Capturing the psychosocial impacts of falls from the perspectives of wheelchair users with spinal cord injury through photo-elicitation

Abstract

Purpose

While the physical consequences of falls among wheelchair users with spinal cord injury have previously been examined, the psychosocial impacts remain understudied. Here, we explored the psychosocial impacts of falls and risk of falling from the perspectives of wheelchair users with spinal cord injury.

Materials and methods

Twelve wheelchair users (aged 41.8 ± 12.5 years; median 17.5 (range 3–44) years post-spinal cord injury) with traumatic spinal cord injury captured photographs of how falls and the risk of falling impacted their recreation/leisure and paid/volunteer work activities. Participants then engaged in photo-elicitation interviews to discuss the content depicted in the photographs. Interviews were analyzed using a thematic analysis.

Results

Two main themes emerged: (1) The varying concern about falling: While some participants experienced a high concern, others were not concerned about falling in their daily activities. The level of concern about falling varied among participants over time and across situations. (2) Fear, falling, and limitations: Falls could impact daily activities, parenting, work, leisure/recreation, and lead participants to want a life without a constant risk of falling.

Conclusions

Falls have a significant psychosocial impact for some, but not all participants. Clinicians should explore whether and to what extent falls/fall risk have a lasting psychosocial impact, and work with individuals to create strategies that may reduce negative psychosocial impacts.

IMPLICATIONS FOR REHABILITATION

• This study highlighted that falls can have a significant psychosocial impact on the lives of some wheelchair users with spinal cord injury.

• Since a wheelchair user’s concern of falls may change overtime, clinicians are encouraged to have ongoing dialogue about every wheelchair user’s level of concern about falls.

• If a wheelchair user expresses a high concern of falls, clinicians are encouraged to provide appropriate supports and resources for individuals to continue engaging in meaningful activities.

Keywords:

• Spinal cord injuries
• qualitative research
• falls
• falling
• psychosocial factors
• rehabilitation research

Disclosure statement

The authors report no conflict of interest.

Additional information

Funding

This work was supported by the Craig H. Neilsen Psychosocial Research Grant, grant number [440070] to KEM; and a student scholarship from the Toronto Rehab Institute-University Health Network to HS.