A comparison of patient outcomes and quality of life in persons with neurogenic bowel: standard bowel care program vs colostomy.
OBJECTIVE
The purpose of this study was to compare patient outcomes and quality of life for people with neurogenic bowel using either a standard bowel care program or colostomy.


METHODS
We analyzed survey data from a national sample, comparing outcomes between veterans with spinal cord injury (SCI) who perform bowel care programs vs individuals with colostomies. This study is part of a larger study to evaluate clinical practice guideline implementation in SCI. The sample included 1,503 veterans with SCI. The response rate was 58.4%. For comparison, we matched the respondents with colostomies to matched controls from the remainder of the survey cohort. A total of 74 veterans with SCI and colostomies were matched with 296 controls, using propensity scores. Seven items were designed to elicit information about the respondent's satisfaction with their bowel care program, whereas 7 other items were designed to measure bowel-related quality of life.


RESULTS
No statistically significant differences in satisfaction or quality of life were found between the responses from veterans with colostomies and those with traditional bowel care programs. Both respondents with colostomies and those without colostomies indicated that they had received training for their bowel care program, that they experienced relatively few complications, such as falls as a result of their bowel care program, and that their quality of life related to bowel care was generally good. However, large numbers of respondents with colostomies (n = 39; 55.7%) and without colostomies (n = 113; 41.7%) reported that they were very unsatisfied with their bowel care program.


CONCLUSIONS
Satisfaction with bowel care is a major problem for veterans with SCI.
Luther
Stephen L
SL
Patient Safety Center of Inquiry and HSR&D REAP on Patient Safety Outcomes, James A Haley Veterans Hospital, Tampa, Florida 33612-5738, USA. steve.luther@med.va.gov
Nelson
Audrey L
AL
Harrow
Jeffrey J
JJ
Chen
Fangfei
F
Goetz
Lance L
LL
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003106:Colon / Q000294:innervation / Q000503:physiopathology; D003108:Colonic Diseases / Q000209:etiology* / Q000601:surgery*; D003125:Colostomy / Q000379:methods*; D003248:Constipation / Q000209:etiology / Q000601:surgery; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D011788:Quality of Life; D012648:Self Care / Q000379:methods*; D013119:Spinal Cord Injuries / Q000150:complications*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014728:Veterans