Abstract
Outdoor recreation programmes (ORP) have the potential to assist in the rehabilitation and community reintegration process for individuals recovering from spinal cord injury (SCI). Previous evidence provides support for the use of meaningful recreation, leisure activities, and physical exercise in the maintenance of health and development of self-efficacy, peer support and socialisation, thus assisting individuals with SCI to reintegrate back into their communities. However, there are few studies that evaluate the lived experience of individuals with SCI participating in ORPs and the potential benefits of these programmes. A qualitative study using constructivist grounded theory was chosen to gain an understanding of the personal experiences of individuals with SCI who attend these programmes and the influence the programme had on their lives.
Eight individuals with SCI who attended an ORP were interviewed twice using semi-structured in-depth interviews. The first interview occurred at the beginning of the ORP and the second interview took place approximately three months following completion of the ORP. Interview data were supplemented by field notes from observation of the participants on the ORPs. From the data collected a model was developed to reflect the key themes and concepts that represented the participants’ experiences and perceptions of attending an ORP. Overall, the participants’ experience was positive. The model depicted three stages in the overall gains made from attending an ORP. These included: immediate benefits, secondary consequences and real life consequences. Three key themes emerged as being the immediate benefits: i) ‘Gaining knowledge and skills’, ii) ‘Learning from peers’ and iii) ‘Pushing boundaries’. These immediate benefits contributed to the secondary consequences: iv) ‘Building confidence’ and v) ‘Self discovery’. The secondary consequences enabled the participant to vi) ‘Get out there’ and participate more following completion of the programme, with increased options in life and therefore to vii) ‘Live and reclaim life’. These latter themes are considered to reflect the real life consequences of attending the ORP.
The overall substantive theory that emerged from this study was how attendance at the ORP contributed to the participants with SCI reclaiming and living their lives. The participants indicated they had benefited physically and psychologically from attendance, with the combination of these gains enabling them to engage more actively in social, recreational and vocational pursuits. This resulted in each individual beginning to reclaim or succeeding in reclaiming and living their lives. The participants felt that they now had opportunities and options in their lives.
Clinically the data collected in this study and the theory that emerged from the data will enable funders and providers of rehabilitation services to consider ORP as a beneficial adjunct to the rehabilitation and reintegration of individuals with SCI, especially for those individuals who have struggled to come to terms with their injury and have not successfully reintegrated back into their communities. It also provides a clearer framework for the development and selection of relevant outcome variables in future studies on the therapeutic effectiveness of these programmes.