Long-term adjustment and community reintegration following spinal cord injury.

This paper presents the results of a 2-year mixed methodology (quantitative and qualitative) study examining the reintegration and quality of life of community-residing adults with spinal cord injury (SCI). A convenience sample of 100 individuals with SCI completed three questionnaires for the quantitative study phase. A self-selected subsample of 34 of the participants then attended qualitative focus groups to further explore adjustment to living in the community after SCI. The results revealed that locus of control is crucial to subjective quality of life, productivity status, satisfaction with performance of daily activities and satisfaction with community integration. Respondents confirmed that substantial adjustments are required after SCI, and that these can be aided through education, involvement in productive activity and participation in social and leisure activities. A dominant finding was that social support and peer mentoring were invaluable. Stable health and appropriate pain management were crucial to subjective satisfaction with community integration, yet for many of the respondents these were elusive. Although the participants valued the rehabilitation process, they felt that "the system" was not client-centred and that the timing of services and information was not always relevant to individual needs. The clinical and practical implications of these results are discussed.