Facilitators and barriers to social and community participation following spinal cord injury

Abstract

Background/aim: One of the factors known to contribute to a 'good life' following an acquired disability is making connections with others, often achieved through participation in activities outside the home. The majority of outcomes research following SCI has focussed on impairments and activity limitations with less emphasis on participation. This paper reports part of a larger study that explored the experience and meaning of social and community participation following SCI. The research question guiding the part of the study reported in this paper was: What are the facilitators and barriers to social and community participation following acquired SCI?

Methods: Semi-structured interviews were conducted with 17 adults with traumatically acquired spinal cord injury living in the community. Interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis.

Results: Three main themes and 11 subthemes were identified. The main themes were: Resources and environmental accessibility impact social participation; other people influence community engagement; health issues affect social participation. Adequate financial resources and social support (from friends and family, and from peer mentors) were found to assist social participation, while the physical environment, unsupportive social attitudes and mental health issues were identified as barriers to community participation.

Conclusions: This study contributes to the evidence base regarding outcomes following SCI. Enabling engagement in meaningful activities in the community must be at the forefront of occupational therapy intervention, both at an individual client level and through advocacy and policy involvement, to improve the quality of life of people with SCI living in the community.

Keywords: OT process/competency standards; community access and participation; domains of practice; populations/conditions, qualitative research; service evaluation; spinal cord injury.