Individual’s experiences of adjusting to changes in body image after spinal cord injury: a literature review and thematic synthesis

To understand how individuals experience and adjust to changes in body image after spinal cord injury (SCI). A systematic search using four databases identified eleven articles that met the inclusion criteria. The studies were critically appraised to determine quality. Interpretative thematic synthesis was used to explore adults’ experiences of adjusting to changes in body image after SCI. Three themes described the influence of sociocultural factors on body image: ‘Sociocultural influences’, ‘Responses of others’ and ‘Experience of rehabilitation’. Six themes described individuals’ experiences of body image. ‘Loss and threat of difference’, ‘Discomfort and disconnection’ and ‘Resistance’ negatively influenced body image. ‘Reconnecting with the body and re-negotiating identity’, ‘Support network’ and ‘Challenging beliefs about disability’ promoted positive body image. Adjustment was a dynamic process, influenced by interactions between individual, relational and sociocultural factors. The physical impacts of SCI, individual’s perceptions, relationships and sociocultural discourses influenced body image. Rehabilitation professionals could support adjustment to changes in body image by considering individual, relational and systemic influences. Furthermore, it is important to include an individual’s support network within their care as social factors influenced body image experiences. Peer support could promote hope and challenge negative sociocultural beliefs about disability. Following spinal cord injury (SCI) individuals described a dynamic process of adjustment to changes in their body image, which can include positive and negative body image experiences.Rehabilitation environments and interactions with clinicians can influence individuals’ body image experiences.Multidisciplinary interventions which consider sociocultural, relational and individual influences on body image may promote positive body image experiences and the renegotiation of identity after SCI. Following spinal cord injury (SCI) individuals described a dynamic process of adjustment to changes in their body image, which can include positive and negative body image experiences. Rehabilitation environments and interactions with clinicians can influence individuals’ body image experiences. Multidisciplinary interventions which consider sociocultural, relational and individual influences on body image may promote positive body image experiences and the renegotiation of identity after SCI.

本研究旨在探究个体在脊髓损伤（spinal cord injury, SCI）后如何体验并适应体像变化。通过在四个数据库中开展系统性检索，共筛选出11篇符合纳入标准的文献。研究人员对纳入文献进行严格质量评价，采用解释性主题合成法分析成年群体在脊髓损伤后适应体像变化的相关体验。

研究共提炼出三类影响体像的社会文化因素主题，分别为「社会文化影响」、「他人反应」与「康复体验」；同时归纳出六项体现个体体像体验的主题：其中「差异感的丧失与威胁」、「不适与疏离感」以及「抗拒」对体像产生消极影响；「与身体重新联结并重构身份认同」、「支持网络」与「挑战残疾相关刻板认知」则有助于塑造积极体像。

适应过程是一个动态变化的历程，受到个体、人际与社会文化因素间交互作用的影响。脊髓损伤带来的生理影响、个体认知、人际关系及社会文化话语均会对体像产生作用。康复专业人员可通过考量个体、人际及系统层面的影响因素，辅助个体适应体像变化。此外，将个体的支持网络纳入照护体系至关重要，因为社会因素会显著影响体像体验。同伴支持可助力个体重拾希望，并挑战针对残疾的消极社会文化刻板认知。

脊髓损伤（SCI）个体将体像变化的适应过程描述为动态变化的历程，其间可同时伴随积极与消极的体像体验。康复环境与临床医护人员的互动会对个体的体像体验产生影响。兼顾社会文化、人际及个体层面体像影响因素的多学科干预方案，或可助力个体在脊髓损伤后形成积极体像并完成身份重构。

脊髓损伤（SCI）个体将体像变化的适应过程描述为动态变化的历程，其间可同时伴随积极与消极的体像体验。康复环境与临床医护人员的互动会对个体的体像体验产生影响。兼顾社会文化、人际及个体层面体像影响因素的多学科干预方案，或可助力个体在脊髓损伤后形成积极体像并完成身份重构。