The lived experience of moving forward for clients with spinal cord
injury: a Parse research method study
Accepted for publication 18 December 2009
Correspondence to H.-Y. Chen: e-mail:
Hsiao-Yu Chen MSc PhD RN
Associate Professor of Nursing
Department of Nursing, National Taichung
Nursing College, Taiwan
CHEN H.-Y. (2010)CHEN H.-Y. (2010)
spinal cord injury: a Parse research method study. Journal of Advanced Nursing
The lived experience of moving forward for clients with
Title. The lived experience of moving forward for clients with spinal cord injury:
a Parse research method study.
Aim. This study is a report of a theory of Humanbecoming-guided study of the lived
experience of moving forward among people with spinal cord injury.
Background. Most people with spinal cord injuries take a long time to recover and
return to their previous life activities. Moving forward is connected with the choices
people make about what is important, what to do, and how to live life in ways they
value. Parse’s Theory of Humanbecoming is a human science theory, and its overall
aims are to improve the quality of life for clients and their families.
Method. The Parse research method was used to explore the lived experience of
moving forward for 15 clients with spinal cord injuries recruited from two Spinal
Injury Associations in Taiwan in 2007. Data were collected and analysed through
the processes of participant selection, dialogical engagement, extraction-synthesis
and heuristic interpretation, as proposed by Parse.
Findings. The core concepts found were confronting difficulties, going on and
finding self-value and confidence, and co-creating successes amid opportunities and
restrictions. Thus, the structure of the lived experience of moving forward is con-
fronting difficulties, going on and finding self-value and confidence to affirm one’s
self while co-creating successes amid opportunities and restrictions.
Conclusion. This study contributes to nursing theory-guided knowledge develop-
ment from a humanbecoming perspective on the experience of moving forward
among clients with spinal cord injury, and informs rehabilitation nurses who use the
Humanbecoming theory as a guide to practice to promote moving forward.
Keywords: human becoming, lived experience, moving forward, nursing, Parse,
spinal cord injury
? 2010 Blackwell Publishing Ltd
JOURNAL OF ADVANCED NURSING
The phenomenon of moving forward is a universal lived
experience of health that is significant to quality of life. All
people experience moving forward at some time in their lives,
possibly in relation to overcoming traumatic life events (such
as traffic accidents, burns, cancer or others), confronting life’s
struggles, living with a condition not of their choice or
carrying on after losing self worth (Shiau 2002, Lane 2005,
Tang et al. 2008, Teixeira 2008). Moving forward is a
human experience intertwined with all life events, embracing
ideals and values, desires and dreams, relationships and
plans, hope and uncertainty. It is a particularly vivid
experience for persons who have had to find ways to go on
with their lives amid the challenges inherent with successful
living after spinal cord injuries (Holicky 2005, Chen & Boore
The Spinal Injuries Association first used ‘moving forward’
on the title page of their guide for living with spinal cord
injury titled ‘moving forward: the guide to living with spinal
cord injury’ (Gatehouse 1995). DeSanto-Madeya (2006a)
stated that spinal cord injury imposed multiple challenges to
adaptation for clients with spinal cord injuries and their
family members. Moving forward was defined as a new way
of life, reflecting families’ learning to see life differently, and
coming to terms with life after injury as a necessary process of
moving forward in new ways of living (DeSanto-Madeya
2006b, Chen & Boore 2008, Lin & Chen 2008).
Parse’s Theory of Humanbecoming is a human science
theory. Human science focuses on the human being’s partic-
ipative experience with the world. The aim of human science
is to understand the connectedness of life itself, which can
never become wholly accessible to complete understanding.
Humanuniverse experiences are connected uniquely to giving
meaning to an individual’s life (Parse 1992).
Moving forward emphasizes leading as full and indepen-
dent a life as possible after a disastrous injury, such as a
spinal cord injury. For such persons, independence does not
mean doing everything for one’s self, but rather, it means
having control over and making the key decisions that affect
life (Gatehouse 1995, Holicky 2005, Chen & Boore 2007).
This independence is very important to those who suffer such
trauma, to enable them and their family members to accept
their reality as a disabled person, and to understand how to
adapt their life again (Liao 2004, DeSanto-Madeya 2009).
Moving forward is associated with courage and triumph over
tragedy, going on with the rest of life after a catastrophic life
event, and confronting challenges (Bournes 2002, Reeve
2003, DeSanto-Madeya 2006b, Chen & Boore 2007, 2008).
‘Moving’ is about acting towards some goal or the arousing
of emotions, and ‘forward’ relates to the future or the
progression of something (Collins Dictionary & Thesaurus,
2002). Much has been written about people suffering and
finding their way to move on or living with their chronic
illness and towards a good result from various disciplines
(Lee et al. 2004, Liao & Lin 2008), yet none of the literature
focuses on the lived experience of moving forward from a
human science perspective for any group, especially those
with spinal cord injury. Therefore, the view of existing
research and literature supports the need for further study of
the phenomenon of moving forward from the perspective of
those who are experiencing it, and particularly, for people
with spinal cord injury. Knowledge of the process of moving
forward is useful for developing a deeper understanding of
the human experience of moving forward, consistent with the
theoretical literature on ‘moving’ and ‘forward’ and ‘moving
forward’. Promoting understanding about what it is like to
move forward gives healthcare professionals a better under-
standing of how these persons find ways to persevere and go
on living day by day, amid their personal difficulties,
disabilities and challenges.
Parse’s Theory of Humanbecoming was first published as
‘man-living-health’ in 1981 (Parse 1981). The theory was
renamed ‘the human becoming theory’ officially in 1992
(Parse 1992) and in 2007, Parse joined the words to create
the Humanbecoming theory (Parse 2007a). Humanbecoming
theory is derived from human science and is based on the
belief that the human is an indivisible, unpredictable, ever-
changing, open being and free to choose meaning in situation
(Parse 1998, 2007b). Parse (1981, 1998) describes humans
co-creating patterns of relating in interchange with the
environment. Human structure means multidimensionally
co-creating rhythmical patterns while cotranscending with
There are three principles in this theory, with concepts and
paradoxes (Parse 1998, 2007a): the first principle of human-
becoming stipulates how humans structuring meaning is the
imaging and valuing of languaging (Parse 2007a, p. 309). In
light of this principle, moving forward is viewed as a process
of structuring meaning while co-creating reality, which
involves explicit-tacit knowing (imaging); choosing meaning
from among imaged options and integrating the meaning
with one’s personal world view (valuing), through speaking
and silence, movement and stillness (languaging).
JAN: ORIGINAL RESEARCH
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Moving forward and spinal cord injury
? 2010 Blackwell Publishing Ltd