Self-Management Embedded in Daily Activities: A Photoelicitation Focus Group Study among Persons with Spinal Cord Injury and Their Primary Caregivers in Bangladesh

Occupational Therapy International, 2022 · DOI: https://doi.org/10.1155/2022/2705104 · Published: March 15, 2022

Spinal Cord Injury Patient Experience Research Methodology & Design

Simple Explanation

This study looks at how people with spinal cord injuries (SCI) and their caregivers in Bangladesh handle daily life. It uses photos and group discussions to understand their strategies. The research identified ways people manage their health, emotions, and daily tasks. It also found that managing social challenges is a key part of living with SCI in Bangladesh. The findings suggest that programs for people with SCI should consider these social challenges, alongside medical and emotional support, to improve their lives.

Study Duration

Not specified

Participants

14 adults with SCI and their primary caregivers

Evidence Level

Not specified

Key Findings

1
Participants developed and followed consistent routines and habits to manage their medical health complications and facilitate participation in daily activities.
2
Participants showed various coping strategies for emotional distress, most of which were analogous to the previous literature in the ﬁeld (e.g., developing authority on emotional issues).
3
A new component of management of social complexities was identified, referring to the management of deteriorating relationships among closely bonded people and the social consequences faced after an injury.

Research Summary

This research explored how persons with SCI and their primary caregivers execute self-management strategies in daily community life and then mapped these strategies to a leading, preexisting self-management framework. Categorizing the nine identified self-management strategies challenged the current composition of the framework of self-management, which is composed of the medical, emotional, and role management categories. Including a newly uncovered fourth component of management of social complexities of self-management reinforces the importance of understanding and acting upon individual and societal perspectives in the local context.

Practical Implications

Community Support Programs

The strategies identified in this study can be used when persons with SCI struggle with adverse conditions.

Healthcare Professional Focus

Healthcare professionals, especially occupational therapists, should focus not only on the individual’s health problems but also on additional social problems to facilitate social justice in daily life.

Self-Management Programs

Any self-management enhancement program should integrate all four components of self-management: medical, emotional, role management, and management of social complexities.

Study Limitations

1
The inability to discuss the management of sexual problems, as the focus groups consisted of a mix of married, single, and male and female participants, some of whom participated with a parent as a primary caregiver, was a limitation.
2
Photoelicitation may have further led the participants to refrain from sharing such private issues, which, as in many cultures besides Bangladeshi culture, is a topic people do not discuss publicly.
3
This study sample likely overrepresented long-term survivors who may be better at self-management in daily life than most persons with SCI, who arguably self-manage poorly.

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