Qualitative Study of Nurses' Experiences of Patients With Spinal Cord Injury Requiring Neurogenic Bowel Management

Friday, 20 July 2018

Tzu-Jung Wu, MS, RN
Department of Nursing, Chung Shan Medical University Hospital and School of Nursing, Kaohsiung Medical University, Taichung, Taiwan
Chiu-Chu Lin, PhD, RN
School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
Hsiao-Yu Chen, PhD, RN
Deaprtment of Nursing, National Taichung University of Science and Technology, Taichung, Taiwan


Neurogenic bowel dysfunction is a chronic complication hindering function and quality of life for people with spinal cord injury (SCI). Effective bowel regimens are difficult to set up. Current evidence suggests that preventing unpredictable bowel movements improves vocational and social functioning and overall quality of life. The aim of this study was to understand and document the experiences of rehabilitation nurses regarding neurogenic bowel management for patients with SCI.


A qualitative study was conducted using face-to-face, semi-structured interviews to explore rehabilitation nurses’ descriptions of their experiences of patients with SCI requiring neurogenic bowel management. Participants were recruited through purposive sampling from the rehabilitation wards of 1 medical center and 2 regional hospitals in Taiwan. A total of 15 participants included 14 female and 1 male aged between 22 and 50 years. The average nursing experience was 10.3 years. The audio-taped interviews were transcribed verbatim and standardized through repeated listening by using thematic content analysis. As categories became apparent, statements were grouped under emerging themes. Each unit of analysis was consistent with a theme that emerged.


After rigorous data analysis and reviews, 4 themes and 10 subthemes were identified. The first theme ‘‘reluctant to perform neurogenic bowl management’’ included 3 subthemes: embarrassment regarding sexual imagination, unpleasant smell, and bothersome care. The second theme ‘‘empathizing with troubling situations’’ includes included 2 subthemes: feeling sad for over patients’ loss of control and predicting the effects of bowel accidents on their future lives. The third theme ‘‘recognizing the effectiveness of neurogenic bowel management’’ includes included 3 subthemes: identifying the value of professionalism, perceiving the effectiveness of feedback, and believing in the need for neurogenic bowel management. The fourth theme ‘‘willingness to take action’’ includes included 2 subthemes: perceiving achievements satisfaction of being a helper and realizing the value of nursing.


The findings obtained from the themes illustrated the perceptions of rehabilitation nurses regarding patients with SCI who require neurogenic bowel management. Understanding the cultural aspects and meanings of the experiences can help in developing interventions tailored to nurses’ requirements for performing neurogenic bowl management for patients with SCI.