB and other chronic health conditions.