Effects of a self-efficacy-centered self-management program on neurogenic bladder after spinal cord injury: A randomized controlled trial

Purpose: The present research aimed to investigate the effects of a self-efficacy-centered self-management program on persons with neurogenic bladder (NGB) after spinal cord injury (SCI).

Design: A randomized controlled trial.

Materials and methods: Eighty-two individuals with NGB after spinal cord injury (SCI) were randomized into either the control or intervention group. The control group received standard admission and discharge education and follow-up. The intervention group received the self-efficacy-centered self-management program. Self-efficacy was assessed at preintervention, 4, 8, and 12 weeks post-intervention. Self-management ability, the incidence of urinary tract infection (UTI), residual urine volume, bladder safety capacity, and quality of life were assessed at 12 weeks post-intervention.

Results: Of the 82 recruited participants, only 79 participants (control group: n = 39, 67% males, intervention group: n = 40, 58% males) received the full intervention. A significant difference was observed in self-efficacy score between the control and intervention groups (2.54 ± .247 versus 2.71 ± .218, mean difference = .174, 95% confidential interval: .070-.278, p = .001) at 12 weeks post-intervention. The intervention group demonstrated significantly better outcomes than the control group at 12 weeks post-intervention in self-management ability, urinary tract infection (UTI) incidence, residual urine volume and bladder safety capacity. There were significant differences in quality of life (vitality [VT] and mental health [MH] subscales) between the two groups.

Conclusions: The self-efficacy-centered self-management program developed in this study can significantly increase participants' self-efficacy and bladder self-management ability, thereby improving their bladder functional status and quality of life.