Barriers and facilitators to changing bowel care practices after spinal cord injury: a Theoretical Domains Framework approach

Spinal Cord, 2022 · DOI: https://doi.org/10.1038/s41393-021-00743-0 · Published: January 7, 2022

Spinal Cord Injury Healthcare Gastroenterology

Simple Explanation

This study investigates why individuals with spinal cord injuries (SCI) often don't change their bowel care routines despite being dissatisfied with them. The researchers used interviews and a framework called the Theoretical Domains Framework (TDF) to understand the barriers and facilitators influencing changes to bowel care. The study identified key factors like workplace flexibility, access to resources, beliefs about the consequences of change, social support, and knowledge of bowel care options as crucial in influencing bowel care changes.

Study Duration

Not specified

Participants

13 individuals with SCI

Evidence Level

Not specified

Key Findings

1
Environmental context and resources, including workplace flexibility and access to support, significantly impact bowel care changes.
2
Beliefs about the consequences of changing bowel care, such as fear of accidents or loss of independence, strongly influence decisions.
3
Social influences, particularly perceived support from peers and healthcare professionals, play a vital role in facilitating or hindering changes.

Research Summary

The study explores the barriers and facilitators to changing bowel care practices among individuals with spinal cord injury (SCI) using the Theoretical Domains Framework (TDF). Key findings highlight the importance of environmental context, beliefs about consequences, social influences, and knowledge in influencing bowel care changes. The research suggests that interventions should target reflective motivation, psychological capability, and social/physical opportunities to improve bowel care satisfaction and quality of life for individuals with SCI.

Practical Implications

Personalized Interventions

Future interventions should be tailored to address individual access to knowledge and resources, beliefs about consequences, and social influences.

Workplace Flexibility Advocacy

Promote increased flexibility in the workplace to accommodate the care needs of individuals with SCI.

Peer Mentorship Programs

Incorporate peer mentorship programs to leverage the unique influence of peers on bowel care knowledge and adjustment after SCI.

Study Limitations

1
The study's scope was specific to individuals living with SCI in British Columbia, Canada.
2
The study may be subject to selection bias, as participants might have been experiencing more profound bowel dysfunction.
3
The study did not investigate cardiovascular autonomic dysfunction in the context of bowel care changes.

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