Psychosocial aspects of health-related quality of life and the association with patient-reported bladder symptoms and satisfaction after spinal cord injury

Abstract

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.

Time-Related Changes in Patient Reported Bladder Symptoms and Satisfaction after Spinal Cord Injury

“…In another recent analysis using the NBRG SCI registry, individuals with SCI with higher positive affect and well-being scores were observed to have better bladder-related QoL than those with lower scores. 18 We found the same relationship in this analysis, with worse bladder symptoms and satisfaction associated with higher pain, and better symptoms and satisfaction associated with better positive affect and well-being. In one study by Etingen et al, the authors observed that longer duration from injury was associated with improved pain interference when also accounting for positive affect/well-being and life satisfaction.…”

“…Psychosocial measurement of HRQoL, which are several panels from the SCI-QoL measurement system, utilize computer-adaptive testing, scored from 1–100, and have a median of 50. 18 Participants self-reported their bladder management, and when they used multiple management methods they were required to indicate which they considered primary.…”

The Effect of Preoperative Health Education, Delivered as Animation Videos, on Postoperative Anxiety and Pain in Femoral Fractures

“…As a consequence, hospitalization will be prolonged ( Alattas et al, 2017 ). This not only increases the economic burden for patients and society but also lowers patient satisfaction ( Rabah et al, 2020 ; Small and Laycock, 2020 ; Dieu et al, 2021 ; Michael, 2021 ; Moghalu et al, 2021 ).…”

Editorial Comment

“…The authors are to be commended for shedding light on what is consistently one of the greatest quality of life issues for the SCI population 2 and for highlighting that a shared decision-making model with a careful assessment of the patient's goals, home environment support, surgical risk, and functional capabilities is always paramount to optimizing outcome when selecting bladder management in our SCI patients.…”