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Special Edition on Neuro-urology

A qualitative assessment of psychosocial aspects that play a role in bladder management after spinal cord injury

Abstract

Study design

Prospective qualitative study using semi-structured, open-ended interviews.

Objectives

To better understand psychosocial aspects of bladder management after spinal cord injury (SCI).

Setting

People with SCI, recruited through three tertiary care centres in North America.

Methods

Thirty-four community-dwelling individuals with SCI were selected using purposive sampling to ensure men and women with both tetraplegia and paraplegia were represented. The interviews were audio recorded and transcribed. NVivo software was used to code psychosocial domains, medical complications, and methods of bladder management. A qualitative interpretive approach was used, and four participants participated in a debrief session to review the study findings.

Results

The median age was 49 (IQR 40–62) years and 61% (21/34) were male. Most had complete injuries (AIS A, 47%, 16/34), and most had a cervical lesion (56%, 19/34). There was a large range of time living with a SCI (median 20 years, IQR 9–31), and most participants managed their bladder with intermittent catheterisation (67% 23/34). The five most common psychosocial domains were anxiety (often in the context of urinary infections, incontinence, or not being able to catheterise), loss of control (due to irregular bladder behaviour), and embarrassment (from incontinence occurring in public); the domains of confidence and independence/planning included both positive and negative examples of bladder management experiences.

Conclusions

This study demonstrated consistent psychosocial topics related to bladder management in people living with SCI. This information will help counsel people regarding bladder management and identify areas for education and optimisation of bladder function from a psychosocial perspective.

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Fig. 1: Intersection of psychosocial domains and bladder complications.

Data availability

The datasets generated during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

Ashlea Wilkes, Robbin Clark and Cameron Futral are thanked for their assistance with this project.

Funding

This study was supported by a Psychosocial Research Grant from the Craig H. Neilsen Foundation.

Author information

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Authors

Consortia

Contributions

BW initiated the collaborative project, obtained funding, co-designed and edited the study protocol, conducted the analysis, and drafted and revised the paper. JM, MK, MM, JW and KG co-designed the study protocol, contributed to the analysis of the results and revised the paper. All authors approved the final paper.

Corresponding author

Correspondence to Blayne Welk.

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Conflict of interest

The authors declare that they have no conflict of interest.

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We certify that all applicable institutional and governmental regulations concerning the ethical use of human volunteers were followed during the course of this research.

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Welk, B., Myers, J.B., Kennelly, M. et al. A qualitative assessment of psychosocial aspects that play a role in bladder management after spinal cord injury. Spinal Cord 59, 978–986 (2021). https://doi.org/10.1038/s41393-020-00538-9

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