| Summary: | 碩士 === 國防醫學院 === 護理研究所 === 92 === Urologic complication is still one of the main causes of morbidity for patient with spinal cord injury (SCI) .Proper bladder management is the essential factors for prevention of urologic complication in SCI patients. Therefore, the purpose of this study was to realize the present state of the bladder management and the factor related to its change, and the quality of life in patients with chronic spinal cord injury for 10 to 15 years.
Forty chronic spinal cord injury patients ranging from 10 to 15 years who had accepted bladder training were included in this study. The data were collected by structured interviews using the patient’s basic information form and the Taiwan version of WHOQOL-BREF. The data were analyzed by the statistic method of descriptive statistics, one way ANOVA, correlation, and multiple regression. The result showed that 82.5% of the 40 patients had experienced urinary tract problems including UTI, leakage, incontinence, and reflux etc. The successful rate of bladder training was as high as 85% at the time of discharge and declined to 67.5% after 10 to 15 years of discharge. Factors related to the change in bladder management included gender and the level of severity of spinal cord injury.
The satisfaction of social relationship is the worst among all domains in the quality of life. Satisfaction of the quality of life was influenced by self-awareness of economic status, ambulatory ability, and independence, which were all statistically significant in regression. Patients being aware of having a poor economic status had the lowest score of satisfaction in physiological, psychological, social relationship and environment domains. But the satisfaction on the quality of life was not significantly related to the severity of injury, duration of illness and types of injury.
To prolong the time of the study might increase the sample size to effectively make inferences from the results. The nursing implication and further study were also suggested based on our results. Longer period of follow up was suggested in order to increase the case number. And, longitudinal study could be a better way to realize the relationships among the way of bladder management, personal characteristic, and disease characteristics in outpatient with spinal cord injury. These results can be the guidance to provide health education for them and also be the references for the medical administrator to make policy to increase the job opportunities and to reimburse the expense for home care service. In addition, it is good for chronic spinal cord injury patients who live alone to establish the shelter factory or institute to provide the social support and also a job opportunity.
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