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Bladder and Bowel Dysfunction, Cognitive Appraisals of Disability, and Life Satisfaction in Individuals With

Olivia E Clark1, Kyle Deane2,3, Lawrence C Vogel2,4

  • 1Loyola University Chicago, Chicago, Illinois.

Topics in Spinal Cord Injury Rehabilitation
|February 25, 2026
PubMed

Insights

Managing bladder and bowel issues after pediatric spinal cord injury (SCI) impacts life satisfaction. Improving bowel management and cognitive appraisals can enhance well-being for individuals with SCI.

Area of Science:

  • Rehabilitation Medicine
  • Pediatric Neurology
  • Psychology of Disability

Background:

  • Pediatric-onset spinal cord injury (SCI) presents unique management challenges compared to adult-onset SCI.
  • Life satisfaction in pediatric SCI is influenced by evolving medical needs, responsibility transitions, and cognitive appraisals of disability.
  • Long-term bladder and bowel management can be demanding and socially disruptive for individuals with pediatric SCI.

Purpose of the Study:

  • To investigate the associations between bladder/bowel accidents, bowel management, cognitive appraisals, and life satisfaction in adults with a history of pediatric-onset SCI.
  • To identify key factors influencing life satisfaction in this specific population.

Main Methods:

  • A study involving 180 adults with SCI onset at age 18 or younger, treated in a pediatric rehabilitation system.
  • Data collected through semi-structured interviews, including demographics, medical history, cognitive appraisals (Appraisals of DisAbility Primary and Secondary Scale-Short Form), and life satisfaction (Satisfaction with Life Scale).
  • Statistical analyses included pairwise correlations and multivariable linear regressions to examine predictors of life satisfaction.

Main Results:

  • Bowel program duration and bladder accident frequency were correlated with negative disability appraisals and reduced life satisfaction.
  • Longer bowel program duration was associated with diminished appraisals of growth and resilience.
  • Multivariable regressions confirmed that extended bowel program duration and negative cognitive appraisals (e.g., fearful despondency, disbelief) significantly predicted lower life satisfaction.

Conclusions:

  • Interventions focused on improving the efficiency of bowel management strategies are recommended.
  • Targeting cognitive appraisals related to disability may be a crucial component in enhancing life satisfaction for individuals with pediatric-onset SCI.
  • Addressing both functional management and psychological adaptation is key to improving outcomes.
Abstract

Keywords:
bladder and bowel managementcognitive appraisalspediatricspinal cord injury

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