The experience and perspective of people with spinal cord injury about well-being interventions: a systematic review of qualitative studies.

Purpose: Promoting well-being is a key aim of rehabilitation. The intentional design of interventions to address well-being requires an understanding of the factors that affect this complex phenomenon. A growing body of qualitative literature has identified determinants that people with SCI report affect their well-being. It is unclear whether or how rehabilitation interventions can influence these well-being determinants. This study sought to explore the experience and perspective of people with SCI about interventions that target their well-being.

Method: Systematic search of seven databases. Deductive analysis to categorize findings related to well-being determinants, and further inductive coding to identify sub-themes, relationships and additional findings.

Results: Twenty studies were selected, involving a wide range of interventions. Each intervention influenced a number of well-being determinants, which were inter-related. People with SCI reported improvements in both subjective and psychological well-being. However, well-being was not always well defined in the studies and people with SCI reported lack of priority for, and opportunity to engage in, well-being interventions in the current rehabilitation system.

Conclusions: Rehabilitation interventions can influence well-being determinants. These determinants form a useful framework for the intentional design of well-being interventions, which should be informed by a broad understanding of well-being.IMPLICATIONS FOR REHABILITATIONWell-being can be influenced by rehabilitation interventions, and a more explicit focus on well-being in intervention design and evaluation is recommended.Conceptual frameworks used to define and measure well-being should adopt a broad understanding of well-being.Well-being interventions should address the determinants identified by people with SCI (engaging in occupation, responsibility, values and perspectives, self-worth, self-continuity, relationships and the environment).People with SCI want a greater priority placed on well-being interventions, and more opportunities to engage in these interventions, especially in the community.