Inclusivity in Occupational Participation: Life Stories of Bangladeshi With Spinal Cord Injury

Abstract

This research aimed to describe the process of occupational participation among persons with spinal cord injury (SCI) discharged from the only SCI rehabilitation hospital in Bangladesh. We analyzed seven participants’ interview transcripts and observations using the trajectory equifinality model. Study participants demonstrated the following occupational participation trajectories: (a) employing a strategy or difficulty in occupational participation; (b) performing solidarity or experiencing deprivation; (c) creating identity or divergence; and (d) being included in or excluded from everyday life. There are four pathways: (I) discouraging conditions that minimized daily performance; (II) reinforcing obligatory connections to optimization of daily performance; (III) reciprocity to facilitate social activities; and (IV) manipulating mastery in occupational participation. Occupational therapists can consider the trajectory phases and pathways of occupational participation when facilitating the inclusion of service users after discharge from the hospital.

Plain language summary

Experience of Occupational Participation Among Persons With Spinal Cord Injury: Life Story Analysis With Trajectory Equifinality Model (TEM)

Persons with spinal cord injury (SCI) in Bangladesh demonstrated inadequate skills in community integration because of limited access to health care follow-ups and unfavorable sociocultural conditions. This research focuses on occupational participation experiences among seven persons with SCI living in the community. We used trajectory equifinality model (TEM) to analyze semi-structured interview and observation data to understand human experiences in an irreversible timeline from a starting point to an endpoint. Data analysis revealed a conceptualization of four periods of occupational participation and four common types of non-linear pathways. Participants optimized shared occupational participation and used mastery over occupations to minimize the experience of occupational deprivation. These findings could assist in developing independent peer-led occupation-based health care programs with few skilled occupational therapists and limited financial resources. These 3 years of interviews and follow-up reports with participants who were selected purposively do not necessarily reflect how actual participation unfolded over time.

Keywords

spinal cord injury participation social participation community participation

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