Toward the design of a new bowel care chair for the spinal cord injured: a pilot study.
Bowel care is a critical aspect of daily living for person with disabilities; ineffective bowel care can lead to severe and costly complications. Staff, patients, and caregivers have often found existing bowel care chairs to be inadequate. These chairs are frequently unsafe, inconvenient, and ineffective for showering and bowel elimination. Because bowel care procedures can be lengthy, proper seating posture and comfort is necessary to prevent pressure ulcers. Patient falls is another common problem, occurring during transfer, transport, or during actual bowel care/shower procedures. There are over 200,000 persons with spinal cord injuries (SCI) in the United States today. The majority of these patients have neurogenic bowels, requiring bowel care an average of three times a week. Each bowel care procedure takes 30 minutes to 3 hours to complete. Advances in bowel care chair design would significantly impact on quality of life, self-esteem, and physical well-being of persons with SCI. Enhanced design would also improve the safety, effectiveness, and efficiency of nurses and caregivers who perform bowel care procedures. An interdisciplinary research team, comprised of an industrial designer, a nurse, two physicians, and a human factors psychologist collaborated to address this important problem. Three bowel care chairs, commonly used in SCI, were evaluated using a combination of videotaping, still photography, and questionnaires. Based on this data, performance criteria for the design of an optimal bowel care chair design were developed.