title: Social and personal consequences of acquired bowel dysfunction for persons with spinal cord injury.
abstract: BACKGROUND
  Traditional literature regarding acquired bowel dysfunction for persons with spinal cord injury (SCI) has focused on clinical assessments of bowel dysfunction and bowel management programs. These studies make reference to the effects of bowel dysfunction on quality of life (QOL), but none systematically study the relationship. This study develops 4 scales that measure impediment to community integration (ICI) due to bowel dysfunction and then examines the relationship between bowel dysfunction, ICI, and QOL.
  
  
  METHODS
  A structured telephone survey was conducted with a convenience sample of 103 SCI consumers. Survey questions documented bowel dysfunction (ie, severity and number of accidents), bowel management (ie, how often bowels are evacuated), ICI, and satisfaction with 4 life domains.
  
  
  RESULTS
  Correlation analyses showed that subjective bowel dysfunction severity and number of days per month a respondent had to stay home because of lack of bowel control were associated with barriers to personal relationships, feelings about self, and home life. Also, the number of bowel accidents per month was associated with feelings about self. ICI scales were shown to be related to lower levels of satisfaction with free time, friendships, family life, and life in general. No statistically significant relationships were found between bowel dysfunction and satisfaction with life.
  
  
  CONCLUSIONS
  Bowel dysfunction is a barrier to community integration and is related to low levels of life satisfaction. Also, it is possible to quantify ICI related to bowel dysfunction. Educational programs can reduce the stigma associated with bowel dysfunction. Further research into the intricate relationships between bowel problems, barriers to participation in the community, and life satisfaction is needed.
authors.affiliation: Northeast Ohio Regional SCI System, Metro Health Medical Center, 2500 Metro Health Drive, Cleveland, OH 44109-1998, USA.
authors.forename: M J
authors.initials: MJ
authors.lastname: Roach
authors.forename: F S
authors.initials: FS
authors.lastname: Frost
authors.forename: G
authors.initials: G
authors.lastname: Creasey
mesh_terms: D000328:Adult; D005260:Female; D006306:Health Surveys; D006801:Humans; D007410:Intestinal Diseases / Q000209:etiology / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010549:Personal Satisfaction; D011788:Quality of Life; D012649:Self Concept; D012720:Severity of Illness Index; D012919:Social Behavior; D012959:Socioeconomic Factors; D013119:Spinal Cord Injuries / Q000150:complications* / Q000523:psychology