Sober-Williams Elin K, Lucci Vera-Ellen M, McBride Christopher B, McGrath Maureen S, Willms Rhonda, Gainforth Heather L, Claydon Victoria E
Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, British Columbia, Canada.
International Collaboration On Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada.
Disabil Rehabil. 2025 Jul;47(14):3602-3612. doi: 10.1080/09638288.2024.2429747. Epub 2024 Nov 18.
Individuals with spinal cord injury (SCI) are dissatisfied with their bowel care, but 71% have not changed their care for at least 5 years. Recently, individuals with SCI expressed a need for knowledge about bowel care options. Healthcare providers (HCP) play a crucial role in supporting bowel care changes.
We aimed to understand the barriers and facilitators HCP face when discussing changes in bowel care with individuals with SCI.
Semi-structured interviews were conducted with HCP in partnership with Spinal Cord Injury British Columbia and key community stakeholders. Barriers and facilitators were extracted, deductively coded using the Theoretical Domains Framework, then inductively analysed for themes.
Themes highlighted that effective bowel care requires diverse knowledge from a multidisciplinary team. Lack of time to prioritise bowel care and limited healthcare resources were barriers to improving care, which may be augmented through regular bowel care review of both medical and person-centered priorities. Facilitators were accessible and tailored knowledge sharing of care options, complemented by peer support.
This study highlights the need for targeted interventions that reduce barriers and enhance facilitators to changing care routines, supporting individuals with SCI to change bowel care when needed, and improving quality of life.
脊髓损伤（SCI）患者对其肠道护理不满意，但71%的患者至少5年未改变其护理方式。最近，脊髓损伤患者表示需要了解肠道护理选择方面的知识。医疗保健提供者（HCP）在支持肠道护理改变方面起着至关重要的作用。
我们旨在了解医疗保健提供者在与脊髓损伤患者讨论肠道护理改变时所面临的障碍和促进因素。
与不列颠哥伦比亚省脊髓损伤协会及关键社区利益相关者合作，对医疗保健提供者进行了半结构化访谈。提取障碍和促进因素，使用理论领域框架进行演绎编码，然后进行归纳分析以确定主题。
主题强调有效的肠道护理需要多学科团队的多种知识。缺乏优先安排肠道护理的时间以及有限的医疗资源是改善护理的障碍，通过对医疗和以患者为中心的优先事项进行定期肠道护理审查，这一情况可能会得到改善。促进因素包括提供可获取且量身定制的护理选择知识共享，并辅以同伴支持。
本研究强调需要有针对性的干预措施，以减少障碍并增强促进护理常规改变的因素，支持脊髓损伤患者在需要时改变肠道护理方式，并提高生活质量。
