Moshi H1,2,3, Sundelin G1, Sahlen K-G4, Rhoda A3, Sorlin A1
1Umea University, Community Medicine and Rehabilitation, Umea, Sweden, 2Kilimanjaro Christian Medical University College, Rehabilitation Medicine (Physiotherapy), Kilimanjaro, Moshi, Tanzania, 3University of the Western Cape, Faculty of Community and Health Sciences, Cape Town, South Africa, 4Umea University, Nursing, Umea, Sweden
Background: Persons with traumatic spinal cord injury (TSCI) in Tanzanian rural settings face a variety of geographical and socioeconomic challenges that make life almost impossible for them. However, some have managed to live relatively long lives despite these difficult conditions. Little is known about the manner in which persons with TSCI manage to survive in such an inaccessible and poor environment.
Purpose: This study aimed at exploring the strategies used by persons with TSCI to survive in a typical resource-constrained rural setting of Tanzanian.
Methods: A modified constructivist grounded theory was employed for the analysis of data from 10 individuals who have lived with TSCI for between 7 and 28 years in typical Tanzanian rural area. The 10 were purposively selected from the community and in-depth interview conducted in the home of each. The analysis followed the constructivist approach in which data was first open and axial coded, prior to construction of the categories. The constructed categories were frequently reviewed in light of the available literature to determine the over-arching core category that describes or connect the rest.
Results: Nine categories (identified as internal and external coping resources) were constructed. The internal coping resources were: secured in God, increase in awareness of health risk, problem-solving skills and social skills. External coping resources were: having a reliable family, varying support from the community, a matter of possession and left without means for mobility. Acceptance was later identified as a core category that determines the identification and utilization of the rest of the coping resources.
Conclusion(s): Persons with traumatic spinal cord injury can survive for a relatively long time in the rural settings of low-income countries despite the hostile environment. Coping with this environment requires the identification and utilization of various coping resources, acceptance being the most important.
Implications: Physiotherapists are involved in a long-term community-based rehabilitation of persons with TSCI. It is important to realize and facilitate achievement of the coping resources to this group for better rehabilitation outcomes and quality of life. Knowledge of coping resources used by this group will guide physiotherapists in facilitating life for persons with TSCI in resource-constrained settings elsewhere.
Keywords: Coping resources, spinal cord injury, rural
Funding acknowledgements: Data collection for this study was financially supported by Health Serve Australia.
Purpose: This study aimed at exploring the strategies used by persons with TSCI to survive in a typical resource-constrained rural setting of Tanzanian.
Methods: A modified constructivist grounded theory was employed for the analysis of data from 10 individuals who have lived with TSCI for between 7 and 28 years in typical Tanzanian rural area. The 10 were purposively selected from the community and in-depth interview conducted in the home of each. The analysis followed the constructivist approach in which data was first open and axial coded, prior to construction of the categories. The constructed categories were frequently reviewed in light of the available literature to determine the over-arching core category that describes or connect the rest.
Results: Nine categories (identified as internal and external coping resources) were constructed. The internal coping resources were: secured in God, increase in awareness of health risk, problem-solving skills and social skills. External coping resources were: having a reliable family, varying support from the community, a matter of possession and left without means for mobility. Acceptance was later identified as a core category that determines the identification and utilization of the rest of the coping resources.
Conclusion(s): Persons with traumatic spinal cord injury can survive for a relatively long time in the rural settings of low-income countries despite the hostile environment. Coping with this environment requires the identification and utilization of various coping resources, acceptance being the most important.
Implications: Physiotherapists are involved in a long-term community-based rehabilitation of persons with TSCI. It is important to realize and facilitate achievement of the coping resources to this group for better rehabilitation outcomes and quality of life. Knowledge of coping resources used by this group will guide physiotherapists in facilitating life for persons with TSCI in resource-constrained settings elsewhere.
Keywords: Coping resources, spinal cord injury, rural
Funding acknowledgements: Data collection for this study was financially supported by Health Serve Australia.
Topic: Disability & rehabilitation; Neurology: spinal cord injury; Service delivery/emerging roles
Ethics approval required: Yes
Institution: National Institute for Medical Research Tanzania
Ethics committee: National Institute for Medical Research Tanzania
Ethics number: NIMR/HQ/R.8a/Vol. IX/1076
All authors, affiliations and abstracts have been published as submitted.
