A Qualitative Study of Health Care Professionals' Views on Bowel Care in Multiple Sclerosis: Whose Job Is It Anyway?

Sue Woodward*, Maureen Coggrave, Lesley Dibley, Doreen McClurg, Christine Norton

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)
72 Downloads (Pure)

Abstract

Background: Bowel dysfunction, including constipation and fecal incontinence, is prevalent in individuals with multiple sclerosis (MS), adversely affecting quality of life and increasing caregiver burden. How health care professionals (HCPs) identify, assess, and manage people with MS with bowel dysfunction is understudied. This study explored how HCPs think about, assess, and manage bowel dysfunction in individuals with MS. Methods: Semistructured interviews were conducted with 18 HCPs from different professional disciplines and clinical specialties recruited from UK National Health Service primary, secondary, and tertiary care services using purposive and chain referral sampling through professional networks. One participant worked for a bladder and bowel charity. Data were analyzed using thematic analysis. Results: Views differed regarding responsibilities for providing bowel care. Participants thought individuals with MS should notify HCPs of bowel symptoms and take responsibility for selfmanagement where possible, with family caregivers required to help with bowel care. Although people with MS were often referred to bladder and bowel specialists when a crisis point was reached, earlier referral was called for by these HCPs. There were variations in assessment processes, treatment options offered, and service provision. Participants thought HCPs needed more education on bowel dysfunction, bowel care should take a high priority, and evidence-based clinical guidelines and referral pathways would improve service delivery. Conclusions: The HCPs caring for individuals with MS see many with bowel dysfunction, and there is variation in care and service provision; HCPs require more education, evidence-based clinical guidelines, and referral pathways to improve case finding, assessment, and management of these symptoms for individuals with MS.

Original languageEnglish
Pages (from-to)81-89
Number of pages9
JournalInternational Journal of MS Care
Volume24
Issue number2
Early online date15 Jun 2021
DOIs
Publication statusPublished - 26 Apr 2022

Keywords

  • Multiple sclerosis (MS)
  • Healthcare professionals
  • Bowel dysfunction
  • Neurogenic bowel

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