How recovery influences community reintegration: perspectives of persons with spinal cord injury and their support persons

Purpose To investigate how perceived recovery influences perspectives on successful community reintegration, from the point of view of persons with spinal cord injury (PWS) and their support persons (SP). Methods Our mixed methods approach included qualitative interviews conducted with civilians and Veterans with spinal cord injury (SCI) and their designated SP at three time points across the first year after SCI: during inpatient rehabilitation, 6 months, and 12 months. Participants with SCI completed measures of independence [Spinal Cord Injury Independence Measure III (SCIM-III)] and self-efficacy (Moorong Self-Efficacy Scale) during inpatient rehabilitation and at 12 months postinjury. Data analysis was informed by the Transformative Framework and International Classification of Functioning, Disability, and Health (ICF). Results Regarding perceptions of how recovery influences community reintegration, PWS most often reported themes related to slow recovery whereas SPs expressed concerns about psychological impacts on PWS. While some participants were equally satisfied with rate of recovery and rate of community reintegration, several deviated from that expected trajectory. Associations between satisfaction with community reintegration and independence or self-efficacy were variable. Conclusions Successful community reintegration cannot be predicted solely on clinical measures. Inclusion of perspectives of PWS and their support systems is critical to inform successful societal participation after SCI.