Endeavouring sustainable participation: Post-discharge adaptation process of occupational participation among persons with spinal cord injury in Bangladesh

Against a background of high levels of morbidity, mortality, and social exclusion among persons with SCI in Bangladesh, the aim of this research was to identify and describe how these persons experienced adaptation of occupations after discharge from an in-patient rehabilitation hospital. Following ethnographic interviewing and observation, the data of 19 adults with SCI were analysed by an iterative process of constant comparative analysis. The research identified three outcomes of adaptation, (1) creating opportunities for daily occupations, (2) reintegrating daily occupations, and (3) striving for sustainability; and seven doing processes of adaptation, (a) solving problems using local materials and knowledge, (b) reframing one's situation, (c) adapting the environment (d) recreating routines and habits, (e) evolving vocational and social roles, (f) forming reciprocity, and (g) producing additional roles. These results show that sustainable participation in occupation requires support that enhances adaptation and eliminates maladaptation among persons with SCI living in Bangladesh.