Prospective qualitative study using semi-structured, open-ended interviews.
To better understand psychosocial aspects of bladder management after spinal cord injury (SCI).
People with SCI, recruited through three tertiary care centres in North America.
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.
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.
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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The datasets generated during the current study are available from the corresponding author on reasonable request.
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Ashlea Wilkes, Robbin Clark and Cameron Futral are thanked for their assistance with this project.
This study was supported by a Psychosocial Research Grant from the Craig H. Neilsen Foundation.
Conflict of interest
The authors declare that they have no conflict of interest.
We certify that all applicable institutional and governmental regulations concerning the ethical use of human volunteers were followed during the course of this research.
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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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