The factors influencing community reintegration of traumatic spinal cord injury patients in a South African population

Spinal cord injury (SCI) is a devastating condition that is associated with permanent disability and decreased life expectancy. Regaining life roles pertaining to living situations, relationships and lifestyle are important for an individual who sustained a SCI. Thus, community reintegration as the main goal for rehabilitation of has been viewed by researchers as vital. The overall aim of the study is to investigate the factors associated with community reintegration after a traumatic spinal cord injury. The study utilized a mixed methods approach, specifically the sequential strategy. For the quantitative component of the study, data was collected from individuals who sustained a traumatic spinal cord injury residing in the Cape Metropolitan region in the Western Cape. Self-administered questionnaires to determine the factors predicting community re-integration namely were used and included the Sydney Psychosocial Reintegration Scale2 (SPRS2) and the Community integration Questionnaire (CIM). For the qualitative data collection, the sample included individuals who took part in the quantitative component who were willing to participate. No “a priori” sample size was calculated and data collection continued until saturation was reached. Quantitative data was captured and analysed using the Statistical Package for Social Sciences (SPSS) version 23. Descriptive statistics were used to summarize the data and was presented using frequency tables expressed as percentages, means and standard deviations. Inferential statistics were used to determine the associations between socio-demographic characteristics, self-efficacy and both psychosocial and community reintegration. The qualitative data was transcribed and categorized into emerging themes. Ethical approval was received was all the relevant authorities. Confidentiality was maintained throughout the study and trustworthiness was ensured by maintaining credibility and confirmability. A total of 102 participants participated in the quantitative part of study and had a http://etd.uwc. ac.za/ mean age of 37.6 years. The highest proportion (58.8 %) of individuals were classified as paraplegic, and 43.2% of injuries occurred due to motor vehicle accidents. The demographic information and the two scales produced very strong significant results utilizing the student ttest the SPRS2 and employment status (p = 0.00); CIM and level of injury (p= 0.000), residential status (P= 0.000). In the correlation analysis utilizing Pearsons correlation the SPRS2 was significant with age (p=0.021; r= 0.228), year of injury (p= 0.007; -0.266), CIM (p= 0.000; r= 0.527). CIM was significant with age (p= 0.014; r= 0.243), year of injury (p= 0.001; r= 0.316). The Qualitative themes included perceptions and attitudes of people; mobility aid; gangsterism/ crime; self-improvement; secondary complications; reliance on primary caregivers; transportation. With increased age and time of injury higher scores were observed in the measures. This could suggest that the older the participants the longer they have been living with their injury and could have had more time to adjust and adapt to their new life circumstances. To most of the participants increasing their education/ skill level and obtaining gainful employment seemed to be one of their main goals that they would wish to achieve. Community reintegration for TSCI is a very complex and multi-faceted phenomenon. Despite tremendous life altering injuries a sense of hope and optimism and a very strong sense of survival and coping mechanisms are vital to successful adaptation. The fear of crime and violence, inability to navigate the terrain due to inappropriate wheelchairs or weakness and lack of caregiver support also resulted in a huge impact on these TSCI individuals to become reintegrated into their communities. Unfortunately violence, access to transport and appropriate wheelchair prescription seemed to be a reoccurring theme. These issues can only be addressed with improved government intervention and policy. http://etd.uwc. ac.za/