Peer Group 16 Mar 2017: Kathy Dwyer

ABSTRACT: Interactions with community health providers following discharge from inpatient rehabilitation: the experience of individuals with spinal cord injury
Kathryn Dwyer(1,2), Dr Hilda Mulligan(2)

(1) Home Action Team/Insight Team – Divisions of Laura Fergusson Trust Canterbury
(2) School of Physiotherapy, University of Otago, New Zealand

Background: There is a growing body of literature investigating community reintegration following spinal cord injury (SCI). Little research, however, examines interactions between individuals with SCI and the community health providers who have considerable involvement with them. This study explored how individuals with SCI viewed the interactions they had with community health providers following discharge from inpatient rehabilitation.

What we did: Six participants (between one and four years after SCI) participated in individual semi-structured interviews. The interviews were analysed using thematic analysis.

What we found: Three themes emerged: (a) Understanding of processes and systems, (b) Knowing what is available and (c) Continuity of care. These themes led to an overarching sense of empowerment encompassing the participants having control, options, choice and being able to get on with life.

Conclusion: The findings suggested that individuals with spinal cord injury wish to be empowered to have control over their lives as they transition back to their community. This study highlights the need for community health providers to purposefully facilitate the empowerment of individuals with SCI. While international literature suggests that a sense of powerlessness and lack of control is experienced by individuals with SCI as they transition to their community, the findings from this study contribute to research in the New Zealand context regarding community reintegration following SCI.

Key practice points: Community health providers can empower individuals with spinal cord injury as they transition back to their community through communication of processes and sharing of knowledge, ensuring continuity of services from the inpatient setting to home and providing consistency of care in the home environment.

Kathy has worked as a physiotherapist in the field of spinal cord injury for 25 years. She initially worked at the Otara Spinal Unit (as it was then called) for two years before coming to the Burwood Spinal Unit in 1993 and stayed for over ten years dropping down to part time work after having a family. For the past twelve years she has worked in an interdisciplinary team contracting to ACC and working in the community primarily with individuals who have sustained a spinal cord injury. Kathy completed a clinical Masters in Physiotherapy in 2015 and enjoyed the opportunity to explore various aspects of SCI applicable to clinical practice. This presentation is on the research project she undertook to complete her Masters. Kathy also travels to Samoa and Tonga each year as a volunteer with the Altus Resource Trust to work with individuals who have sustained SCI. And the beaches and cocktails aren’t too much of a hardship either!