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Sadeghi Akbari A, Mahmoudirad G. Investigating the Profound Impact of External Perceptions and Expectations on Self-Concept in Spinal Cord Injury During Rehabilitation: A Qualitative Study. jrehab 2025; 26 (2) :206-229
URL: http://rehabilitationj.uswr.ac.ir/article-1-3499-en.html

Objective Spinal cord injury (SCI) significantly impacts an individual’s life and necessitates extensive rehabilitation to regain independence. Self-concept, defined as the sum of an individual’s beliefs and feelings about oneself, is crucial in motivating individuals to engage in rehabilitation efforts and ultimately achieve success. The primary objective of this study is to qualitatively examine the influence of perceptions and expectations of others, particularly therapists and family members, on the self-concept of individuals with SCI during the rehabilitation process.
Materials & Methods This study employed a qualitative research approach using content analysis to understand the lived experiences of individuals with SCI. The data were collected via semi-structured interviews with 19 individuals diagnosed with SCI (aged 23-50 years) who were purposively selected from disability associations and rehabilitation centers. Interviews continued until data saturation was reached. For data analysis, an inductive content analysis approach was utilized. Initially, interviews were fully transcribed and then coded using the MAXQDA software, version 2020. To enhance the credibility of the findings, Guba and Lincoln’s criteria, as well as data triangulation and participant feedback, were employed.
Results The findings of this study revealed a core theme labeled " the existential affirmation on traversing recovery " along with three key categories: "Creating a new identity based on willpower and effort": This category highlighted significant motivational factors in the recovery process, including validation from therapists, encouragement from family and friends, and witnessing one's positive impact on others. “Therapist Empathy and Support in the Rehabilitation Process ": Within this category, therapists played a crucial role by providing emotional support and reinforcing self-belief, thereby shaping individuals' rehabilitation experiences. “Finding power in overcoming challenges": Individuals with spinal cord injury (SCI) pushed their boundaries, utilizing external limitations as motivational drivers for personal growth and progress.
Conclusion Individuals with SCI are profoundly influenced by their perceptions and expectations of their environment. Social support, encouragement from therapists, and observing the progress of others play a crucial role in shaping motivation and self-belief in these individuals. The results of this research underscore the necessity of adopting a comprehensive approach to SCI rehabilitation. This approach should extend beyond physical recovery and also address psychological and social dimensions. Emotional support from therapists, strengthening self-belief, and fostering motivation in patients are key components of this approach. Individuals with SCI often face limitations imposed by their injury. However, the findings of this study demonstrate that many of these individuals have achieved significant progress by transforming these limitations into motivation.