Life experiences and perceived community reintegration of people with spinal cord injury after hospital discharge in Malawi

Abstract

Spinal cord injury (SCI) is described as a complex condition that disrupts life and results in profound impairments and functional loss. Despite efforts of rehabilitation professionals to improve the functional independence of people with spinal cord injury (PWSCI) for their successful community reintegration, PWSCI face challenges to achieving significant community reintegration levels which is its primary goal. This study aimed to explore the life experiences and perceived community reintegration of PWSCI who were at least 6 months post-hospital discharge in Blantyre, Malawi. This qualitative study used a phenomenological approach and participants who were purposively sampled. Thirteen voluntarily consenting participants took part in the study. Their mean age was 38.1 years (SD 12.38). Their mean duration of living with SCI was 3.2 years (SD 1.21), with the mean length of hospital stay being 5.1 months (SD 2.40). Data were collected through semi-structured interviews using an interview schedule. The interviews were digitally recorded and transcribed verbatim. Thematic content analysis was used during data analysis in which codes were grouped, and themes were generated. Three objectives were explored in this study. Five themes emerged under the objective of exploring the challenges facing PWSCI in relation to community reintegration, namely, limited community participation, experience of vocational challenges, presence of secondary health conditions, experience of lack of resources, and restrictive environment. The study also explored the coping strategies that PWSCI use to mitigate the challenges they face and four themes emerged: having effective social support, spiritual health and accepting change, becoming self-reliant, and managing life with available resources. Finally, the study sought suggestions from PWSCI on ways to further improve their community reintegration and two themes emerged, namely, community proactiveness in environmental modifications and effective preparedness of PWSCI for home. The study findings highlight the need for a collective effort from various stakeholders to address the challenges PWSCI face and reinforce the coping strategies they adopt to facilitate successful community reintegration.