Occupational disruption among people with a spinal cord injury: A South African cross-sectional study

Abstract

Introduction: The environmental and socio-economic realities of people with spinal cord injury (SCI) living in low-middle-income countries (LMIC) present challenges to engagement in meaningful occupations following discharge from rehabilitation. Participation depends on adaptation to occupational disruptions. The purpose of this study was to determine the disruption of occupational-identity, -competence and -settings among people with SCI in a LMIC. The association of occupational disruption and health-related quality of life (HRQoL) was also considered. Methodology: A cross-sectional quantitative study assessed 29 people with SCI, 4 months post-rehabilitation, using the Occupational Performance History Interview 2nd Version (OPHI II) and the European Quality of Life (5-dimensions and 3-levels) (EQ-5D-3L) survey. Results: Total interval key scores on a scale of 100 for occupational identity (49.97) and competence (51.21) were higher than those for occupational settings (38.62). Present functioning in occupational -identity and -competence was significantly lower ( p = 0.001) than previously. However, HRQoL was most affected by pain and discomfort, with a low correlation between scores for mobility, usual activities and self-care and occupational disruption ( r = -0.37–0.34, p ⩽ 0.05). Conclusion: Results suggest strengthening occupational therapy services post-discharge, with a focus on occupational settings disruption, particularly to support engagement in work and leisure, facilitating occupational identity and competence are required.