Bridging the gap: The experiences and needs of people with spinal cord injury when transitioning out of inpatient rehabilitation

Abstract

Background: The rehabilitation experience can influence the transition back to home and community life. With impending National Health Insurance reform and limited rehabilitation guidelines in South Africa, there is a need to understand the current state of rehabilitation services. To the authors’ knowledge, no other South African study has explored inpatient rehabilitation experiences and their influence on the readiness to transition home in spinal cord injury (SCI). Objectives: To explore the experiences of inpatient rehabilitation among people with SCI, to examine how the experience influenced their transition out of inpatient rehabilitation, and to identify the needs of people with SCI when transitioning out of inpatient rehabilitation. Method: A phenomenological, qualitative design was used. Semi-structured interviews were conducted with 11 patients with SCI in their final week of inpatient rehabilitation from October 2023 to February 2024. The interview guide was developed from similar studies in New Zealand. Interviews were transcribed verbatim and inductively analysed to identify themes. Results: Three themes emerged: overall rehabilitation experience, factors influencing the experience and transition readiness, and needs impacting the transition to home. Participants reported a positive experience overall, although some negative elements were noted. Key needs for a smoother transition included bridging the gaps in the approach to care, more realistic home environment simulations and individualised psychological support. Conclusion: Rehabilitation experiences highlight the need for a specialised, patient-centred approach to SCI care. Addressing unmet needs can enhance preparedness for reintegration, especially in contexts without a structured SCI model of care. Clinical implications: Ongoing professional development, improved rehabilitation environments and structured psychological support during rehabilitation are needed.