A qualitative study uncovering rehabilitation challenges: Perspectives of individuals with spinal cord injury.

Context: Rehabilitation is an essential set of interventions to optimize functioning and minimize disability in individuals with spinal cord injuries (IwSCI). However, accessing rehabilitation services presents unique challenges for these individuals, particularly in low- and middle-income countries.

Objectives: This study aims to explore the perspectives of IwSCI regarding the challenges they face in accessing effective spinal cord injury (SCI) rehabilitation services in Nepal.

Methods: In this qualitative study, 16 participants with SCI were recruited from community settings and a rehabilitation center in Nepal. In-depth interviews were conducted either face-to-face or via cell phone between August and September 2023. The participants' responses were analyzed using a reflexive thematic analysis approach.

Results: Qualitative analysis identified five overarching themes concerning the challenges experienced by IwSCI in accessing rehabilitation services in Nepal. Participants highlighted that personal challenges related to finances, education, and health, along with socio-cultural influences and caregiving, shortcomings in healthcare and support systems, limited services and resources within rehabilitation centers, and geographical and infrastructural barriers to accessibility hindered their ability to access or continue rehabilitation services.

Conclusions: While rehabilitation is essential for managing secondary conditions improving functionality, and maximizing independence, IwSCI in Nepal experience significant challenges in receiving effective rehabilitation services. Collective efforts from families, communities, rehabilitation centers, and the government are vital to reducing these challenges and enhancing the effectiveness of SCI rehabilitation services in Nepal.