Socio-cultural considerations of home modifications from the perspective of people with spinal cord injury in Iran

Abstract

PURPOSE: The main purpose of this study was to investigate the socio-cultural considerations for home modifications among individuals with spinal cord injury (SCI) in Iran. MATERIALS AND METHODS: A descriptive qualitative design was employed, involving semi-structured interviews with 18 participants. Data were analyzed using reflexive thematic analysis to identify key themes and subthemes. RESULTS: Three main themes were identified: (1) Holding out hope for recovery from SCI, (2) Absence of home modifications led to unique solutions but potential risks, and (3) Occupational therapy recommendations regarding home modifications need to be culturally safe. Participants often received misinformation about their prognosis, leading to delayed or avoided home modifications. CONCLUSION: The findings underscore the importance of providing accurate information regarding SCI prognosis to facilitate the implementation of needed home modifications. Occupational therapists and other health care professionals are advised to consider cultural factors, including practices related to values such as privacy, to ensure that recommendations are client-centered, effective, and culturally adaptable. This study highlights the necessity of developing culturally sensitive guidelines for home modifications and emphasize the critical role of involving in decision-making process, and improving access to appropriate assistive technology. Cultural sensitivity in home modificationRehabilitation professionals should consider cultural values and practices when recommending home modifications.Enhanced communication and educationThere is a need for better communication and education about the typical trajectory of spinal cord injury and the importance of home modification. Providing clear, accurate information to both clients and their families can help manage expectations and reduce resistance to necessary changes.Support for assistive technology accessGiven the low availability of assistive technology in low- and middle- income countries, efforts should be made to improve access to these products.Empowering caregiversCaregivers often take on significant responsibilities, leading to burnout and over dependence of the person with SCI. Rehabilitation programs should include support for caregivers, providing them with the necessary tools and knowledge to manage their roles effectively without compromising their well-being.Tailored occupational therapy interventionsOccupational therapists should focus on practical, user-centered recommendations that align with the specific needs and preferences of individuals with SCI.