The meaning of leisure for children and young people with physical disabilities: a systematic evidence synthesis

Aim
Participation in leisure has known health benefits. Children and young people (CYP) with physical disabilities demonstrate reduced participation in leisure. To facilitate their meaningful participation, one must understand what leisure means to CYP. The aim of this study was to systematically synthesize evidence from qualitative studies on the meaning of leisure for CYP with physical disabilities.

Methods
CINAHL, MEDLINE, AMED, EMBASE, PsycINFO, and ERIC were searched periodically from January 2012 until May 2013. Qualitative studies reporting the views of CYP (0–18y) with physical disabilities on leisure participation were included. The analysis involved thematic syntheses, double coding, and established quality appraisal procedures.

Results
Twelve studies met inclusion criteria, addressing the leisure experiences of 146 CYP with disabilities. Four themes core to the meaning of leisure for these CYP were (1) ‘fun’: the enjoyment and pleasure experienced from leisure; (2) ‘freedom’ of choice and from constraints; (3) ‘fulfilment’: discovering, developing, and displaying potential; and (4) ‘friendship’: social connectedness and belonging.

Interpretation
The identified themes resonate with the psychological needs outlined by self‐determination theory: fun relates to satisfaction and intrinsic motivation; freedom relates to ‘autonomy’; fulfilment relates to a belief in 'competence'; and friendship resonates with ‘relatedness’. Social context had an impact on all of these themes, indicating that this is an important target for leisure participation interventions.