Exercising choice and control: A qualitative meta-synthesis of perspectives of people with a spinal cord injury

Publication date: Available online 19 February 2019

Source: Archives of Physical Medicine and Rehabilitation

Author(s): Carolyn M. Murray, Gisela van Kessel, Michelle Guerin, Susan Hillier, Mandy Stanley

Abstract

Objective

To systematically search the literature and construct a meta-synthesis of how choice and control are perceived by people with spinal cord injury (SCI)

Data Sources

Medline, Academic Search Premier, CINAHL, Cochrane, EMBASE, HealthSource, ProQuest, PsychInfo, SAGE and SCOPUS were searched from 1980 until September 2018 including all languages. Reference lists of selected studies were also reviewed.

Study Selection

Eligible qualitative studies included perspectives about choice of control as reported by people with SCI. Studies were excluded if they included perspectives from other stakeholder groups. 6706 studies were screened for title and abstract and full text of 127 studies were reviewed resulting in a final selection of 29.

Data Extraction

Characteristics of the studies were extracted along with any data (author interpretations and quotes) relating to perspectives on choice and control.

Data Synthesis

First order analysis involved coding the data in each study and second order analysis involved translating each segment of coded data into broader categories with third order analysis condensing categories to two broad overarching themes. These themes were experiencing vulnerability or security and adapting to bounded abilities.

Conclusions

Perspectives of choice and control are influenced by inter-related environmental, interpersonal and personal contexts. From a personal perspective, participants reported a readiness for adaptation that included turning points where emotional and cognitive capacity to make choices and take control changed. Health professionals need to be responsive to this readiness, promote empowerment and foster, rather than remove, hope.

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