Bladder management in persons with spinal cord lesion.
Dahlberg A, Perttilä I, Wuokko E, Ala-Opas M. Käpylä Rehabilitation Centre, Finnish Association of People with Mobility Disabilities, Nordenskiöldinkatu 18B, PO Box 103, 00251 Helsinki, Finland. Spinal Cord. 2004 Dec;42(12):694-8.
STUDY DESIGN: Cross-sectional clinical descriptive prevalence study.
OBJECTIVE: To evaluate the methods of self-reported bladder management, the frequency of urinary tract infection (UTI) and subjective disturbance of bladder problems of all those individuals with traumatic spinal cord lesion (SCL) living in Helsinki area.
SETTING: Helsinki, Finland.
METHODS: A total of 152 persons with SCL were found in the Helsinki area (546 000 inhabitants). A structured questionnaire was sent to all subjects and they were invited to a clinical visit.
RESULTS: The final study-group consisted of 129 (85%) subjects. They were defined into seven specific subgroups of bladder management: 14 (11%) subjects in the normal voiding group, 15 (12%) in the controlled voiding group, 16 (12%) in the clean intermittent catheterization (CIC) group, 30 (23%) in the mixed group, 31 (24%) in the suprapubic tapping group, 16 (12%) in the compression or straining group and seven (5%) in the catheter or conduit group. The frequency of UTI was highest in the mixed group. The bladder management was a biggest bother to the subjects in the compression or straining group.
CONCLUSIONS: This prevalence study assesses the self-reported bladder management methods in all the persons with traumatic SCL in the Helsinki area. The subjects who used CIC and other methods for bladder management had more problems than others. These subjects might manage better by using either CIC or suprapubic tapping as the only method for bladder emptying.
Preventive care in spinal cord injuries and disorders: examples of research and implementation.
Weaver FM, LaVela SL. Center for Management of Complex Chronic Care, Health Services Research (151H), VA Hospital, Hines, IL 60141, USA. frances.weaver@va.gov Phys Med Rehabil Clin N Am. 2007 May;18(2):297-316, vii.
Individuals with disabilities are less likely to receive preventive care services than those in the general population. Prevention is very important in persons with spinal cord injuries and disorders for both common conditions such as respiratory infections and for conditions common in spinal cord disorders such as neurogenic bowel, because these individuals are at increased risk for negative outcomes. Clinical practice guidelines provide evidence-based recommendations for patient care. However, dissemination of guidelines is not sufficient to increase use of recommended care. Implementation research has identified strategies to increase use of evidence-based care and subsequently improve patient outcomes.