Biopsychosocial challenges of spinal cord injury survivors in Bangladesh: a qualitative investigation

Background: Spinal cord injury (SCI) is a life-altering condition, often leading to long-term disability, significantly impacting individuals worldwide. However, there is a dearth of research on the life experiences of people affected by SCI, particularly in lower-middle-income countries. Thus, this study aimed to explore the psychosocial impact of people living with SCI in Bangladesh. 

Methods: This study employed a qualitative approach which included conducting 22 In-depth Interviews (IDIs) with persons with SCI in Bangladesh. Data were collected from October 2023 to December 2023 within the Spinal Cord Injuries’ Development Association Bangladesh (SCIDAB), a rehabilitation center for SCI patients. Thematic analysis was utilized for this study. 

Results: Utilizing the bio-psychosocial framework, findings highlighted the biological, psychological, and social factors underlying the psychological barriers experienced by participants. Sub-themes identified included biological factors: paralysis and loss of sensation, challenges in bowel and bladder management, psychological factors: a sudden change in life, and loss of independence and autonomy; insecurity about the future, suicidal thoughts, stigmatized by society, and social isolation; and social factors: lack of support system, lack of specialized working environment, and transportation obstacles. 

Conclusion: Individuals living with SCI reported experiencing both significant physical and psychosocial impacts. In addition to providing effective mental health services, there is a critical need for comprehensive rehabilitation for people affected by SCI and social awareness within the community is essential to reduce stigma and foster inclusion.