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Abstract

Participation is a significant rehabilitation outcome for individuals with spinal cord injury and/or disorder (SCI/D), yet few qualitative studies have described the social aspect of disability and community participation. We used the photovoice methodology to explore perceptions and experiences related to participation among Veterans with SCI/D. We recruited a convenience sample of individuals with SCI/D at the Hines Veterans Affairs (VA) SCI/D Unit. Participants were asked to take photographs exemplifying their experiences and activities regarding participation. Within four weeks, participants returned their photographs and completed semi-structured interviews to discuss their photographs. Interview transcripts were analyzed using an inductive coding approach to identify emerging themes. Of the 18 Veterans with SCI/D who completed the initial orientation session, 9 (50%) completed the photography phase and follow-up interviews. A majority of participants were White (67%) and the mean age was 64 years. The mean duration of injury was 21.8 years, and 75% of participants were paraplegic. Most participants (78%) were community-dwelling. All participants discussed participation as a highly relevant issue in their lives. A majority of participants (67%) described sports as an example of participation. Over half (56%) emphasized the positive effects of participation (i.e., feelings of enjoyment / accomplishment) in sports as well as engaging in faith-based activities, being outdoors, and managing business- or household-related responsibilities. Barriers to participation were mobility impairments, lack of transportation and cost. Findings from this study can be used to address environmental changes or other accommodations that influence participation, both inside and outside the health care setting.

Keywords

Spinal Cord Injury, Community Participation, Photovoice, Veterans

Author Bio(s)

Salva Balbale, MS is a doctoral candidate at Northwestern University Feinberg School of Medicine and a Research Associate at the Department of Veterans Affairs (VA) Center of Innovation for Complex Chronic Healthcare. Correspondence regarding this article can be addressed directly to: salva.balbale@northwestern.edu.

Keshonna Lones, MPH is a Social Science Analyst with VA Center of Innovation for Complex Chronic Healthcare. Correspondence can be directed to k.lones1908@gmail.com.

Jennifer N. Hill, MA is the Associate Implementation Research Coordinator (IRC) and a Social Science Analyst with VA Center of Innovation for Complex Chronic Healthcare. Correspondence regarding this article can also be addressed directly to: jennifer.hill3@va.gov.

Sherri L. LaVela, PhD, MPH, MBA is a Senior Research Health Scientist at the VA Center for Innovation for Complex Chronic Healthcare and an assistant professor at Northwestern University Feinberg School of Medicine. Correspondence regarding this article can also be addressed directly to: sherri.lavela@va.gov.

Acknowledgements

This study was supported by the Department of Veterans Affairs, Office of Research and Development, Health Services Research and Development Service, Quality Enhancement Research Initiative (RRP-13-248). Disclaimer: The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs. Conflict of Interest: All authors declare that they have no conflicts of interest. Disclaimer: The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs. Conflict of Interest: All authors declare that they have no conflicts of interest.

Publication Date

7-9-2017

Creative Commons License

Creative Commons Attribution-Noncommercial 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 4.0 License.

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