Endeavouring sustainable participation: Post-discharge adaptation process of occupational participation among persons with spinal cord injury in Bangladesh

ABSTRACT

Against a background of high levels of morbidity, mortality, and social exclusion among persons with SCI in Bangladesh, the aim of this research was to identify and describe how these persons experienced adaptation of occupations after discharge from an in-patient rehabilitation hospital. Following ethnographic interviewing and observation, the data of 19 adults with SCI were analysed by an iterative process of constant comparative analysis. The research identified three outcomes of adaptation, (1) creating opportunities for daily occupations, (2) reintegrating daily occupations, and (3) striving for sustainability; and seven doing processes of adaptation, (a) solving problems using local materials and knowledge, (b) reframing one’s situation, (c) adapting the environment (d) recreating routines and habits, (e) evolving vocational and social roles, (f) forming reciprocity, and (g) producing additional roles. These results show that sustainable participation in occupation requires support that enhances adaptation and eliminates maladaptation among persons with SCI living in Bangladesh.

KEYWORDS:

• Adaptation
• participation
• occupations
• occupational therapy
• transition
• spinal cord injury
• disability
• Bangladesh

Acknowledgements

This study was conducted as part of the requirements for the first author’s PhD degree in Occupational Therapy at Tokyo Metropolitan University. The Tokyo Human Resource Fund for City Diplomacy Scholarship financially supported the first author. Our special thanks go to the participants who willingly shared their experiences, to Kristin Will for her English poof reading and to staff at the Centre for the Rehabilitation of Paralysed (CRP), Bangladesh, who supported recruitment of participants. This paper will fulfil the partial requirement of the Ph.D. degree under Department of Occupational Therapy in Tokyo Metropolitan University.

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Yeasir Arafat Alve http://orcid.org/0000-0001-5607-4146

Peter Bontje http://orcid.org/0000-0002-8188-0411