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February 22, 2026Topics in Spinal Cord Injury Rehabilitation0 citations

Bladder and Bowel Dysfunction, Cognitive Appraisals of Disability, and Life Satisfaction in Individuals With Pediatric-Onset Spinal Cord Injury

OCOlivia E. Clark KDKyle Deane VLVogel Lc

Key Points

This research aims to explore the links between bladder and bowel dysfunction, cognitive appraisals of disability, and life satisfaction among individuals with pediatric-onset spinal cord injury.
Participants included 180 adults aged ≤18 with pediatric-onset spinal cord injury.
Data were collected through semi-structured interviews focusing on demographics and medical needs.
Cognitive appraisals and life satisfaction were measured using standardized scales.
Statistical analyses included pairwise correlations and multivariable linear regressions.
Bladder accidents and longer bowel program duration were correlated with negative disability appraisals (r = .17-.22, P < .05).
Longer bowel program duration was associated with lower life satisfaction (r = -.29, P < .01).
Increased bowel program duration correlated with reduced positive cognitive appraisals (r = .32, P < .001).
Negative cognitive appraisals and bowel program duration were predictors of reduced life satisfaction (R2 = .12-.24).

Abstract

Background: Individuals with pediatric-onset spinal cord injury (SCI) represent a distinct group; management can be more complex than in adult-onset SCI. Changing medical needs, transfer of responsibility, and cognitive appraisals of disability may all impact life satisfaction in pediatric-onset SCI. Further, bladder/bowel management over many years may be time-consuming and socially disruptive. Cognitive appraisal of disability has been linked to life satisfaction and functioning in pediatric-onset SCI. Objectives: This study examines associations between bladder/bowel accidents, bowel management, cognitive appraisals, and life satisfaction in pediatric-onset SCI. Methods: Part of a larger study, 180 adults who sustained SCI age ≤18 and received treatment at a pediatric rehabilitation hospital system were interviewed. Participants were 55.6% male, 83.3% White, 38.6 years at interview, and 13.1 years at injury; 66.1% had complete injury, and 51.1% had paraplegia. Participants reported demographics/medical needs via semi-structured interview. Cognitive appraisals and life satisfaction were assessed using Appraisals of DisAbility Primary and Secondary Scale–Short Form and Satisfaction with Life Scale. Pairwise correlations with all constructs of interest and multivariable linear regressions using bowel program duration and cognitive appraisals as predictors of life satisfaction were conducted. Results: Correlations align with literature suggesting associations between bladder accident frequency/bowel program duration and negative appraisals of disability (r = .17-.22, P .05) and bowel program duration and reduced life satisfaction (r = -.29, P .01). Increased bowel program duration is associated with reduced growth and resilience appraisals (r = .32, P .001). Regressions indicate that increased bowel program duration and negative appraisals (fearful despondency, overwhelming disbelief, negative perceptions) are associated with reduced life satisfaction (R2 = .12-.24). Conclusion: Findings suggest interventions targeting bowel management efficiency and cognitive appraisals may improve life satisfaction in this population.

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