Evaluation of Daily Life Participation and Depression among Person with Spinal Cord Injury after Rehabilitation: A Cross-Sectional Study

Abstract

Background: Spinal cord injury (SCI) is a life-altering condition that can lead to long-term physical limitation and reduce person’s ability to participate in daily life activities. Participation in daily life is a key indicator of successful community reintegration after rehabilitation. Many persons with SCI still experience participation restrictions and psychological problems within community setting after completing rehabilitation. Aim: To evaluate the level of daily life participation and severity of depression among person with SCI after rehabilitation and to find out the relationship between participation and depression. Methods: A cross-sectional study was conducted among 126 community-dwelling persons with SCI who had completed rehabilitation. Data were collected using a socio-demographic questionnaire, The Utrecht Scale for Evaluation of Rehabilitation–Participation (USER-P) to assess participation frequency, restrictions, satisfaction and the Bangla version of the Patient Health Questionnaire-9 (PHQ-9) to measure depression severity. Descriptive and inferential statistical analyses were performed to examine associations and correlations. Results: Among 126 participants, 78.6% were male and the mean age 38.9 ± 12.06 years. Total family income before injury <16000 BDT was 15.9% and after injury it is 53.2%. Incomplete SCI was reported 74.6% and 69.0% were wheelchair dependent. Level of participation analysis showed that lower participation frequency 87.3%, higher participation restrictions 54.0% and 61.9% had higher satisfaction with participation. Regarding depression severity 43.7% had minimal depression while 27.0% mild, 18.3% moderate, 7.1% moderately severe and 4.0% severe depression. Statistical analysis showed significant differences in severity of depression across participation frequency (p=0.002), participation restrictions (p=0.001) and participation satisfaction (p=0.001). Severity of depression showed a negative correlation with participation frequency and participation restriction (r = -.505, p < 0.001; r = -.538, p < 0.001). Gender was significantly associated with participation frequency & satisfaction (p=0.001). Family income after injury was significantly associated with severity of depression (p=0.005) and mobility status significantly associated with participation restriction (p<0.001). Conclusion: Participation limitations and depression are common among persons with SCI after rehabilitation. Lower participation is significantly associated with greater depression severity. Improving rehabilitation follow-up, accessibility and reducing environmental barriers may enhance daily life participation. Public awareness, family support and inclusive policies may improve daily life participation and quality of life for persons with SCI. Keywords: Spinal Cord Injury, After Rehabilitation, Participation, Depression.