Date Presented 4/18/2015
In this phenomenological study, we describe how participating in a community wellness program positively influences well-being from the perspective of 4 adults with a spinal cord injury (SCI). Understanding these perspectives will benefit occupational therapists (OTs) as they prepare their patients for community reintegration and health promotion.
SIGNIFICANCE: Given gaps in traditional occupational therapy rehabilitation programs, individuals with spinal cord injury (SCI) are seeking community-based wellness programs to maximize their recovery. In this study, we explore the relationship between participating in an activity-based community wellness program and well-being from the perspective of individuals with SCI, and implications for occupational therapy practice.
INNOVATION: Findings contribute to the theoretical understanding of the transactional nature of occupation, particularly how participation in occupation influences physical, mental, and social well-being and how context influences meaning of experiences. Understanding the experiences of individuals with SCI as they seek community-based programs to maximize their recovery will help inform future occupational therapy practice.
APPROACH: In this study, we attempt to answer the following research question: How do individuals with an SCI describe their experiences participating in an activity-based community wellness center program; the meaning of these experiences; and how their experiences influence their physical, social, and mental well-being?
Gaps in traditional occupational therapy due to reimbursement constraints require individuals with SCI to pursue activity-based community programs to maximize their recovery. The majority of literature relating to SCI, community wellness programs, and well-being describes physiological benefits of exercise or physical activity. Little is known about how participating in an activity-based wellness program influences physical, mental, and social well-being. Gaining an understanding of the meaning and experiences of individuals with an SCI as they participate in activity-based community programs can inform future occupational therapy practice and can add to the literature on the transactional nature of occupation.
METHOD: In this study, we used a phenomenological design. We recruited members of an activity-based community program designed specifically for individuals with an SCI using convenience and purposive sampling strategies. Recruitment continued until saturation occurred. Four members 18 yr and older with an SCI participated in the study. Data methods included individual interviews with a semistructured interview and observation of participants as they engaged in their activity-based wellness routine. Audio recordings of interviews and field notes of observations were transcribed verbatim and were reviewed for accuracy. Data were analyzed by gaining a sense of the whole and coding for meaning units, structure of the experience, and essence of the experience. Five investigators performed separate analyses of data until saturation was achieved.
RESULTS AND CONCLUSION: Trustworthiness of findings was established through triangulation, peer debriefing, member checks, and use of an external auditor and audit trail; we also established trustworthiness by providing sufficient details and rich, thick descriptions using quotes to illustrate themes. The following themes emerged from the data: benefits to physical and mental well-being, perseverance, a supportive community, and a place for hope. The findings describe how community wellness centers provide a supportive and hopeful environment of peers with SCI and how participation positively influences all aspects of well-being. Findings also show the need for occupational therapists to act as advocates for individuals with SCI as they transition to the community to maximize their recovery and well-being.
