Occupational therapy rehabilitation managers’ perspectives on community integration of persons with spinal cord injuries in Nairobi, Kenya

Abstract

Introduction:

Spinal cord injuries (SCI) present complex clinical challenges requiring comprehensive rehabilitation management to facilitate adequate community reintegration. Rehabilitation managers are suitably positioned to enforce and enact policy related to holistic rehabilitation intervention, including preparing patients for community integration. However, due to discrepancies within the chain of care systems, they are unable to ensure individuals with SCI in Kenya are discharged to their respective communities fully prepared for effective community integration. Exploring their perspectives may therefore highlight potential barriers or enablers to ensuring more effective community integration for survivors of SCIs.

Methods: A qualitative, descriptive study was conducted via individual interviews with 12 purposively sampled rehabilitation managers. Data were audiorecorded and transcribed and underwent content analysis.

Findings: The study findings revealed inadequacies in the process of spearheading and facilitating community integration of individuals that sustained a spinal cord injury. On the other hand, the study suggested possible strategies to reinforce community integration for individuals with spinal cord injuries by involving all stakeholders in decision making, addressing training gaps, facilitating research programmes and equipping rehabilitation centres with specialised spinal cord units.

Conclusions: Implementing disability policies to minimise barriers to community integration and access to essential services is required. This includes developing clear guidelines on comprehensively managing individuals with spinal cord injuries in the community within the Kenyan context.

Implications for practice

• Occupational therapy managers have a role to play in the facilitation of empowerment strategies aimed at influencing community (re) integration of survivors of SCIs.

• There is the need for the enactment of an effective rehabilitation framework to enforce the role of occupational therapists as a key role player in facilitating community (re) integration.

• Goodwill is required from the governmental political systems and organisations to spearhead the enforcement of the existing disability legislation if the welfare of survivors of SCIs are to be achieved.