The purpose of this study was to develop a substantive theory to explain how the timing of impairment in women's lives influenced health-promoting lifestyles among 45 women age 43 to 79 years with impairments of varying onset across the life course. From this grounded theory exploration, we suggest that women created health-related lifestyles that were comprised of changing abilities, roles, and rituals in support of perceived self. The ultimate goal of a healthy lifestyle was healthy aging, which was self-determination in the support of positive relationships. Environment and resources had direct influence on the perceived self. Our proposed substantive theory provides an understanding of how women develop a healthy lifestyle after the onset of permanent sensory or physical impairment. It also takes steps toward an understanding of how timing of impairment influences the perceptions women have of themselves and their health behaviors.
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