Disability and a sense of community belonging. A study among tetraplegic spinal-cord-injured persons in France

The Mediating Effect of Disability Acceptance in Individuals with Spinal Cord Injury Participating in Sport for All

The purpose of this study is to examine the importance of disability acceptance among individuals with spinal cord injury (SCI) participating in the Sport for All program through self-help group activities with other individuals with SCI. This study investigated whether disability acceptance mediates the relationship between self-efficacy and life satisfaction and between sense of belonging and life satisfaction. Subjects were 142 individuals with SCI participating in the self-help group with other sports activities including para table tennis, swimming, wheelchair rugby, and weight training. A simple mediation effect analysis showed that disability acceptance significantly mediated the relationship between self-efficacy and life satisfaction (indirect effect, b = 0.219) and between the sense of belonging and life satisfaction (indirect effect, b = 0.289). The results suggest the importance of disability acceptance for individuals with SCI participating in "Sports for All" programs.

Sense of Community and Its Impact on the Life Satisfaction of Adults With Brain Injury

Sense of community (SOC) refers to feelings of belonging and attachment one has for a community. Despite a growing focus on adjustment and community outcomes following disability, this construct has received little attention in the rehabilitation literature. The primary aim of this study was to examine the extent to which SOC and social identification with one’s town contribute to life satisfaction outcomes among adults with brain injury, controlling for demographic, disability, and other related social constructs (e.g., social support and social integration). Members from brain injury associations across the United States ( N = 177) participated in a survey-based study. Results from hierarchical regression analysis indicated that the final model accounted for 45% of the variance in life satisfaction, with SOC variables contributing 11%. Symptom severity, perceived emotional support, and the SOC dimension reinforcement of needs were significant independent predictors of life satisfaction. Findings from this study highlight the importance of examining SOC variables among clients with brain injury to enhance subjective well-being.

Environmental Factors and Their Role in Community Integration after Spinal Cord Injury

Background. The International Classification of Functioning, Disability and Health (ICF) model presents an opportunity to better understand previously neglected longterm social outcomes after traumatic spinal cord injury (SCI), especially the experience of participation. Purpose. The study explored the relationship between perceived environmental barriers and perceived community integration (a participation proxy) in a sample of adults with traumatic SCI. Methods. The study interviewed African American and White women and men (n=136) who had lived with SCI for an average of 11.5 years. Results. Participants reported environmental barriers at twice the level indicated by previous studies; the natural environment and the policies of government were the most problematic. Levels of community integration were also high. Data suggest a significant relationship (p<.01) between perceived environmental barriers and community integration for adults with SCI, providing support for the ICF model. Implications. Improved measures and more sophisticated concepts and theories are needed to explicate the relationship between environmental factors and participation concepts in the ICF. With respect to practice, occupational therapists need to be aware that removal of environmental barriers is only a first step in the more complex effort to facilitate optimal community integration after SCI.

Toll motorway accessibility for wheelchair users: a survey

OBJECTIVE

To identify difficulties encountered by wheelchair users who travel on toll motorways, with the goal of defining areas for improvement.

DESIGN

Survey. After observing a wheelchair user travelling on a toll motorway and using the associated services, we designed a self-questionnaire on perceptions by wheelchair users of toll motorway accessibility.

SETTING

Toll motorway and rehabilitation hospital in France.

SUBJECTS

We recruited 167 wheelchair users by advertisement and, to assess selection bias, 19 consecutive outpatients who visited our hospital's wheelchair showroom.

INTERVENTION

None.

RESULTS

Of the 186 included subjects, 91 (49%) were used to driving independently on toll motorways. Among them, only 16% used automatic toll booths and 32% reported difficulties at toll booths. Furthermore, 53% routinely asked for help at filling stations, and only 27% were aware of the availability of a free-of-charge assistance service for disabled people at some filling stations. Among the 186 toll motorway users, only 84 (45%) reported never encountering difficulties in lay-bys; 162 (87%) felt that toilet accessibility was the most important feature of lay-bys and 143 (77%) preferred the locked toilets reserved for disabled people.

CONCLUSION

Wheelchair users reported difficulties on toll motorways that could be corrected fairly easily.

Environmental factors and their role in community integration after spinal cord injury

BACKGROUND

The International Classification of Functioning, Disability and Health (ICF) model presents an opportunity to better understand previously neglected longterm social outcomes after traumatic spinal cord injury (SCI), especially the experience of participation.

PURPOSE

The study explored the relationship between perceived environmental barriers and perceived community integration (a participation proxy) in a sample of adults with traumatic SCI.

METHODS

The study interviewed African American and White women and men (n = 136) who had lived with SCI for an average of 11.5 years.

RESULTS

Participants reported environmental barriers at twice the level indicated by previous studies; the natural environment and the policies of government were the most problematic. Levels of community integration were also high. Data suggest a significant relationship (p < .01) between perceived environmental barriers and community integration for adults with SCI, providing support for the ICF model.

IMPLICATIONS

Improved measures and more sophisticated concepts and theories are needed to explicate the relationship between environmental factors and participation concepts in the ICE With respect to practice, occupational therapists need to be aware that removal of environmental barriers is only a first step in the more complex effort to facilitate optimal community integration after SCI.