Experience of bowel, bladder and sexual problems and the effectiveness of a health program on quality of life and mental health in people with spinal cord injury in Manguzi

Abstract

Background: The quality of life of people with spinal cord injury is significantly affected by secondary health conditions such as bowel, bladder, and sexual problems. Literature on the experiences of bowel, bladder, and sexual problems is limited and studies on health interventions in people with SCI are also scarce in South Africa. Aim: To explore the experience of bowel, bladder and sexual problems and the effectiveness of a health program on the quality of life and mental health, as well as to determine the effectiveness of a health program on the quality of life (QoL) and mental health of people with SCI in Manguzi, KwaZulu Natal. Method: This study was a mixed study. An explorative qualitative study design using semi structured interviews was employed. The interviews were transcribed verbatim, and content analysis was conducted to identify the themes and categories. A Quasi-Experimental quantitative design was used. A face-to-face health program on the prevention and management of bowel, bladder, and sexual problems in SCI was conducted for the participants with SCI. WHOQoL Bref and SF-12 questionnaires were administered before and six weeks post-intervention respectively. Paired t-test was used to identify changes in QOL and mental health pre and post intervention. Significance was set at p-value ≤ 0.05. Results: The themes that emerged from the experience of bladder and bowel problems were “no control” and “frustration”. The categories related to the experiences were: types of bladder and bowel problems, managing bladder and bowel problems and the effects on well-being: The main theme for the experience of sexual health problems was “Dissatisfaction”. The categories were: types of sexual health problems, factors influencing sexual activity, the impact of sexual problems, and the management of sexual health problems. The long-term care needs for bowel and bladder problems included access to proper toilets, nappies, medication (Dulcolax), ease of bowel movement, and health information on diet and how to manage their bowel and bladder problems better. The long-term care needs for sexual health problems included the need for medication (sexual enhancement pills) and information on how to manage sexual health problems. There were no statistically significant changes in the pre-test and post-test scores of both the quality of life and mental health.