{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T10:30:59Z","timestamp":1785407459462,"version":"3.56.0"},"reference-count":47,"publisher":"AOSIS","issue":"1","license":[{"start":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T00:00:00Z","timestamp":1776038400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Background:\u00a0The rehabilitation experience can influence the transition back to home and community life. With impending National Health Insurance reform and limited rehabilitation guidelines in South Africa, there is a need to understand the current state of rehabilitation services. To the authors\u2019 knowledge, no other South African study has explored inpatient rehabilitation experiences and their influence on the readiness to transition home in spinal cord injury (SCI).\nObjectives:\u00a0To explore the experiences of inpatient rehabilitation among people with SCI, to examine how the experience influenced their transition out of inpatient rehabilitation, and to identify the needs of people with SCI when transitioning out of inpatient rehabilitation.\nMethod:\u00a0A phenomenological, qualitative design was used. Semi-structured interviews were conducted with 11 patients with SCI in their final week of inpatient rehabilitation from October 2023 to February 2024. The interview guide was developed from similar studies in New Zealand. Interviews were transcribed verbatim and inductively analysed to identify themes.\nResults:\u00a0Three themes emerged: overall rehabilitation experience, factors influencing the experience and transition readiness, and needs impacting the transition to home. Participants reported a positive experience overall, although some negative elements were noted. Key needs for a smoother transition included bridging the gaps in the approach to care, more realistic home environment simulations and individualised psychological support.\nConclusion:\u00a0Rehabilitation experiences highlight the need for a specialised, patient-centred approach to SCI care. Addressing unmet needs can enhance preparedness for reintegration, especially in contexts without a structured SCI model of care.\nClinical implications:\u00a0Ongoing professional development, improved rehabilitation environments and structured psychological support during rehabilitation are needed.<\/jats:p>","DOI":"10.4102\/sajp.v82i1.2260","type":"journal-article","created":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T11:33:01Z","timestamp":1775820781000},"update-policy":"https:\/\/doi.org\/10.4102\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Bridging the gap: The experiences and needs of people with spinal cord injury when transitioning out of inpatient rehabilitation"],"prefix":"10.4102","volume":"82","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-6845-2777","authenticated-orcid":false,"given":"Cleopatra","family":"Floudiotis","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03rp50x72","id-type":"ROR","asserted-by":"publisher"}],"name":"University of the Witwatersrand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0606-9669","authenticated-orcid":false,"given":"Sonti I.","family":"Pilusa","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03rp50x72","id-type":"ROR","asserted-by":"publisher"}],"name":"University of the Witwatersrand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2580","published-online":{"date-parts":[[2026,4,13]]},"reference":[{"key":"ref0","doi-asserted-by":"crossref","unstructured":"Ashipala, D.O. & Langendorf, L., 2022, \u2018Experiences of spinal cord injury patients admitted to the rehabilitation unit at the national referral hospital in Khomas Region, Namibia\u2019, African Journal of Disability 11, a1018. https:\/\/doi.org\/10.4102\/ajod.v11i0.1018","DOI":"10.4102\/ajod.v11i0.1018"},{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Bender, A.A. & Burgess, E.O., 2020, \u2018Constructing recovery narratives: Experiences and expectations following spinal cord injury\u2019, Rehabilitation Nursing 45(5), 254\u2013262. https:\/\/doi.org\/10.1097\/RNJ.0000000000000202","DOI":"10.1097\/RNJ.0000000000000202"},{"key":"ref2","doi-asserted-by":"crossref","unstructured":"Bourke, J.A., Hay-Smith, E.J.C., Snell, D.L. & DeJong, G., 2014, \u2018Attending to biographical disruption: The experience of rehabilitation following tetraplegia due to spinal cord injury\u2019, Disability and Rehabilitation 37(4), 296\u2013303. https:\/\/doi.org\/10.3109\/09638288.2014.918188","DOI":"10.3109\/09638288.2014.918188"},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"Budd, M.A., Gater, D.R., Jr. & Channell, I., 2022, \u2018Psychosocial consequences of spinal cord injury: A narrative review\u2019, Journal of Personalized Medicine 12(7), 1178. https:\/\/doi.org\/10.3390\/jpm12071178","DOI":"10.3390\/jpm12071178"},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"Cheng, C.L., Plashkes, T., Shen, T., Fallah, N., Humphreys, S., O\u2019Connell, C. et al., 2017, \u2018Does specialized inpatient rehabilitation affect whether or not people with traumatic spinal cord injury return home?\u2019 Journal of Neurotrauma 34(20), 2867\u20132876. https:\/\/doi.org\/10.1089\/neu.2016.4930","DOI":"10.1089\/neu.2016.4930"},{"key":"ref5","doi-asserted-by":"crossref","unstructured":"Clifton, S., 2014, \u2018Grieving my broken body: An autoethnographic account of spinal cord injury as an experience of grief\u2019, Disability and Rehabilitation 36(21), 1823\u20131829. https:\/\/doi.org\/10.3109\/09638288.2013.872202","DOI":"10.3109\/09638288.2013.872202"},{"key":"ref6","doi-asserted-by":"crossref","unstructured":"Colley, J., Zeeman, H. & Kendall, E., 2018, \u2018\u201cEverything happens in the hallways\u201d: Exploring user activity in the corridors at two rehabilitation units\u2019, Health Environments Research and Design Journal 11(2), 163\u2013176. https:\/\/doi.org\/10.1177\/1937586717733149","DOI":"10.1177\/1937586717733149"},{"key":"ref7","doi-asserted-by":"crossref","unstructured":"Conti, C., Dimonte, V., Rizzi, A., Clari, M., Mozzone, S., Garrino, L. et al., 2020, \u2018Barriers and facilitators of education provided during rehabilitation of people with spinal cord injuries: A qualitative description\u2019, PLoS One 15(10), 1\u201314. https:\/\/doi.org\/10.1371\/journal.pone.0240600","DOI":"10.1371\/journal.pone.0240600"},{"key":"ref8","unstructured":"Creswell, J.W., 1998, Qualitative inquiry and research design: Choosing among five traditions, Sage, Thousand Oaks, CA."},{"key":"ref9","doi-asserted-by":"crossref","unstructured":"Du Plessis, M., McGaffin, C.R., Molepo, T., Oelofse, R., Van Zyl, S. & Mashola, M.K., 2018, \u2018Perceived readiness for hospital discharge: Patients with spinal cord injury versus physiotherapists\u2019, South African Journal of Physiotherapy 74(1), 437. https:\/\/doi.org\/10.4102\/sajp.v74i1.437","DOI":"10.4102\/sajp.v74i1.437"},{"key":"ref10","doi-asserted-by":"crossref","unstructured":"Guest, G., Bunce, A. & Johnson, L., 2006, \u2018How many interviews are enough?\u2019 Field Methods 18, 59\u201382. https:\/\/doi.org\/10.1177\/1525822X05279903","DOI":"10.1177\/1525822X05279903"},{"key":"ref11","doi-asserted-by":"crossref","unstructured":"Ho, C., Atchison, K., Noonan, V.K., McKenzie, N., Cadel, L., Ganshorn, H. et al., 2021, \u2018Models of care delivery from rehabilitation to community for spinal cord injury: A scoping review\u2019, Journal of Neurotrauma 38(6), 677\u2013697. https:\/\/doi.org\/10.1089\/neu.2020.7396","DOI":"10.1089\/neu.2020.7396"},{"key":"ref12","doi-asserted-by":"crossref","unstructured":"Joseph, C., Ernst, S., Virginia, W., Joyce, M. & Francois, T., 2017, \u2018People with spinal cord injury in Republic of South Africa\u2019, American Journal of Physical Medicine and Rehabilitation 96(2), S109\u2013S111. https:\/\/doi.org\/10.1097\/PHM.0000000000000594","DOI":"10.1097\/PHM.0000000000000594"},{"key":"ref13","doi-asserted-by":"crossref","unstructured":"Joseph, C., Wahman, K., Phillips, J. & Wikmar, L.N., 2016, \u2018Client perspectives on reclaiming participation after a traumatic spinal cord injury in South Africa\u2019, Physical Therapy 96(9), 1372\u20131380. https:\/\/doi.org\/10.2522\/ptj.20150258","DOI":"10.2522\/ptj.20150258"},{"key":"ref14","unstructured":"Kashif, M., Jones, S., Darain, H., Iram, H., Raqib, A. & Butt, A.A., 2019, \u2018Factors influencing the community integration of patients following traumatic spinal cord injury: A systematic review\u2019, Journal of the Pakistan Medical Association 69(9), 1336\u20131342."},{"key":"ref15","doi-asserted-by":"crossref","unstructured":"Krefting, L., 1991, \u2018Rigor in qualitative research: The assessment of trustworthiness\u2019, American Journal of Occupational Therapy 45(3), 214\u2013222. https:\/\/doi.org\/10.5014\/ajot.45.3.214","DOI":"10.5014\/ajot.45.3.214"},{"key":"ref16","doi-asserted-by":"crossref","unstructured":"Krysa, J.A., Gregorio, M.P., Pohar Manhas, K., MacIsaac, R., Papathanassoglou, E. & Ho, C.H., 2022, \u2018Empowerment, communication, and navigating care: The experience of persons with spinal cord injury from acute hospitalization to inpatient rehabilitation\u2019, Frontiers in Rehabilitation Sciences 3, 1\u201311. https:\/\/doi.org\/10.3389\/fresc.2022.904716","DOI":"10.3389\/fresc.2022.904716"},{"key":"ref17","doi-asserted-by":"crossref","unstructured":"Lindberg, J., Kreuter, M., Taft, C. & Person, L.-O., 2013, \u2018Patient participation in care and rehabilitation from the perspective of patients with spinal cord injury\u2019, Spinal Cord 51, 834\u2013837. https:\/\/doi.org\/10.1038\/sc.2013.97","DOI":"10.1038\/sc.2013.97"},{"key":"ref18","doi-asserted-by":"crossref","unstructured":"Louw, Q.A., Conradie, T., Xuma-Soyizwapi, N., Davis-Ferguson, M., White, J., Stols, M. et al., 2023, \u2018Rehabilitation capacity in South Africa \u2013 A situational analysis\u2019, International Journal of Environmental Research and Public Health 20, 3579. https:\/\/doi.org\/10.3390\/ijerph20043579","DOI":"10.3390\/ijerph20043579"},{"key":"ref19","doi-asserted-by":"crossref","unstructured":"Machida, M., Irwin, B. & Feltz, D., 2013, \u2018Resilience in competitive athletes with spinal cord injury: The role of sport participation\u2019, Qualitative Health Research 23(8), 1054\u20131065. https:\/\/doi.org\/10.1177\/1049732313493673","DOI":"10.1177\/1049732313493673"},{"key":"ref20","doi-asserted-by":"crossref","unstructured":"Madasa, V., Boggenpoel, B., Phillips, J. & Joseph, C., 2020, \u2018Mortality and secondary complications four years after traumatic spinal cord injury in Cape Town, South Africa\u2019, Spinal Cord Series and Cases 6(1), 84. https:\/\/doi.org\/10.1038\/s41394-020-00334-w","DOI":"10.1038\/s41394-020-00334-w"},{"key":"ref21","doi-asserted-by":"crossref","unstructured":"Mashola, M.K., Olorunju, S.A.S. & Mothabeng, J., 2019, \u2018Factors related to hospital readmissions in people with spinal cord injury in South Africa\u2019, South African Medical Journal 109(2), 107\u2013111. https:\/\/doi.org\/10.7196\/SAMJ.2019.v109i2.13344","DOI":"10.7196\/SAMJ.2019.v109i2.13344"},{"key":"ref22","doi-asserted-by":"crossref","unstructured":"Mathee, A., Moyes, J., Mkhencele, T., Kleynhans, J., Language, B., Piketh, S. et al., 2021, \u2018Housing quality in a rural and an urban settlement in South Africa\u2019, International Journal of Environmental Research and Public Health 18(5), 2240. https:\/\/doi.org\/10.3390\/ijerph18052240","DOI":"10.3390\/ijerph18052240"},{"key":"ref23","doi-asserted-by":"crossref","unstructured":"Mayosi, B.M. & Benatar, S.R., 2014, \u2018Health and health care in South Africa \u2013 20 Years after Mandela\u2019, New England Journal of Medicine 371(14), 1344\u20131353. https:\/\/doi.org\/10.1056\/NEJMsr1405012","DOI":"10.1056\/NEJMsr1405012"},{"key":"ref24","doi-asserted-by":"crossref","unstructured":"Melin, J., Persson, L.O., Taft, C. & Kreuter, M., 2018, \u2018Patient participation from the perspective of staff members working in spinal cord injury rehabilitation\u2019, Spinal Cord 56(6), 614\u2013620. https:\/\/doi.org\/10.1038\/s41393-018-0061-7","DOI":"10.1038\/s41393-018-0061-7"},{"key":"ref25","doi-asserted-by":"crossref","unstructured":"Moran, K., Barclay, L. & Lannin, N.A., 2022, \u2018Experiences of people with non-traumatic spinal cord injuries returning home after inpatient rehabilitation\u2019, Disability and Rehabilitation 46(2), 362\u2013368. https:\/\/doi.org\/10.1080\/09638288.2022.2162611","DOI":"10.1080\/09638288.2022.2162611"},{"key":"ref26","doi-asserted-by":"crossref","unstructured":"Morris, L.D., Grimmer, K.A., Twizeyemariya, A., Coetzee, M., Leibbrandt, D.C. & Louw, Q.A., 2021, \u2018Health system challenges affecting rehabilitation services in South Africa\u2019, Disability and Rehabilitation 43(6), 877\u2013883. https:\/\/doi.org\/10.1080\/09638288.2019.1641851","DOI":"10.1080\/09638288.2019.1641851"},{"key":"ref27","doi-asserted-by":"crossref","unstructured":"Morse, J.M., 1995, \u2018The significance of saturation\u2019, Qualitative Health Research 5(2), 147\u2013149. https:\/\/doi.org\/10.1177\/104973239500500201","DOI":"10.1177\/104973239500500201"},{"key":"ref28","doi-asserted-by":"crossref","unstructured":"Mothabeng, D., Malinga, C.P., Van der Merwe, C., Qhomane, P.T. & Motjotji, S.N., 2007, \u2018The views of patients with spinal cord injuries on their rehabilitation experience\u2019, South African Journal of Physiotherapy 63(3), 22\u201325. https:\/\/doi.org\/10.4102\/sajp.v63i3.139","DOI":"10.4102\/sajp.v63i3.139"},{"key":"ref29","doi-asserted-by":"crossref","unstructured":"Nizeyimana, E., Louw, Q. & Joseph, C., 2025, \u2018A community reintegration model for persons with traumatic spinal cord injury in South Africa: Process and outcomes\u2019, Advances in Rehabilitation Science and Practice 14, 1\u201310. https:\/\/doi.org\/10.1177\/27536351251326797","DOI":"10.1177\/27536351251326797"},{"key":"ref30","doi-asserted-by":"crossref","unstructured":"Nowell, L.S., Norris, J.M., White, D.E. & Moules, N.J., 2017, \u2018Thematic analysis: Striving to meet the trustworthiness criteria\u2019, International Journal of Qualitative Methods 16(1), 1\u201313. https:\/\/doi.org\/10.1177\/1609406917733847","DOI":"10.1177\/1609406917733847"},{"key":"ref31","doi-asserted-by":"crossref","unstructured":"Nunnerley, J.L. & Dean, S.G., 2013, \u2018Leaving a spinal unit and returning to the wider community: An interpretative phenomenological analysis\u2019, Disability and Rehabilitation 35(14), 1164\u20131173. https:\/\/doi.org\/10.3109\/09638288.2012.723789","DOI":"10.3109\/09638288.2012.723789"},{"key":"ref32","doi-asserted-by":"crossref","unstructured":"Ownsworth, T., Mols, H., O\u2019Loghlen, J., Xie, Y., Kendall, M., Nielsen, M. et al., 2024, \u2018Stigma following acquired brain injury and spinal cord injury: Relationship to psychological distress and community integration in the first-year post-discharge\u2019, Disability and Rehabilitation 46(9), 1796\u20131806. https:\/\/doi.org\/10.1080\/09638288.2023.2205173","DOI":"10.1080\/09638288.2023.2205173"},{"key":"ref33","doi-asserted-by":"crossref","unstructured":"Pefile, N., Mothabeng, J.D. & Naidoo, S., 2019, \u2018Profile of patients with spinal cord injuries in Kwazulu-Natal, South Africa: Implications for vocational rehabilitation\u2019, Journal of Spinal Cord Medicine 42(6), 709\u2013718. https:\/\/doi.org\/10.1080\/10790268.2018.1428264","DOI":"10.1080\/10790268.2018.1428264"},{"key":"ref34","doi-asserted-by":"crossref","unstructured":"Pilusa, S., Myezwa, H. & Potterton, J., 2021, \u2018Secondary health conditions in people with spinal cord injury in South Africa: Prevalence and associated factors\u2019, South African Medical Journal 111(12), 1211\u20131217. https:\/\/doi.org\/10.7196\/SAMJ.2021.v111i12.15761","DOI":"10.7196\/SAMJ.2021.v111i12.15761"},{"key":"ref35","doi-asserted-by":"crossref","unstructured":"Pryor, J., Haylen, D. & Fisher, M., 2021, \u2018Problems people with spinal cord injury experience accessing help with bowel care when hospitalised outside a specialist spinal injury service\u2019, Journal of Clinical Nursing 30(11\u201312), 1633\u20131644. https:\/\/doi.org\/10.1111\/jocn.15717","DOI":"10.1111\/jocn.15717"},{"key":"ref36","doi-asserted-by":"crossref","unstructured":"Samuel, V.M., Moses, J., North, N., Smith, H. & Thorne, K., 2007, \u2018Spinal cord injury rehabilitation: The experience of women\u2019, Spinal Cord 45(12), 758\u2013764. https:\/\/doi.org\/10.1038\/sj.sc.3102111","DOI":"10.1038\/sj.sc.3102111"},{"key":"ref37","doi-asserted-by":"crossref","unstructured":"Saunders, B., Sim, J., Kingstone, T., Baker, S., Waterfield, J., Bartlam, B. et al., 2018, \u2018Saturation in qualitative research: Exploring its conceptualization and operationalization\u2019, Quality & Quantity 52(4), 1893\u20131907. https:\/\/doi.org\/10.1007\/s11135-017-0574-8","DOI":"10.1007\/s11135-017-0574-8"},{"key":"ref38","doi-asserted-by":"crossref","unstructured":"Scheel-Sailer, A., Post, M.W., Michel, F., Weidmann-H\u00fcgle, T. & H\u00f6lzle, R.B., 2017, \u2018Patients\u2019 views on their decision making during inpatient rehabilitation after newly acquired spinal cord injury \u2013 A qualitative interview-based study\u2019, Health Expect 20(5), 1133\u20131142. https:\/\/doi.org\/10.1111\/hex.12559","DOI":"10.1111\/hex.12559"},{"key":"ref39","doi-asserted-by":"crossref","unstructured":"Simpson, B., Villeneuve, M. & Clifton, S., 2020, \u2018The experience and perspective of people with spinal cord injury about well-being interventions: A systematic review of qualitative studies\u2019, Disability and Rehabilitation 44(14), 3349\u20133363. https:\/\/doi.org\/10.1080\/09638288.2020.1864668","DOI":"10.1080\/09638288.2020.1864668"},{"key":"ref40","doi-asserted-by":"crossref","unstructured":"Smith, E., Sakakibara, B. & Miller, W., 2014, \u2018A review of factors influencing participation in social and community activities for wheelchair users\u2019, Disability and Rehabilitation: Assistive Technology 11, 1\u201314. https:\/\/doi.org\/10.3109\/17483107.2014.989420","DOI":"10.3109\/17483107.2014.989420"},{"key":"ref41","doi-asserted-by":"crossref","unstructured":"Steensgaard, R., Kolbaek, R. & Angel, S., 2022, \u2018Nursing staff facilitate patient participation by championing the patient\u2019s perspective: An action research study in spinal cord injury rehabilitation\u2019, Health Expectations 25(5), 2525\u20132533. https:\/\/doi.org\/10.1111\/hex.13574","DOI":"10.1111\/hex.13574"},{"key":"ref42","doi-asserted-by":"crossref","unstructured":"Sweet, S.N., Hennig, L., Shi, Z., Clarke, T., Flaro, H., Hawley, S. et al., 2021, \u2018Outcomes of peer mentorship for people living with spinal cord injury: Perspectives from members of Canadian community-based SCI organizations\u2019, Spinal Cord 59, 1301\u20131308. https:\/\/doi.org\/10.1038\/s41393-021-00725-2","DOI":"10.1038\/s41393-021-00725-2"},{"key":"ref43","doi-asserted-by":"crossref","unstructured":"Tsai, I.-H., Graves, D.E., Chan, W., Darkoh, C., Lee, M.-S. & Pompeii, L.A., 2017, \u2018Environmental barriers and social participation in individuals with spinal cord injury\u2019, Rehabilitation Psychology 62(1), 36\u201344. https:\/\/doi.org\/10.1037\/rep0000117","DOI":"10.1037\/rep0000117"},{"key":"ref44","doi-asserted-by":"crossref","unstructured":"Turner-Stokes, L., Williams, H., Bill, A., Bassett, P. & Sephton, K., 2016, \u2018Cost-efficiency of specialist inpatient rehabilitation for working-aged adults with complex neurological disabilities: A multicentre cohort analysis of a national clinical data Set\u2019, BMJ Open 6(2), e010238. https:\/\/doi.org\/10.1136\/bmjopen-2015-010238","DOI":"10.1136\/bmjopen-2015-010238"},{"key":"ref45","unstructured":"World Health Organization (WHO), 2002, Towards a common language for functioning, disability and health: ICF, WHO, Geneva, viewed 16 July 2021, from https:\/\/www.who.int\/classifications\/icf\/icfbeginnersguide.%0Apdf?ua=1%0A."},{"key":"ref46","unstructured":"World Health Organization (WHO), 2017, Rehabilitation 2030: A call for action, WHO, Geneva, viewed 16 July 2021, from https:\/\/www.who.int\/publications\/i\/item\/rehabilitation-2030-a-call-for-action."}],"container-title":["South African Journal of Physiotherapy"],"original-title":[],"link":[{"URL":"https:\/\/sajp.co.za\/index.php\/sajp\/article\/view\/2260\/4181","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T11:33:22Z","timestamp":1775820802000},"score":1,"resource":{"primary":{"URL":"https:\/\/sajp.co.za\/index.php\/sajp\/article\/view\/2260"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,13]]},"references-count":47,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,1]]}},"URL":"https:\/\/doi.org\/10.4102\/sajp.v82i1.2260","relation":{},"ISSN":["0379-6175","2410-8219"],"issn-type":[{"value":"0379-6175","type":"print"},{"value":"2410-8219","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,13]]},"article-number":"a2260"}}