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

Using conjoint analysis to measure the importance of psychosocial traits in the choices of bladder management after spinal cord injury

“…Finally, consistent with previous research, people with cervical lesions were more likely to use an indwelling catheter 23 and people who used indwelling catheters placed significantly more importance on UTIs, time, fluid intake, and social life in relation to their bladder function. These findings were also consistent with our previous qualitative study that identified the latter three (time, fluid intake and social life) as potential advantages of indwelling catheters 11 . The literature generally supports that indwelling catheters are associated with more UTIs, 24 which may be why indwelling catheter users place more priority on this complication.…”

“…It is not surprising that UTIs were ranked most important, as they are in the top three secondary health complications after SCI, 6 they are more common in people with SCI who using indwelling catheters or CIC, 20 and they are frequently referenced in relation to psychosocial domains such as anxiety and loss of control after SCI. 11,21 The three domains that were least important in choosing a bladder management were need for a urine bag, limitations in the way one can dress and limiting fluid intake. The need for a urine bag, and bladder function impacting the way a person could dress both represent aspects of body image and have been shown to improve following the immediate period after SCI.…”

“…IQR, interquartile range (time, fluid intake and social life) as potential advantages of indwelling catheters. 11 The literature generally supports that indwelling catheters are associated with more UTIs, 24 which may be why indwelling catheter users place more priority on this complication. Surprisingly, despite having several relevant demographic variables that are felt in the medical literature to drive bladder management (such as obesity, sex, and level/completeness of SCI), and an assessment of the relative importance of several relevant psychosocial attributes and personality traits, we could only account for approximately a third of the variability in the use of either an indwelling catheter or CIC.…”

“…10 As part of this project, we started with a qualitative study to identify and explore key psychosocial themes related to bladder management in a representative sample of people living with SCI. 11 Using this work, combined with previous systematic reviews, 8,12 and the clinical and lived experiences of the research team, we created an initial list of attributes of interest. Statements were then created to represent the attribute of interest in the context of bladder management.…”

Is coronavirus disease 2019 associated with indicators of long‐term bladder dysfunction?

“…This time period was chosen as we felt it would be unlikely that people would seek care for urinary symptoms during their acute illness, and patients may be admitted to hospital for a period of a few weeks during their acute COVID-19 disease. 12 We identified the following a priori outcomes of interest: whether patients underwent cystoscopy (OHIP fee code Z606, Z607), consulted with a urologist (OHIP fee code A355), or filled a prescription for an overactive bladder medication (solifenacin, oxybutynin, mirabegron, fesoterodine, tolterodine, or darifenacin). Our hypothesis was that if COVID-19 was associated with chronic urinary symptoms, these should be more frequent among COVID-19 patients.…”