The choice for colostomy following spinal cord injury: a Grounded Theory study.

Abstract

Aim: Explore experiences and choices related to bowel management following spinal cord injury. Background: In one UK spinal centre more are choosing a colostomy soon after injury in contravention of professional guidelines. Reasons for this were unknown. Keywords: spinal cord injury, colostomy, stoma, neurogenic bowel management, long-term care, grounded theory Methods: Grounded theory study using semi-structured interviews with twelve individuals living with spinal cord injury. Results: All ‘Experienced Loss’ related to bowel function. Those who chose colostomy later ‘Progressed into Suffering’. Colostomy transformed lives and was likened to ‘Being Alive Again’. ‘Failures of Care’ contributed to experiences and decision-making. Conclusion: Possessing information and choice emerge as key in transforming lives following spinal cord injury. They allow individuals to make choices from a lifeworld perspective, which may differ from those professionals assume. Present neurogenic bowel management guidelines fail to account for the wider lifeworlds of those they are designed for.