Impact of divorce and separation for the women with spinal cord injury in community reintegration

Abstract

Introduction: Divorce and separation is a personal as well a social issue. Female had 1.42 times more chance to be divorced than male with spinal cord injury (Kreuter,et al., 2011). Divorce rate mainly depends on level of injury as well age, education and occupation (Derakhshanrad.et al., 2016). Community integration is the ultimate goal of physical, mental, and drug rehabilitation (Kratz,et al., 2015). It helps the people to return normal lifestyle which is closely related to quality of life of the people (Liu,et al., 2014). General Objectives: (1) To identify the socio demographic status of both divorced and separated women with spinal cord injury. (2) To find out the level of community reintegration based on the aspect of home integration, social integration, productive activities and integration into electronic social media for women with SCI. (3) To understand the perception about the consequences of divorce and separation in community reintegration. Methodology: This study was done by using mixed methods, which was combination of cross sectional and qualitative design study in the community setting in Bangladesh. The study population was all spinal cord injury patients who rehabilitated at CRP from July 2011 to June 2016. All the participants were taken who were fulfilled the inclusion criteria for the study. Data were collected by using a standard developed questionnaire (CIQ-R) and semi-structured open ended questionnaire was used for this research which was developed throughout maintaining proper procedure. Researcher maintained the all-ethical issues. Data were numerically captured in SPSS 20 version. Contain analysis was done for qualitative part of the study. Result: Total community integration score was 12.03 and SD was ± 3.87. This score was significantly lower to compare other study for person with SCI. The mean and SD of home integration (2.89, ±1.53), social integration (3.74, ±1.16), productivity (3.12, ±1.81) and electronic social networking (2.54, ±1.86) scores were also lower than compare to other study. Age, education, occupation, religion, living area, monthly income, marriage before or after injury, 14

duration of marriage, number of children, duration of divorce or separation, ASIA, neurological level were found to be significant predictors of divorce or separation. Four major themes were found in this study (1) Causes of divorce and separation (2) Impact on relationship with family member (3) Impact on social participation (4) Impact on productive activities. Regardless of all participants reported loss of autonomy and functional ability, loss of sex life, loss of self-identity, loss of intimacy with in laws, loss of autonomy were the main causes of divorce and separation. After divorce family relationship affected by with whom live, support from family, nutrition, and role as decision maker. Social participation affected with relationships with community people, recognition, acceptance at social activities, asked to share decision making. On the other hand nature of problem, financial worries, fear of increased dependency and isolation, loss of future, dreams, and physical environment were the impact of divorce and separation in productive activities. Conclusion: Participants scored low in total community integration was lower than compare to other. Suggesting there is a great need to develop interventions by governmental and non-governmental organizations to better integrate individuals of women with divorce and separation with spinal cord injury in the community. Key words: Spinal Cord Injury, Women, Divorce, Separation, Community Integration.