Study Design:
Prospective, multi-centered, observational
Objectives:
To characterize the relationship between psychosocial aspects of health-related quality of life (HRQoL) and patient-reported bladder outcomes.
Setting:
Multi-institutional sites in the United States, cohort drawn from North America
Methods:
We performed a cross-sectional analysis of data collected as part of the multicenter, prospective Neurogenic Bladder Research Group Spinal Cord Injury (SCI) Registry. Outcomes were:
Neurogenic Bladder Symptom Score
(
NBSS
),
Neurogenic Bladder Symptom Score Satisfaction
(
NBSS-Satisfaction
), and
SCI-QoL Bladder Management Difficulties
(
SCI-QoL Difficulties
). Adjusted multiple linear regression models were used with variables including demographic, injury characteristics, and the following psychosocial HRQoL measures;
SCI-QoL Pain Interference (Pain), SCI-QoL Independence
, and
SCI-QoL Positive Affect and Well-being (Positive Affect)
. Psychosocial variables were sub-divided by tertiles for the analysis.
Results:
There were 1479 participants, 57% had paraplegia, 60% were men, and 51% managed their bladder with clean intermittent catheterization. On multivariate analysis, higher tertiles of
SCI-QoL Pain
were associated with worse bladder symptoms, satisfaction, and bladder management difficulties; upper tertile
SCI-QoL Pain
(
NBSS
3.8, p <0.001;
NBSS-satisfaction
0.6, p <0.001;
SCI-QoL Difficulties
2.4, p<0.001). In contrast, upper tertiles of
SCI-QoL Independence
and
SCI-QoL Positive Affect
were associated with improved bladder-related outcomes; upper tertile
SCI-QoL Independence
(
NBSS
−2.3, p=0.03;
NBSS-satisfaction
−0.4, p<0.001) and upper tertile
SCI-QoL Positive Affect
(
NBSS
−2.8, p<0.001;
NBSS-satisfaction
−0.7, p<0.001;
SCI-QoL Difficulties
−0.7, p<0.001).
Conclusion:
In individuals with SCI, there is an association between psychosocial HRQoL and bladder-related QoL outcomes. Clinician awareness of this relationship can provide insight into optimizing long-term management after SCI.