Barriers and facilitators encountered by healthcare providers when supporting individuals with SCI to change their bowel care.

Abstract

Individuals with spinal cord injury (SCI) are dissatisfied with their bowel care, but 71% have not changed their care for at least 5 years. Recently, individuals with SCI expressed a need for knowledge about bowel care options. Healthcare providers (HCP) play a crucial role in supporting bowel care changes. We aimed to understand the barriers and facilitators HCP face when discussing changes in bowel care with individuals with SCI. Semi-structured interviews were conducted with HCP in partnership with Spinal Cord Injury British Columbia and key community stakeholders. Barriers and facilitators were extracted, deductively coded using the Theoretical Domains Framework, then inductively analysed for themes. Themes highlighted that effective bowel care requires diverse knowledge from a multidisciplinary team. Lack of time to prioritise bowel care and limited healthcare resources were barriers to improving care, which may be augmented through regular bowel care review of both medical and person-centered priorities. Facilitators were accessible and tailored knowledge sharing of care options, complemented by peer support. This study highlights the need for targeted interventions that reduce barriers and enhance facilitators to changing care routines, supporting individuals with SCI to change bowel care when needed, and improving quality of life.