Restrictions in social participation of young adults with spina bifida

Purpose. To determine participation restrictions of young adults with spina bifida (SB) in relation to health condition and activity limitations.

Method. A total of 179 persons aged 16-25 years and born with SB participated in a cross-sectional study. The main outcome on four domains of participation (independent living, employment, education and partner relationships) was assessed using a structured questionnaire.

Results. At the mean age of 21 years only 16% were living independently, more than one-third of the participants went to special secondary education, 53%, of those who finished education did not have a regular job and 71%, did not have a partner. Health condition variables (type of SB, hydrocephalus and level of lesion) and to a lesser extent activity limitations (wheelchair dependence and incontinence) were significant determinants for having participation restrictions. Perceived hindrances in participation included long-distance transportation (19-36%), accessibility (10-42%), physical impairments (22-40%), emotional barriers (20-32%) and financial limits (3-17%,). More severe SB, defined as hydrocephalus, high level of lesion and wheelchair dependence, was related with more experienced hindrances clue to long-distance transportation accessibility of buildings.

Conclusions. Many young adults with spina bifida experience participation restrictions. Severity of SB was negatively related to participation. Social integration should be a major focus in the professional guidance of youngsters with physical disabilities.