Patterns of bladder management and associated factors among community-dwelling persons with spinal cord injury: a latent class analysis

Abstract

Abstract Background People with spinal cord injury are vulnerable to neuropathic lower urinary tract dysfunction. Active bladder management is crucial to manage the neuropathic lower urinary tract dysfunction. Understanding the type of bladder management patterns will assist with targeted intervention for people with spinal cord injury. Thus, this study aimed to identify different patterns of bladder management among community-dwelling persons with spinal cord injury and explore the factors associated with latent classes. Methods The study was conducted in four regions (eastern region, northeast region, central region and western region) in China from August 3, 2020 to August 31, 2020. A convenience sample of 2582 participants was included in the analysis. The data were collected by a questionnaire consisting of socio-demographic factors, disease-related factors, and a list of 8 bladder management methods. Latent class analysis was used to identify different latent classes of bladder management. Then the multinomial logistic regression was applied to analyze the relationship between bladder management patterns and socio-demographic and disease-related factors. Results Bladder management pattern among community-dwelling persons with spinal cord injury was divided into four latent classes: “urinal collecting apparatus dominated pattern” (40.3%), “bladder compression dominated pattern” (30.7%), “intermittent catheterization dominated pattern” (19.3%) and “urethral indwelling catheterization dominated pattern” (9.6%). Multinomial logistic regression analysis found that the employment status, residential region, nursing need, payment method for catheterization products, hand function, time since spinal cord injury, urinary incontinence and concerns about social interaction affected by urination problems were significantly associated with latent classes. Conclusion Only 19.3% of people used the intermittent catheterization as their main bladder management method. More attention needs to be paid to the promotion of the standardization process of intermittent catheterization in community-dwelling persons with spinal cord injury. The associated factors of the four classes can be used for tailored and targeted interventions to increase the use of intermittent catheterization.