Neurogenic Bowel and Bladder Management After Spinal Cord Injury: Examining Factors Involved in Successful Decision-Making Processes

Living with SCI requires the ability to make extensive and complex decisions to address the many associated health issues and complications. Persons with SCI make daily decisions about their care that directly and indirectly impact the management of their condition, especially in relation to neurogenic bladder and bowel (NBB) dysfunction. Very few studies discuss decision-making on NBB management among persons with SCI. Of those, none focus on patient decision-making and enactment. This study aims to examine veterans and civilians NBB management decisions and resulting outcomes. The aims are: 1) to identify the factors influencing the decision-making process and potential changes across time considering age and time since injury; 2) to assess participants abilities and coping styles in carrying out NBB management decisions; and 3) to assess the outcomes of these decisions on their health and wellbeing, overall satisfaction, and quality of life (QoL) while comparing these decisions to clinical practice guidelines. To address these aims we interviewed 61 SCI participants. Data is being analyzed using content analysis to identify topics, themes and patterns. Matrices are being for each aim. Data counts will be compared to scores from selected quantitative assessments. Implications for treatment will be drawn from this study and specific recommendations will be made for clinician care on how to educate and share the decision-making process with their patients. It is anticipated that findings may impact existing clinical practice guidelines by suggesting patient involvement in their future development and revisions. An earlier study by our team found that veterans with SCI more frequently chose surgical and more invasive methods for NBB management than did civilians with SCI.