Browne Catherine, Salmon Nancy, Kehoe Maria
a Department of Clinical Therapies , University of Limerick , Limerick , Ireland and.
b Community Physiotherapy Department , Kildare/West Wicklow, Co. Kildare , Ireland.
Disabil Rehabil. 2015;37(25):2350-8. doi: 10.3109/09638288.2015.1027007. Epub 2015 Mar 24.
Bladder dysfunction affects 75% of people with multiple sclerosis (MS). People with MS are reluctant to seek treatment for this distressing symptom. This is the first-known study to explore in depth how bladder dysfunction interferes with quality of life for people with MS.
Nineteen individual semi-structured interviews were conducted (M = 8, F = 11). Participants had a definite diagnosis of MS, aged between 37 and 64 years and had at least one bladder dysfunction symptom. The audio-recorded interviews lasted up to 90 min and were transcribed verbatim.
Thematic analysis within NVivo10 yielded two key themes: (1) Disruptions and loss and (2) ways of knowing. "Disruptions and Loss" explores how bladder dysfunction interrupted daily living activities and how this contributed to experiencing loss. "Ways of knowing" portrays the types of knowledge that existed around bladder dysfunction. Participants described using their experiential knowledge to self-manage bladder symptoms without advice from healthcare providers.
Bladder dysfunction imposes major disruptions on daily life. People with MS attempt to self-manage their bladder symptoms, despite current barriers to navigating existing healthcare infrastructure. Understanding these barriers and the individual strategies employed by people with MS are the first steps in facilitating independent management of bladder dysfunction. Implications for Rehabilitation Each individual's experience of bladder dysfunction is unique. Healthcare professionals must be prepared to discuss all disruptions and losses associated with bladder dysfunction for people with MS. People with MS have a vast range of knowledge in relation to their own bladder symptoms and healthcare professionals need to explore their existing self-management strategies during assessment. People with MS and healthcare professionals need to be educated on the wider health implications relating to bladder dysfunction.
膀胱功能障碍影响75%的多发性硬化症（MS）患者。MS患者不愿为这种令人痛苦的症状寻求治疗。这是已知的第一项深入探讨膀胱功能障碍如何干扰MS患者生活质量的研究。
进行了19次个人半结构化访谈（男性=8人，女性=11人）。参与者被明确诊断为MS，年龄在37至64岁之间，且至少有一种膀胱功能障碍症状。录音访谈持续长达90分钟，并逐字转录。
在NVivo10中进行的主题分析产生了两个关键主题：（1）干扰与丧失，以及（2）认知方式。“干扰与丧失”探讨了膀胱功能障碍如何打断日常生活活动以及这如何导致丧失体验。“认知方式”描绘了围绕膀胱功能障碍存在的知识类型。参与者描述了在没有医疗保健提供者建议的情况下，如何利用他们的经验知识自我管理膀胱症状。
膀胱功能障碍对日常生活造成重大干扰。尽管在利用现有医疗保健基础设施方面存在障碍，但MS患者仍试图自我管理膀胱症状。了解这些障碍以及MS患者采用的个体策略是促进膀胱功能障碍独立管理的第一步。对康复的启示 每个人膀胱功能障碍的经历都是独特的。医疗保健专业人员必须准备好讨论与MS患者膀胱功能障碍相关的所有干扰和丧失情况。MS患者对自己的膀胱症状有广泛的了解，医疗保健专业人员在评估期间需要探索他们现有的自我管理策略。MS患者和医疗保健专业人员需要接受有关膀胱功能障碍更广泛健康影响的教育。
