Descriptions of community by people with spinal cord injuries: concepts to inform community integration and community rehabilitation.

Effective measurement and optimization of re-entry into the community after injury depends on a degree of understanding of how those injured persons actually perceive their community. In light of the limited research about foundational concepts regarding community integration after spinal cord injury, this study investigated how a large number of adults with spinal cord injury described their local communities. In the course of telephonic interviews, qualitative descriptions of community were obtained from 269 participants (1-56 years postinjury). These were thematically analysed for content and valence by three researchers. In addition to descriptions of community as 'place', findings echoed the three dimensions commonly included in measures of community integration, namely social integration, occupation and independent living. Participants who described their community in social and relationship terms reflected generally positive views about that community, whereas those who described their community in terms of physical space and access expressed a relatively greater proportion of negative views when describing their community. In general, substantial diversity of responses across participants suggested a need for greater complexity in understanding, measurement and clinical application of the notion of community within the area of community integration and participation. Specifically, the importance of focusing on social and relationship dimensions of community integration is emphasized for rehabilitation practice.