Social and community participation following spinal cord injury

Abstract

Evaluation of rehabilitation outcomes following acquired disability should include participation in social and community life. Evidence is needed to guide clinical practice to ensure that it is client-centered; therefore, findings from studies that report on social and community participation following spinal cord injury (SCI) need to be reviewed and synthesized. The objectives of this critical literature review are to examine the available evidence on social and community participation following SCI and to examine the factors that influence that participation. The barriers and facilitators will be identified and described in terms of the contextual factors - personal or environmental, as outlined by the International Classification of Functioning, Disability and Health. An additional objective is to appraise the quality of the evidence examined. A systematic literature search was completed in the databases OVID MEDLINE, AMED, CINAHL PLUS, PSYCHINFO, and hand searches were carried out. Quantitative, qualitative, and mixed methods studies were included. Twenty-three studies fulfilled the inclusion criteria: 17 quantitative, five qualitative, and one mixed methods. In general, studies were of low methodological quality, and no intervention studies were identified. The terms participation, social participation, and community participation were used interchangeably often without clarification of meaning. Adequate personal care assistance, appropriate social support, having adequate specialized equipment, and appropriate occupational therapy input were found to facilitate social and community participation, whereas problems with transport, inaccessibility of the natural and built environment, issues with healthcare services and rehabilitation providers, and pain were identified as barriers. In-depth investigation into what aspects of social and community participation are important to those living with SCI is needed so that client-focused solutions and interventions can be identified and developed, aimed at creating and promoting opportunities for social and community participation.

Problematic secondary health conditions among adults with spinal cord injury and its impact on social participation and daily life

“…impairment or functioning level) to the impact environmental and personal factors, as well as participation and activity can have on one's health and quality of life. 6,7 Participation ("a person's involvement in a life situation") 8 strongly related to quality of life 9 has emerged as an important clinical outcome with the SCI population. 6 Furthermore, social participation as a subset of participation is defined as engagement in activities that entail social interactions with others within the community and outside the home environment.…”

“…6,7 Participation ("a person's involvement in a life situation") 8 strongly related to quality of life 9 has emerged as an important clinical outcome with the SCI population. 6 Furthermore, social participation as a subset of participation is defined as engagement in activities that entail social interactions with others within the community and outside the home environment. 10 In recent years, the influence of the ICF on investigating and treating individuals with SCI from a different perspective has advanced the treatment and management of secondary conditions.…”

Functioning and Physical Activity after Spinal Cord Injury.

“…But references of Pelletier [34] presented data does not correspond to our study results, which suggest that at the end medical rehabilitation period decreased the participation in recreation and leisure activities and in subsequent periods remained at the same level. However, authors [20,35] participation and engagement in sports and recreational activities increased with every year after SCI onset, and too low participation in these activities related to the limited opportunities of people with disabilities in sports and employment, especially in smaller towns. Therefore, the authors claim that the even during inpatient rehabilitation, it is important to start encourage people after SCI participation in sport and active leisure, by engaging in nongovernmental, and employment of the disabled sports organizations.…”

“…Mostly during inpatient rehabilitation for assessing rehabilitation outcomes and effectiveness were used mobility and daily activities assessing [2,3,17], but none of them can be considered as a standard and none of them covers all aspects of functioning and physical activity in long-term context [4,18,19]. It is very important comprehensively assess functioning and disability, to identify the prototypical spectrum of functional problems associated with personal daily and social life, occupations and activities issues that people with SCI could experience in real life after rehabilitation in 1, 5, 10 and more years [10,20].…”

Examining How the Perception of Health Can Impact Participation and Autonomy Among Adults with Spinal Cord Injury

“…27 Prior research with the SCI population has indicated that participation in life activities, when included in community-based rehabilitation, has a direct influence on physical and psychosocial clinical outcomes. 28,29 Yet, it is still unclear what aspects of community and social participation within the realm of the ICF actually have a significant impact on the overall health of this population. 29 Although the literature has examined QOL in people with SCI, few studies have examined how perception of health impacts participation and autonomy for this population.…”