Experience of performing instrumental activities of daily living at community of adults with paraplegia following rehabilitation: a qualitative phenomenological study

Abstract

Background: Instrumental Activities of Daily living are essential for leading an independent life with quality of well-being. However, there needs to be more evidence of IADL practice in developing, low and middle-income countries for people with SCI. In Bangladesh, people with SCI increasing day by day. The mortality rate at post discharge period is high in developing, low and middle-income countries rather than high income country. This study aims to explore the experience of performing instrumental activities of daily living in the community of adults with paraplegia following rehabilitation. Method: The phenomenological study design of qualitative research was used to explore the personal experience of eight participants with spinal cord injuries who completed a rehabilitation program from CRP, recruited through purposive sampling. The self-developed semi-structured guide was used face-to-face for conducting interviews. The interview timing for individuals was 40 to 50 minutes, audio recorded and transcribed verbatim. According to Braun and Clark, the data analysis approach was inductive, followed by a six-step thematic analysis. Results: Six males and two females were paraplegic in this study. The study's findings were facilitators or barriers to performing IADL. Eight main themes represent the study findings;1) areas of IADL, 2) physical health issues, 3) enablers to IADL performance, 4) barriers to IADL performance, 5) intrapersonal skill effect, 6) safety awareness,7) social feedback,8) Income Generating Activities (IGA) and follow up. Conclusion: The findings indicate that the multi-disciplinary team has a significant role in institutional rehabilitation services to engage the person with SCI in IADL. A supportive environment from the health care professionals, family, and community people can assist the person with SCI to perform IADL. An occupational therapist can educate the person with SCI about self-advocacy to ensure accessibility by cost-effective adaptation and modification, which facilitates the person with SCI to live independently within the community. Keywords: Instrumental Activities of Daily Living, Performance, Community, Spinal Cord Injury, Rehabilitation.