Abstract
Study designExplorative qualitative study based on an interpretative phenomenological approach.ObjectivesThis study explored the possibility of transferring knowledge and skills from a spinal cord injury (SCI) unit to the home environment; the individual and structural factors that potentially influenced this transfer; and its compatibility with a meaningful everyday life.SettingHospital-based rehabilitation unit and community in Denmark.MethodsFourteen individuals with SCI were selected with maximum variation according to age, sex, marital status, and level of injury. In-depth, semi-structured interviews were conducted in the participants’ homes, 2–10 months after discharge from an SCI unit. Data analysis involved taking an interpretative phenomenological approach combined with a template analysis and applying the transfer of training theory to the discussion.ResultsTransitioning from the SCI unit to the home environment involved a multidimensional change of context in which most of the participants’ previous life roles had changed. This overarching theme had a decisive influence on: balancing loss and acceptance, facing external structural barriers, and the strength of social relationships when the knowledge and skills acquired at the unit were applied in a meaningful everyday life.ConclusionsTransition from the SCI unit to the home environment is influenced by a multidimensional change of context that may restrict the use of acquired skills post-discharge, provide distant prospects for tertiary health promotion, and aggravate the experience of loss in people with SCI. Maintaining relationships is a strong mediator for transferring skills and re-establishing a meaningful everyday life.
Highlights
Supplementary information The online version of this article contains supplementary material, which is available to authorized users.Individuals who sustain a spinal cord injury (SCI) may experience severe functional and long-lasting impairments, such as loss of locomotor function, pain, spasticity, bladder/ bowel, and sexual dysfunction [1, 2]
The study aims to explore the possibility of transferring knowledge and skills from the SCI unit to the home environment; the individual and structural factors that potentially influence this transfer; and its compatibility with a meaningful everyday life. This is a qualitative study that uses an interpretative phenomenological analysis (IPA) approach [18] to assess empirical data generated from in-depth, semi-structured interviews of individuals with SCI following specialized rehabilitation in Denmark
This study contributes to furthering understanding of the perception of transferring knowledge and skills to the home environment and identified the multidimensional change of context present when the SCI unit’s safe and supportive environment was replaced by physical, emotional, and social uncertainty at home
Summary
Individuals who sustain a spinal cord injury (SCI) may experience severe functional and long-lasting impairments, such as loss of locomotor function, pain, spasticity, bladder/ bowel, and sexual dysfunction [1, 2]. A meta-analysis concluded that, in addition to the physical consequences, depression was reported in 22% of individuals with SCI [3]. Another prospective study found that 17–25% experience increased psychosocial distress following SCI and after transitioning into the community [4]. Organizing SCI treatment into specialized interdisciplinary care centers has led to significant improvements in major SCI outcomes [6], reducing mortality and the number and severity of SCI complications [7] and increasing the likelihood of being discharged to the home [8].
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