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Table 4 Summary of identified facilitators and barriers to self-management, corresponding self-management program components, and implementation considerations in individuals with traumatic spinal cord injury and their caregivers

From: Perceived facilitators and barriers to self-management in individuals with traumatic spinal cord injury: a qualitative descriptive study

Identified facilitators (F), barriers (B) Suggested self-management program components/modules Implementation considerations
-Physical support from the caregiver (F) -Caregiver component (i.e., skills training and emotional support) -Training and support for caregivers needs to be responsive to the evolving needs of individuals with traumatic SCI (i.e., as they age and/or develop chronic conditions)
-Emotional support from the caregiver (F)   -The sustainability of caregiver activities and support required in SCI may be affected by aging and/or the chronic health conditions among caregivers themselves
-Caregiver burnout (B)   
-Peer support and feedback (F) -Peer support component -Matching peer mentors and mentees by specific demographic and clinical/injury characteristics (age, sex, etiology of injury) should be considered
-Timing of support should be considered (e.g., acute phase of recovery may be too early)
-Maintaining Independence/Control over Care (F) -Self-efficacy component -Time since injury may play an important role in (increasing) self-efficacy in traumatic SCI
-Importance of Positive Outlook and Acceptance (F) -Mood (depression) component (or Mind-Body component) -Time since injury may play an important role in (increasing) mood in traumatic SCI
-Difficulty Achieving Positive Outlook or Mood (B)   -Physical limitations and secondary complications, chronic conditions, and co-morbid traumatic brain injury should be considered
-Physical Limitations and Secondary Complications (B)   
-Funding and Funding Policies (B) -Awareness/knowledge of various funding programs -Health system factors (funding, accessibility) need to be optimized for overall self-management optimization among individuals with traumatic SCI and their caregivers
-Lack of accessibility (B) -Advocacy skills training