Colostomy formation for neurogenic bowel dysfunction after spinal cord injury: a national survey.

BACKGROUND

Neurogenic bowel dysfunction significantly affects those living with spinal cord injury (SCI). Guidelines position colostomy as a last resort, but this is not reflected in current practice. Pathways and professional attitudes are inconsistent.

AIM: Explore the attitudes of health professionals towards colostomy as an option for people living with SCI.

METHODS

Online questionnaire for health professionals; descriptive statistics and thematic analysis.

RESULTS

122 responses. Indications for colostomy: increasing independence (87%), intractable bowel difficulties (82%), patient choice (80%). Concerns regarded complications (71% overall), decisional regret (35% overall) and access to specialist nursing/lack of patient education (each 32% overall). Free-text analysis revealed themes of 'Lives transformed', 'Patient-centred choice', 'Right services, right reasons', 'Colostomy concerns', 'Health professionals' knowledge gaps', 'Differing perspectives' and 'Patient education is key'.

CONCLUSION

Attitudes to colostomy are shifting, however concerns and inconsistencies in pathways, knowledge and support persist. Guidance needs to evolve to reflect current practice and incorporate patient perspectives.