Abstract:
Background: Spinal cord injury (SCI) adversely impacts mobility, independence, and
emotional stability. In Bangladesh, challenges are heightened by limited rehabilitation
services, financial barriers, and inadequate social support. Understanding how individuals
adapt post-injury is crucial for developing effective rehabilitation services that promote
community inclusion for those with SCI. Objective: The study aimed to explore how
individuals with SCI in Bangladesh adapt to sustainable disability living in the community,
and to identify the key predictors that influence their adaptation. Methods: A cross
sectional study investigated 210 individuals with spinal cord injuries (SCI) who completed
rehabilitation at the Centre for the Rehabilitation of the Paralysed (CRP) and had been in
their communities for 6 months to 10 years post-injury. Data were collected using Bangla
versions of the WHO Disability Assessment Schedule (WHODAS 2.0) and the Adaptation
to
Disability Scale-Revised (ADS-R). Descriptive statistics summarized sample
characteristics, while chi-square tests, one-way ANOVA, and Kruskal-Wallis tests
identified associations. Spearman correlation assessed factor relationships, and multiple
regression analysis determined predictors of adaptation to disability. Results:
Among 210 participants, 71.4% had moderate disability acceptance, 28.1% had low
acceptance, and only 0.5% had high acceptance. Low adaptation was linked to factors like
complete injuries, tetraplegia, unemployment, pressure ulcers, and delayed rehabilitation.
Interestingly, higher education did not ensure better emotional adjustment. Positive factors
for better adaptation included earlier rehabilitation, continued income, and family caregiver
support. Significant relationships were identified between adaptation and variables such as
disability severity, injury type, employment status, income changes, and rehabilitation
timing. Conclusion: Many individuals with spinal cord injuries in Bangladesh face
challenges adapting to life after their injuries. The study highlights the importance of timely
rehabilitation, ongoing support, and psychosocial care to improve outcomes. Early
intervention and community-based rehabilitation can enhance long-term well-being and
participation.
Key words: Spinal cord injury, adaptation, disability acceptance, WHODAS 2.0, ADS-R,
Spearman correlation, community reintegration, Bangladesh
Description:
A thesis is submitted to the SSARC Regional Interprofessional Master’s Program in Rehabilitation Science of Centre for the Rehabilitation of the Paralysed (CRP) in conformity with the requirements for the Degree of M.Sc. in Rehabilitation Science, Bangladesh Health Professions Institute, Faculty of Medicine, the University of Dhaka, Bangladesh.