What self-care behaviours are essential for people with spinal cord injury? A systematic review and meta-synthesis

Abstract

Purpose

To systematically identify, evaluate, and synthesise the qualitative literature on the self-care behaviours, skills, and strategies performed by individuals with spinal cord injury (SCI).

Review methods

The Joanna Briggs Institute (JBI) meta-aggregation method was followed. The search was conducted on five databases and limited to papers published from January 2000 to March 2020. Two independent reviewers screened, extracted the data from, and assessed the methodological quality of selected papers using the JBI qualitative assessment and critical appraisal instrument.

Results

Eleven qualitative papers were included. Three synthesised findings with a moderate level of confidence emerged from 90 findings: people with SCI perform self-directed or directed-by-other behaviours focused on their physical condition (i); and on their social life (ii); people with SCI perform self-directed behaviours focused on their emotional well-being (iii). Individuals with SCI are aware of their condition and incorporate self-care behaviours into their routine to maintain health and prevent complications.

Conclusion

This meta-synthesis provides evidence on the self-care behaviours performed by people with SCI to prevent, control, and manage the physical, emotional, and social effects of their condition. These findings may help healthcare providers to understand the self-care process in SCI survivors and tailor educational programmes to their experiences.

IMPLICATIONS FOR REHABILITATION

• SCI survivors are directly responsible for their health and must reach their maximum level of independence by acquiring self-care behaviours and adjusting them over time.

• Self-care behaviours must be incorporated into SCI survivors’ daily routine to maintain their condition, promote their social participation, and prevent complications.

• Caregiver contributions to self-care should be given more value, as these are fundamental to maintain SCI survivors’ well-being and social participation.

Keywords:

• Spinal cord injuries
• self-care
• meta-aggregation
• qualitative research
• systematic review

Author contributions

AC and MC were responsible for the conception and the design of the study; the acquisition, analysis, and interpretation of data; and drafted the manuscript. BM contributed to data acquisition and analysis. MK, AB, and SC were involved in the design of the study and critically reviewed the manuscript for important intellectual content. All the authors approved the final version of the manuscript.

Disclosure statement

A. Conti, M. Clari, M. Kangasniemi, B. Martin, A. Borraccino, and S. Campagna declare that they have no conflict of interest.