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Bladder and bowel function effects on emotional functioning in youth with spinal cord injury: a serial multiple mediator analysis

Spinal Cord volume 61, pages 415–421 (2023)Cite this article

Subjects

Abstract

Study design

Preliminary explanatory or mechanistic cross-sectional study.

Objectives

This preliminary cross-sectional study investigates the hypothesized serial mediating effects of bladder/bowel worry, social worry, and social participation in the relationship between bladder function or bowel function and emotional functioning in youth with spinal cord injury (SCI) from their perspective.

Methods

The Bladder Function, Bowel Function, Worry Bladder Bowel, Worry Social, and Social Participation Scales from the PedsQL™ Spinal Cord Injury Module and the Emotional Functioning Scale from the PedsQL™ 4.0 Generic Core Scales Short Form SF15 were completed by 127 youth with SCI ages 8–24. Serial multiple mediator model analyses were conducted to test the hypothesized sequential mediating effects of bladder/bowel worry, social worry, and social participation as intervening variables separately for the cross-sectional association between bladder function or bowel function and emotional functioning.

Results

The separate cross-sectional negative association of bladder function and bowel function with emotional functioning were serially mediated by bladder/bowel worry, social worry and social participation, accounting for 28% and 31%, respectively, of the variance in youth-reported emotional functioning (p < 0.001), representing large effect sizes.

Conclusions

In this preliminary study, bladder/bowel worry, social worry, and social participation explain in part the cross-sectional negative association of bladder function and bowel function with emotional functioning in youth with SCI from the youth perspective. Identifying the hypothesized associations of bladder function and bowel function, bladder/bowel worry, social worry, and social participation with emotional functioning may help inform future clinical research and practice for youth with SCI.

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Fig. 1: Hypothesized conceptual model.
Fig. 2: Hypothesized conceptual model.

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Data availability

The data are available from the corresponding author on reasonable request.

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Funding

Funding

The PedsQL™ Spinal Cord Injury Module field test study was supported by a grant from the Craig H. Neilsen Foundation Grant #542021.

Author information

Authors and Affiliations

  1. Department of Pediatrics, College of Medicine, Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University, College Station, TX, USA

    James W. Varni

  2. Shriners Children’s Chicago, Chicago, IL, USA

    Kathy Zebracki, Miriam Hwang & Lawrence C. Vogel

  3. Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Kathy Zebracki

  4. Center for Outcomes and Measurement, Jefferson College of Rehabilitation Sciences, Department of Physical Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA

    Mary Jane Mulcahey

  5. Department of Pediatrics, Rush Medical College, Chicago, IL, USA

    Lawrence C. Vogel

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  1. James W. Varni
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  4. Mary Jane Mulcahey
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  5. Lawrence C. Vogel
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Contributions

JWV was involved in the conception and design of the study, in the writing of the first draft of the manuscript, the analysis of the data and the interpretation of the data. KZ, MH, and LCV were involved in the conception and design of the study, the acquisition of the data, interpretation of the data, and critical revision of the manuscript for important intellectual content. MJM was involved in the conception and design of the study, interpretation of the data, and critical revision of the manuscript for important intellectual content. All authors read and approved the final manuscript.

Corresponding author

Correspondence to James W. Varni.

Ethics declarations

Competing interests

JWV holds the copyright and the trademark for the PedsQL™ and receives financial compensation from the Mapi Research Trust, which is a nonprofit research institute that charges distribution fees to for-profit companies that use the Pediatric Quality of Life Inventory™. The other authors report no competing interests related to this study.

Ethical approval

This study was reviewed and approved by the Western Institutional Review Board (Study Number 1248478). We certify that all applicable institutional regulations concerning the ethical use of human volunteers were followed during the course of this research.

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Varni, J.W., Zebracki, K., Hwang, M. et al. Bladder and bowel function effects on emotional functioning in youth with spinal cord injury: a serial multiple mediator analysis. Spinal Cord 61, 415–421 (2023). https://doi.org/10.1038/s41393-023-00912-3

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