Quality of life after spinal cord injury: a meta-synthesis of qualitative findings

Study design: Meta-synthesis of qualitative research. Objectives: To identify, compare and synthesize the factors found to contribute to, or detract from the experience of a life worth living following spinal cord injury ( SCI). Methods: Published articles were identified from the Medline, CINAHL and Sociological Abstracts databases, a hand search through selected journals published since 1990, and from reference lists. These were assessed for their relevance to the focus of interest and appraised for rigour and quality. The key themes that emerged from the data were summarized, compared and synthesized. Results: The search located 64 papers and four books, of which seven papers met the review criteria for relevance and rigour, and in which 10 main concepts were identified: ( 1) body problems, ( 2) loss, ( 3) relationships, ( 4) responsibility for, and control of one's life, ( 5) occupation, and ability to contribute, ( 6) environmental context, ( 7) new values/ perspective transformation, ( 8) good and bad days, ( 9) self-worth, ( 10) self- continuity. Conclusions: This study demonstrates the utility of synthesizing qualitative research to provide a greater depth of insight into the factors that contribute to, and detract from, quality of life ( QOL) after SCI. It also provides a more nuanced understanding of the experience of QOL following SCI than is achievable by quantitative methods. Future qualitative research is required to probe further the concepts and connections identified in this study, and to identify how rehabilitation services might best address these issues.