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Malde S, Belal M, Mohamed-Ahmed R, Gibson W, Padilla-Fernandez B, Rantell A, Selai C, Solomon E, Abrams P. Can we define the optimal postvoid residual volume at which intermittent catheterization should be recommended, and are there other measures that could guide an intermittent catheterization protocol: ICI-RS 2023. Neurourol Urodyn 2023. [PMID: 37905437 DOI: 10.1002/nau.25324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 10/24/2023] [Indexed: 11/02/2023]
Abstract
AIMS The postvoid residual (PVR) volume of urine in the bladder is widely used in clinical practice as a guide to initiate treatment, including clean-intermittent self-catheterization (CISC). It is often believed that an elevated PVR causes complications such as recurrent urinary tract infections (UTI) and renal failure. However, evidence for this is limited and identifying alternative measures to guide treatment decisions may optimize patient care. At the International Consultation on Incontinence Research Society (ICI-RS) meeting in 2023 a Think Tank addressed the question of whether we can define the optimal PVR at which CISC should be recommended, and whether there are other measures that could guide a CISC protocol. METHODS The Think Tank conducted a literature review and expert consensus meeting focusing on current limitations in defining and measuring PVR, and highlighting other measures that may optimize selection for, and persistence with, CISC. RESULTS There is no consensus on the threshold value of PVR that is considered "elevated" or "significant." There is a lack of standardization on terminology, and the normal range of PVR in different populations of different ages remains to be well-studied. The measurement of PVR is influenced by several factors, including intraindividual variation, timing and method of measurement. Furthermore, the evidence linking an elevated PVR with complications such as UTI and renal failure is mixed. Other measures, such as bladder voiding efficiency or urodynamic parameters, may be better at predicting such complications, and therefore may be more relevant at guiding a CISC protocol. CONCLUSIONS There is a lack of high quality evidence to support PVR as a predictor for complications of UTI or renal failure. Threshold values for normal PVR in different populations are unknow, and so threshold values for "elevated" or "significant" PVR cannot be determined. Other factors, such as urodynamic findings, may be better at predicting complications and therefore guiding management decisions, and this remains to be studied. Areas for further research are proposed.
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Affiliation(s)
- Sachin Malde
- Department of Urology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Mo Belal
- Department of Urology, Queen Elizabeth Hospital, Birmingham, UK
| | | | - William Gibson
- Division of Geriatric Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Barbara Padilla-Fernandez
- Department of Urology, Hospital Universitario de Canarias, Universidad de La Laguna, Santa Cruz de Tenerife, Spain
| | - Angela Rantell
- Department of Urogynaecology, King's College Hospital, London, UK
| | - Caroline Selai
- Department of Uro-Neurology, The National Hospital for Neurology and Neurosurgery, London, UK
| | - Eskinder Solomon
- Department of Urology, Guy's and St Thomas' NHS Foundation Trust, London, UK
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Ramadan F. Intermittent self-catheterisation: the community nurse's role in identifying and overcoming the barriers. Br J Community Nurs 2023; 28:224-228. [PMID: 37130717 DOI: 10.12968/bjcn.2023.28.5.224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
With their expertise and ability to leverage the therapeutic relationship, community nurses are well-placed to manage the complications and challenges associated with intermittent self-catheterisation. Francesca Ramadan provides an overview of the patient-, training- and environmentally-related barriers to intermittent self-catheterisation and of the ways in which these can be overcome by personalised, person-centred training and education.
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Lauridsen SV, Averbeck MA, Krassioukov A, Vaabengaard R, Athanasiadou S. UTI assessment tool for intermittent catheter users: a way to include user perspectives and enhance quality of UTI management. BMC Nurs 2022; 21:272. [PMID: 36199133 PMCID: PMC9535847 DOI: 10.1186/s12912-022-01033-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 09/02/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Urinary Tract Infections (UTIs) are among the most severe complications for users of intermittent catheterisation (IC), with numerous risk factors contributing to their occurrence. The aim of this study was to develop a tool to assess UTI risk factors among IC users in a systematic way that considers the perspective of the individual user. METHODS The Design Thinking Process was used to guide the development of the content and format of the tool. The UTI Risk Factors model by Kennelly et al. was used as a basis for developing the content. Insights on the appropriate content and format were collected via the Coloplast Nurse Advisory Boards and by conducting a qualitative evidence synthesis on user perspectives and practices in relation to UTIs. RESULTS The literature search identified a total of 3544 articles, out of which 22 met the inclusion criteria. Additionally, three rounds of meetings were conducted with approximately 90 nurses from the Nurse Advisory Boards across Europe. The qualitative evidence synthesis showed that users describe their UTI symptoms in different terms and that personal needs and priorities impact their adherence and catheter selection. Furthermore, some users lack relevant and updated knowledge about IC and UTIs. The nurses described that correct UTI diagnosis is essential. They pointed that they would assess the user's general condition, adherence, technique, and catheter type as potential areas of risk factors and emphasised the importance of adequate support for users. The study resulted in the development of the UTI assessment tool for intermittent catheter users, which comprises three elements: a guide for healthcare professionals, a dialogue board, and a notepad. The tool starts with a confirmation of the UTI incidence, and then assesses risk factors via questions on health, adherence, technique, and catheter, and concludes with a support section. CONCLUSIONS The UTI assessment tool for intermittent catheter users is designed to help healthcare professionals assess UTI risk factors in a systematic way, while engaging users and taking their perspective into account. By identifying the relevant risk factors, the use of this tool has the potential to reduce the occurrence of UTIs for the individual IC user.
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Affiliation(s)
- S V Lauridsen
- Department of Urology, Copenhagen University Hospital, Copenhagen, Denmark. .,WHO-CC, Parker Institute, Copenhagen University Hospital, Frederiksberg and Bispebjerg Hospital, Frederiksberg, Denmark.
| | | | - A Krassioukov
- International Collaboration on Repair Discoveries (ICORD), Division of Physical Medicine and Rehabilitation, Department of Medicine, Faculty of Medicine, International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Endowment Lands, Canada.,G.F. Strong Rehabilitation Centre, Vancouver Coastal Health, Vancouver, British Columbia, Canada
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Dwyer L, Bugge C, Hagen S, Goodman K, Agur W, Dembinsky M, Graham M, Guerrero K, Hemming C, Khunda A, McClurg D, Melone L, Thakar R, Kearney R. Theoretical and practical development of the TOPSY self-management intervention for women who use a vaginal pessary for pelvic organ prolapse. Trials 2022; 23:742. [PMID: 36064727 PMCID: PMC9446823 DOI: 10.1186/s13063-022-06681-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 08/23/2022] [Indexed: 11/13/2022] Open
Abstract
Background Pelvic organ prolapse (POP) is a common condition in women, where the downward descent of pelvic organs into the vagina causes symptoms which impacts quality of life. Vaginal pessaries offer an effective alternative to surgery for the management of POP. However, the need for regular follow-up can be burdensome for women and requires significant healthcare resources. The TOPSY study is a randomised controlled trial which aims to determine the clinical and cost-effectiveness of self-management of vaginal pessaries. This paper describes the theoretical and practical development of the self-management intervention. Methods The intervention was developed using the MRC complex intervention framework, normalisation process theory (NPT) and self-management theory. The intervention aims to boost perceived self-efficacy in accordance with Bandura’s social cognitive theory and is guided by the tasks and skills Lorig and Hollman describe as necessary to self-manage a health condition. Results The TOPSY intervention was designed to support women to undertake the medical management, role management and emotional management of their pessary. The six self-management skills described by Lorig and Hollman: problem-solving, decision-making, resource utilisation, formation of a patient-provider partnership role, action planning and self-tailoring, are discussed in detail, including how women were supported to achieve each task within the context of pessary self-management. The TOPSY intervention includes a self-management support session with a pessary practitioner trained in intervention delivery, a follow-up phone call 2 weeks later and ongoing telephone or face-to-face support as required by the woman initiated by contacting a member of the research team. Conclusions The TOPSY study intervention was developed utilising the findings from a prior service development project, intervention development and self-efficacy theory, relevant literature, clinician experience and feedback from pessary using women and members of the public. In 2022, the findings of the TOPSY study will provide further evidence to inform this important aspect of pessary management. Trial registration ISRCTN Registry ISRCTN62510577. Registered on June 10, 2017
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Affiliation(s)
- Lucy Dwyer
- The Warrell Unit, St. Mary's Hospital, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.
| | - Carol Bugge
- Health Sciences & Sport, University of Stirling, Stirling, UK
| | - Suzanne Hagen
- Nursing, Midwifery & Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Kirsteen Goodman
- Nursing, Midwifery & Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Wael Agur
- NHS Ayrshire & Arran, Crosshouse Hospital, Kilmarnock, UK.,School of Medicine, Dentistry & Nursing, University of Glasgow, Glasgow, UK
| | | | | | - Karen Guerrero
- Department of Urogynaecology, NHS Greater Glasgow & Clyde, Glasgow, UK
| | - Christine Hemming
- Aberdeen Maternity Hospital & Aberdeen Royal Infirmary, Grampian University Hospitals NHS Trust, Aberdeen, UK
| | - Aethele Khunda
- South Tees Hospitals NHS Foundation Trust, James Cook University Hospital, Middlesbrough, UK
| | - Doreen McClurg
- Nursing, Midwifery & Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Lynn Melone
- Nursing, Midwifery & Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Ranee Thakar
- Croydon Health Services NHS Trust, Croydon University Hospital, Croydon, UK
| | - Rohna Kearney
- The Warrell Unit, St. Mary's Hospital, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
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[An initial lack of knowledge of the perineal anatomy does not influence the learning of intermittent self-catheterization in women]. Prog Urol 2022; 32:744-750. [PMID: 35715253 DOI: 10.1016/j.purol.2022.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/16/2022] [Accepted: 04/07/2022] [Indexed: 11/21/2022]
Abstract
AIM To evaluate the impact of female perineal anatomy knowledge on the success of a first learning of intermittent self-catheterization (ISC). METHODS Thirty subjects benefited from educational diagnosis, training and follow-up during 2 visits in a neuro-urology department. Three knowledge anatomical tests were carried out: a freehand drawing, then a diagram to be annotated and a self-location of the following 6 structures (labia majora, labia minora, clitoris, urethral meatus, vaginal orifice, anus) as well as a physiological knowledge test. A correction was made after annotating the diagram to perfect the learning process before performing the procedure. RESULTS Of the women studied, 83.3% had a neurological pathology and 77.7% had a gyneco-obstetrical history. Half of them had undergone perineal rehabilitation. Our study shows a lack of knowledge of the perineum prior to learning self-catheterization: 43.3% thought they knew it partially and 46.7% reported that they did not know it. Fifty-three percent of the subjects did not indicate the urethral meatus and 43.3% did not annotate the vaginal orifice on the diagram. Difficulties in anatomical transposition were observed: the urethral meatus was self-located in only 43.3% of subjects and 30% did not locate the vaginal orifice. Previous perineal rehabilitation was not benefical in the self-recognition of anatomical structures. However, all the patients, including those who did not initially locate the urethral meatus, acquired the technique of ISC. CONCLUSION Intial perineal anatomy ignorance in women was frequent but was not an obstacle to learning ISC. LEVEL OF PROOF 4.
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Abstract
Intermittent self-catheterisation (ISC) is now considered the standard of care for most patients with neurological conditions and associated lower urinary tract disorders. Numerous societies, led by the International Continence Society, are in agreement on the effectiveness of ISC. Use of intermittent catheters is reported to reduce the risk of catheter-associated urinary tract infection compared with indwelling urinary catheters while improving patient comfort and quality of life. However, previous studies have shown that, despite the benefits of ISC, it will not guarantee behavior change and the integration of this procedure into the daily life of patients. Patients may encounter internal (related to the patient themselves) and external (related to their environment) difficulties. Identifying these obstacles early will help promoting ISC success. This review aims to identify internal and external barriers related to ISC and to propose adequate solutions to avoid them.
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Affiliation(s)
- Salma Balhi
- Department of Epidemiology and Public Health, Faculty of Medicine of Tunis, Tunis, Tuinisia
| | - Rym Baati Arfaoui
- Urodynamics and Functional Exploration Unit, Charles Nicolle Hospital, Tunis, Tunisia
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Jenks J. Voiding dysfunction and the experience of intermittent self-catheterisation. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2020; 29:1314-1316. [PMID: 33325286 DOI: 10.12968/bjon.2020.29.22.1314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Julie Jenks
- Advanced Nurse Practitioner, University College London Hospitals NHS Foundation Trust
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8
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Collins L. Intermittent self-catheterisation: good patient education and support are key. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2019; 28:964-966. [PMID: 31393766 DOI: 10.12968/bjon.2019.28.15.964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Linda Collins
- Associate Professor in Adult Nursing, Kingston University and St George's University of London
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Lake H. Intermittent self-catheterisation: patient perceptions and experience. ACTA ACUST UNITED AC 2018; 27:S4-S6. [DOI: 10.12968/bjon.2018.27.18.s4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Helen Lake
- Urology Specialist Nurse, BBraun Medical Limited
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10
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Benício CDAV, Rocha DDM, Dourado GOL, Bezerra SMG, Andrade EMLR, Nogueira LT. Fatores associados ao conhecimento de pacientes e cuidadores acerca do cateterismo vesical intermitente limpo: revisão integrativa. Rev Esc Enferm USP 2018; 52:e03362. [DOI: 10.1590/s1980-220x2017033703362] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 03/26/2018] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo Identificar na literatura os fatores associados ao conhecimento de pacientes e cuidadores acerca do cateterismo vesical intermitente limpo que dificultam ou facilitam o procedimento. Método Revisão integrativa da literatura nas bases de dados MEDLINE/PubMed, CINAHL, Cochrane, Web of Science, SCOPUS e LILACS. Resultados Após a revisão por pares, 13 estudos primários compuseram a amostra. A síntese do conhecimento foi realizada em duas categorias: Fatores associados ao conhecimento de pacientes e cuidadores sobre o que dificultam o procedimento e Fatores associados ao conhecimento de pacientes e cuidadores acerca do que facilitam o procedimento. Os fatores que dificultam e facilitam o procedimento relacionaram-se, respectivamente, à necessidade de informação e a sentimentos negativos, uso de linguagem de fácil compreensão, aplicação de folhetos informativos, entre outros. Conclusão Há escassez de artigos publicados sobre a temática, e os que foram identificados apresentaram baixo nível de evidência, exigindo, portanto, maior empenho e compromisso por parte de profissionais de saúde e pesquisadores para utilizarem desenhos mais robustos.
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Davis C, Rantell A. Selecting an intermittent self-catheter: key considerations. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2018; 27:S11-S16. [PMID: 30088972 DOI: 10.12968/bjon.2018.27.sup15.s11] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This article explores the factors that must be considered when assessing patients for intermittent self-catherisation (ISC). It discusses the various types of intermittent catheters and their properties. Key considerations for the health professional when making product recommendations are covered and emphasis is placed on teaching patients the ISC technique. The article also highlights what patients value in terms of product choice and the importance of ongoing support. It concludes by introducing the GentleCath Glide, a new product that incorporates FeelClean™ technology, which leaves less residue on the hands and clothes.
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Affiliation(s)
- Cathy Davis
- Urogynaecology, Clinical Nurse Specialist, King's College Hospital NHS Foundation Trust
| | - Angie Rantell
- Lead Nurse Urogynaecology/Nurse Cystoscopist, King's College Hospital NHS Foundation Trust
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Intermittent Self-catheterization in Older Adults: Predictors of Success for Technique Learning. Int Neurourol J 2018; 22:65-71. [PMID: 29609423 PMCID: PMC5885133 DOI: 10.5213/inj.1835008.504] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 03/01/2018] [Indexed: 11/17/2022] Open
Abstract
Purpose The main goal of this retrospective study is to explore the predictors of success in learning clean intermittent self-catheterization (CISC) in patients over 65 years of age. The secondary goal is to assess whether in this population, the risk of failure to perform CISC is greater, compared with patients under 65 with similar pathologies. Methods All patients older than 65 consulting between January 2011 and January 2016 for learning CISC were included. A control population younger than 65 matching with sex, body mass index, and pathology was selected. Results One hundred sixty-nine of the 202 patients (83.7%) over 65 succeeded in learning CISC. Obesity (P<0.05), low pencil and paper test (PP test) (P<0.01) and low functional independence measure (FIM) (P<0.01) scores were risk factors of failure. No significant differences were found with sex or pathology. In multivariate analysis, low PP test perineum access (odds ratio [95% confidence interval], 2.30 [1.32–4.42]), low FIM motor (1.04 [1.01–1.08]), and FIM cognition (1.18 [1.03–1.37]) scores were independent factors of learning failure. Compared to control group, age over 65 was not predictive of failure (P=0.15). Conclusions Our study shows that success in learning CISC does not depend on age but on difficulties in mobility, access to perineum and probably cognitive disorders.
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Souza-Junior VDD, Mendes IAC, Mazzo A, Santos CAD, Andrade EMLR, Godoy SD. Telenursing manual for providing care to patients using clean intermittent urinary catheterization. ESCOLA ANNA NERY 2017. [DOI: 10.1590/2177-9465-ean-2017-0188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Objective: To develop and evaluate apparent and content validity of a telenursing manual to support nurses in the care delivery of patients using clean intermittent urinary catheterization. Methods: Methodological study addressing the development and validation of a telenursing manual. The expert group who validated the telenursing manual was composed of 11 nurses. An inter-rater level of agreement of 70% was considered for each aspect of the instrument. Results: The following levels of agreement were obtained for each aspect: Language 97%, Content 97.7% and Objectives, Relevance, Functionality and Usability 100% each. Conclusion: The manual is available for access and represents an important initiative for the field of telenursing in Brazil, assisting nurses in the telecare provided to patients using clean intermittent urinary catheterization.
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Clean Intermittent Self-Catheterization as a Treatment Modality for Urinary Retention: Perceptions of Urologists. Int Neurourol J 2017; 21:189-196. [PMID: 28954460 PMCID: PMC5636956 DOI: 10.5213/inj.1734824.412] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Accepted: 03/21/2017] [Indexed: 11/16/2022] Open
Abstract
Purpose Clean intermittent self-catheterization (CISC) is now considered the gold standard for the management of urinary retention. In the literature, several articles on patients’ perspectives on CISC and adherence to this technique have been published. No studies have yet explored the points of view of professional caregivers, such as nurses and doctors. The aim of this study was to explore the opinions of urologists about CISC and to evaluate the need for dedicated nurses specialized in CISC through a self-administered questionnaire. Methods A questionnaire was developed to explore the opinions of professional caregivers about self-catheterization and to evaluate the need to provide nurses with specialized education in CISC. Questionnaires were sent to 244 urologists through email. We received 101 completed questionnaires. The response rate was 41.4%. Results Hand function, the presence or absence of tremor, and visual acuity were rated as the most important determinants for proposing CISC to a patient. Twenty-five percent of the urologists reported that financial remuneration would give them a greater incentive to propose CISC. The lack of dedicated nurses was reported by half of the urologists as a factor preventing them from proposing CISC. A meaningful number of urologists thought that patients perceive CISC as invasive and unpleasant. Although most urologists would choose CISC as a treatment option for themselves, almost 1 urologist out of 5 would prefer a permanent catheter. Conclusions This questionnaire gave valuable insights into urologists’ perceptions of CISC, and could serve as the basis for a subsequent broader international study. Further research should also focus on the opinions of nurses and other caregivers involved in incontinence management. Apart from financial remuneration, it is also clear that ensuring sufficient expertise and time for high-quality CISC care is important. This could be a potential role for dedicated nurses.
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Logan K. The female experience of ISC with a silicone catheter. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2017; 26:82-88. [PMID: 28132559 DOI: 10.12968/bjon.2017.26.2.82] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Intermittent self-catheterisation (ISC) is a safe and effective treatment in the management of neuropathic bladder, voiding dysfunction and urinary incontinence in women. ISC has been shown to improve quality of life when used appropriately. It provides freedom for individuals who require bladder drainage as they can choose where and when to catheterise to empty the bladder. ISC requires minimum equipment, is a more discreet solution than an indwelling catheter and is relatively easy to teach in one patient visit. There are a range of different ISC catheters available on prescription. Many have been designed specifically for women and patient choice regarding product selection is an important consideration. This article describes a UK patient-satisfaction survey evaluating the female patient's perspective of learning ISC using a silicone intermittent catheter called HydroSil Go™ that is manufactured by C.R. Bard, Inc.
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Affiliation(s)
- Karen Logan
- Consultant Nurse, Continence Service, Llanfrechfa Grange Hospital, Cwmbran
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Cobussen-Boekhorst H, Beekman J, van Wijlick E, Schaafstra J, van Kuppevelt D, Heesakkers J. Which factors make clean intermittent (self) catheterisation successful? J Clin Nurs 2016; 25:1308-18. [DOI: 10.1111/jocn.13187] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2015] [Indexed: 11/30/2022]
Affiliation(s)
| | - Joke Beekman
- Department of Rehabilitation; Sint Maartenskliniek; Ubbergen The Netherlands
| | - Edith van Wijlick
- Department of Urology; Canisius Wilhelmina Hospital; Nijmegen The Netherlands
| | - Judith Schaafstra
- Department of Urology; Canisius Wilhelmina Hospital; Nijmegen The Netherlands
| | - Dirk van Kuppevelt
- Department of Rehabilitation; Sint Maartenskliniek; Ubbergen The Netherlands
| | - John Heesakkers
- Department of Urology; Radboud University Medical Center; Nijmegen The Netherlands
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Cobussen-Boekhorst H, Hermeling E, Heesakkers J, van Gaal B. Patients’ experience with intermittent catheterisation in everyday life. J Clin Nurs 2016; 25:1253-61. [DOI: 10.1111/jocn.13146] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2015] [Indexed: 11/27/2022]
Affiliation(s)
| | - Erna Hermeling
- Department of Urology; Radboud University Medical Center; Nijmegen The Netherlands
| | - John Heesakkers
- Department of Urology; Radboud University Medical Center; Nijmegen The Netherlands
| | - Betsie van Gaal
- IQ Healthcare; Radboud Institute for Health Sciences; Radboud University Medical Center; Nijmegen The Netherlands
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Maguire T, Doshani A, Mayne C, Slack M, Tincello D. Patients' experience and expectations of conservative management strategies, anti-muscarinics and treatment with intravesical onabotulinum toxin for overactive bladder - a qualitative interview study. INTERNATIONAL JOURNAL OF UROLOGICAL NURSING 2015. [DOI: 10.1111/ijun.12073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Turlough Maguire
- Obstetrics and Gynaecology; University Hospitals of Coventry and Warwickshire; Coventry UK
| | - Angie Doshani
- Obstetrics & Gynaecology; University Hospitals of Leicester NHS Trust; Leicester UK
| | - Christopher Mayne
- Obstetrics & Gynaecology; University Hospitals of Leicester NHS Trust; Leicester UK
| | - Mark Slack
- Obstetrics & Gynaecology; Addenbrookes Cambridge NHS Trust; Cambridge UK
| | - Douglas Tincello
- Prolapse Incontinence Group; University of Leicester; Leicester UK
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Wilson M. Clean intermittent self-catheterisation: working with patients. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2015; 24:76, 78, 80 passim. [PMID: 25615991 DOI: 10.12968/bjon.2015.24.2.76] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Clean intermittent self-catheterisation is carried out when the bladder cannot be emptied adequately by voiding. Because learning how to self-catheterise can be daunting, it is essential that the nurse has the time, knowledge and skills necessary support the patient during the learning phase, so that he or she can develop confidence and master the technique. Causes for urinary retention are considered and step-by-step instructions are given for both female and male patients, including problems that may be encountered and how these can be overcome. Examples of catheters and other aids available are suggested, with reference to particular features they may have, to overcome difficulties or to assist patients with particular needs. Issues including infection, frequency of catheterisation and fluid intake are also discussed.
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Affiliation(s)
- Mary Wilson
- retired Nurse Practitioner for Bladder and Bowel Health, Humber NHS Foundation Trust
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20
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Engkasan JP, Ng CJ, Low WY. Who decides? A qualitative study on the decisional roles of patients, their caregivers and doctors on the method of bladder drainage after spinal cord injury. Spinal Cord 2014; 53:130-4. [PMID: 25403504 DOI: 10.1038/sc.2014.199] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Revised: 07/22/2014] [Accepted: 09/27/2014] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Qualitative study using individual in-depth interviews. OBJECTIVE To explore the roles of patients, their caregivers and doctors when making decisions on the method of bladder drainage after spinal cord injury (SCI). SETTING Five public hospitals in Malaysia. METHODS Semistructured (one-to-one) interviews with 17 male patients with SCI, 4 caregivers and 10 rehabilitation professionals. RESULTS Eight themes describing the respective decisional roles of patients, their caregivers and doctors emerged from the analysis: patient's right and responsibilities, patient as an informed decision maker, forced to accept decision; surrogate decision maker, silent partner; doctor knows best, over-ride patient's decision, or reluctant decision maker. Both patients and doctors acknowledged the importance of patient autonomy but not all patients had the chance to practice it. Some felt that they were forced to accept the doctor's decision and even alleged that the doctor refused to accept their decision. Doctors considered the caregiver as the decision maker in cases that involved minors, elderly and those with tetraplegia. Some patients considered bladder problems an embarrassing subject to discuss with their caregivers and did not want their involvement. Doctors were described as knowledgeable and were trusted by patients and their caregivers to make the most appropriate option. Some doctors were happy to assume this role whereas some others saw themselves only as information providers. CONCLUSIONS A paternalistic model is prevalent in this decision-making process and there is a discrepancy between patients' preferred and actual decisional roles.
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Affiliation(s)
- J P Engkasan
- Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - C J Ng
- Department of Primary Care, University of Malaya, Kuala Lumpur, Malaysia
| | - W Y Low
- Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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21
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Malik RD, Cohn JA, Bales GT. Urinary Retention in Elderly Women: Diagnosis & Management. Curr Urol Rep 2014; 15:454. [DOI: 10.1007/s11934-014-0454-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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22
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Mazzo A, Souza-Junior VD, Jorge BM, Nassif A, Biaziolo CF, Cassini MF, Santos RC, Mendes IAC. Intermittent urethral catheterization—descriptive study at a Brazilian service. Appl Nurs Res 2014; 27:170-4. [DOI: 10.1016/j.apnr.2013.12.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Revised: 08/21/2013] [Accepted: 12/14/2013] [Indexed: 11/29/2022]
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Perkins K, Randall D, Toozs-Hobson P, Sitch A, Ismail KMK. Hardiness and Outcome of Self-catheterisation Training (HOST): protocol for an observational study exploring the effects of personality traits in women on ability to learn clean intermittent self-catheterisation. BMJ Open 2014; 4:e003986. [PMID: 24401725 PMCID: PMC3902464 DOI: 10.1136/bmjopen-2013-003986] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION Clean intermittent self-catheterisation (CISC) is the recommended first-line management of voiding dysfunction; however, psychological factors involved in acceptance and take up are often neglected. There is a tendency to discuss the success of CISC in relation to factors that affect teaching and learning, with subsequent success or failure being attributed to these. There is limited research investigating what extent, personality traits impact on a woman's willingness to learn CISC and subsequent mastery of the technique. METHOD AND ANALYSIS All women attending a tertiary urogynaecology department as eligible for CISC will be invited to participate in the study. Over the 14-month recruitment period, an estimated 130 women will be involved. The participants will complete a series of self-reported questionnaires. Personality types will be assessed using The Hardiness Scale and State-Trait Anxiety Inventory. The impact of urinary symptoms and CISC on quality of life (QoL) will be measured using an electronic pelvic-floor assessment questionnaire (ePAQ). Success and mastery will be measured by recording the number of hospital appointments and the length of time taken to learn. Confidence will be measured using the Likert scale. A sample of 20 women will be invited to participate in semi-structured in-depth interviews to explore women's views and experiences of CISC. ETHICS AND DISSEMINATION Regulatory approvals will be in place prior to the start of the study. Good clinical practice guidelines will be followed throughout. Eligibility and training for CISC will be undertaken in accordance to individualised care plans in line with unit protocol and will not be influenced by the study. Trial data will be anonymised and participant confidentiality will be maintained. The Study findings will be disseminated through publications in relevant journals and will be presented at multiprofessional conferences and scientific meetings.
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Affiliation(s)
- Kalbinder Perkins
- Urogynaecology Department, Birmingham Women's Hospital, Edgbaston, Birmingham, UK
- University of Birmingham, Edgbaston, Birmingham, UK
| | | | - Philip Toozs-Hobson
- Urogynaecology Department, Birmingham Women's Hospital, Edgbaston, Birmingham, UK
| | - Alice Sitch
- University of Birmingham, Edgbaston, Birmingham, UK
| | - Khaled MK Ismail
- Urogynaecology Department, Birmingham Women's Hospital, Edgbaston, Birmingham, UK
- University of Birmingham, Edgbaston, Birmingham, UK
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Rew M, Lake H. A survey of short- and long-term pre-lubricated intermittent catheters. ACTA ACUST UNITED AC 2013; 22:S12, S14-8. [PMID: 24121768 DOI: 10.12968/bjon.2013.22.sup18.s12] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The prospect of having to undertake clean intermittent self-catheterisation (CISC) for a short time, or for the rest of a patient's life, can be very daunting. It has an impact on their social, sexual, work and family life. Despite the challenges of the practical performance of the procedure, CISC has many advantages and is a means of reducing the subsequent problems and cost implications associated with long-term indwelling catheter use. There are many different products available on prescription for patients performing CISC and it can be a challenge to choose the right one. This article discusses the impact CISC has on the individual and focuses on a regional survey conducted in a district in the UK of nearly 100 patients who agreed to complete a confidential questionnaire about their experiences using a pre-lubricated CISC catheter (Actreen®). It also discusses the challenges facing nurses with patients practising CISC and offers advice to help patients come to terms with this procedure and its effect on their daily life.
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Kelly L, Spencer S, Barrett G. Using intermittent self-catheters: experiences of people with neurological damage to their spinal cord. Disabil Rehabil 2013; 36:220-6. [DOI: 10.3109/09638288.2013.785606] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Griebling TL. Detrusor Underactivity and Urinary Retention in Geriatric Patients: Evaluation, Management and Recent Research. CURRENT BLADDER DYSFUNCTION REPORTS 2013. [DOI: 10.1007/s11884-013-0183-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Psychological coping with intermittent self-catheterisation (ISC) in people with spinal injury: a qualitative study. Int J Nurs Stud 2013; 50:1341-50. [PMID: 23473391 DOI: 10.1016/j.ijnurstu.2013.01.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2011] [Revised: 01/21/2013] [Accepted: 01/26/2013] [Indexed: 11/24/2022]
Abstract
BACKGROUND Management of bladder function is important in rehabilitation of spinal injury. Failure to comply with bladder management techniques, such as intermittent catheterisation, can have long-term consequences leading to renal failure. It is important, therefore, that spinal injured people adapt to the therapy at an early stage, but there is little research aimed at exploring patient experiences of ISC. OBJECTIVES This study explores the experiences of patients who have a spinal cord injury and who carry out ISC in order to identify psychological coping factors that might affect therapy adherence. DESIGN A qualitative study using a Grounded Theory framework involving individual interviews. SETTING AND PARTICIPANTS There were 15 participants (11 men and 4 women), median age 52 years (range 24-68) who were discharged from spinal rehabilitation, living in the community and using ISC. The sample was recruited from the patient lists of a tertiary spinal injury unit and a Specialist Continence Service. METHODS In-depth interviews were carried out in participants' own homes by a trained interviewer. Interviews were audio-recorded, transcribed and analysis carried out using NUD*IST6 software. RESULTS A core category of 'normalisation' was identified and the causes and consequences related to this category are reported. Categories of 'independence' and 'control' were closely related to, and were interdependent with, 'normalisation'. Participants were relieved of worry when they could exert control over their bladder function, and a feeling of normalisation helped them to maintain the integrity of their self-image. The ultimate outcome was either adaptation or maladaptation. Adaptation was dependent on positive acceptance of intermittent catheterisation and the need for good bladder management at the outset, whereas maladaptation was a result of avoidance and denial. CONCLUSIONS Adherence to ISC is related to early psychological coping strategies of active acceptance rather than denial and avoidance in relation to bladder management. It is important to support positive appraisals of ISC, particularly from the patient perspective, which suggest that it is the first step to independence and that it also provides normalisation and control of bladder function. ISC can contribute to a good quality of life, dignity, privacy and self-esteem.
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Gakis G, Ninkovic M, Stenzl A. Bladder hypocontractility--extending the indication for LDDM. Nat Rev Urol 2012; 9:231. [PMID: 22450607 DOI: 10.1038/nrurol.2011.27-c1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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