Body Appreciation and Experience of Body Image Transition among Persons with Spinal Cord Injury: a mixed methods study

Abstract

Background: Body image is a multifaceted concept incorporating cognitive, perceptual, emotional, and behavioral components, influenced by cultural standards and body appreciation. Body appreciation, essential for accepting and respecting the body, can be disrupted by physical disabilities like spinal cord injury (SCI). SCI, whether traumatic or non-traumatic, leads to motor, sensory, or autonomic function loss below the injury level, affecting mobility, bowel-bladder control, and sexual functioning. Research on body image and appreciation among individuals with SCI has been extensively conducted in Western contexts, but evidence from South Asia remains scarce. Therefore, it is important to understand the experience of body image transition and body appreciation following the rehabilitation and community reintegration. Aim: This study aims to measure body appreciation and understand the experience of body image transition among persons with SCI. Methods: This mixed-methods study, using a convergent parallel approach, investigated body appreciation and explored the experience of body image transition among individuals with SCI. Quantitative data were collected from 101 participants to measure body appreciation by the Body Appreciation Scale-2 and examine its association with demographic and injury-related factors, while qualitative data were gathered through face-to-face interviews with 16 participants, including 10 community dwelling and 6 from the inpatient unit. Results: Of all participants, 46.5% demonstrated high body appreciation. The mean age of community participants was 37.19 years (SD+12.636) and the median age of the in patient group was 44 years, IQR=22.50-44.25. Community participants exhibited significantly higher body appreciation compared to inpatients. Body appreciation significantly differed among age and religious groups. Qualitative findings revealed the body image experience in different perspectives of a person with SCI and also found that personal and social factors profoundly influenced body image transition. Conclusion: The findings stress the importance of addressing the body image transition during rehabilitation among people with SCI. This research offers valuable insights for healthcare professionals to create more personalised and inclusive care. It also calls for more studies on body acceptance and emotional challenges faced by people with SCI in different settings. Key Words: Body image, Body appreciation, Spinal cord injury, Community, Inpatient, Rehabilitation