ABSTRACT
AIM: This paper is a report of a study to explore the experiences of learning to carry out clean intermittent self-catheterization and user views of service provision. BACKGROUND: This treatment imposes a variety of challenges to users, both physical and emotional. Safety, infection rates and complications have been investigated, but the practicalities of learning and performing self-catheterization have not been addressed. What is currently known about the topic from a user perspective is based on audit, small projects or anecdotal reports provided by continence advisers. METHOD: In-depth interviews were carried out in 2006 with eight men and seven women, aged 33-81 years (median 65), and carrying out self-catheterization for a variety of reasons. A grounded theory framework was used. FINDINGS: Themes identified were psychological issues, physical problems and service interaction. The communication skills of nurses helped facilitate the learning experience. In conjunction with nurses' skills, a friendly relaxed approach alleviated embarrassment and anxiety, thus facilitating information exchange and retention of information. CONCLUSION: Adequate information and thorough instruction by healthcare professionals helps empower people to take control and master the treatment, with potential contribution to ongoing compliance and long-term urinary tract health. Development of a policy supporting evidence-based care and a consistent teaching programme is highly recommended for use where this treatment is regularly employed.
Subject(s)
Adaptation, Psychological , Quality of Life/psychology , Self Care/methods , Urinary Catheterization/methods , Adult , Aged , Aged, 80 and over , Catheters, Indwelling , Female , Humans , Interviews as Topic , Male , Middle Aged , Nurse-Patient Relations/ethics , Nursing Methodology Research/education , Nursing Methodology Research/standards , Patient Education as Topic/standards , Patient Satisfaction , Qualitative Research , Self Care/psychology , Treatment Outcome , Urinary Catheterization/nursingABSTRACT
AIM: This paper is a report of a study to describe the experience of people carrying out clean intermittent self-catheterization and the impact on their quality of life. BACKGROUND: Clean intermittent self-catheterization is a recommended treatment for people experiencing urinary voiding difficulties. The majority of the literature to date has focused on biomedical issues such as complication rates and use of different catheters. METHOD: A qualitative approach was used based on grounded theory. Fifteen users (eight men and seven women) of intermittent self-catheterization took part in semi-structured interviews during 2006. Ages ranged from 33 to 81 years (median 65 years). Reasons for self-catheterization included multiple sclerosis, urethral stricture and high residual volumes. Thematic analysis was used to develop hypotheses about the causes and consequences of the core category 'quality of life'. FINDINGS: The core category consisted of two subcategories of positive and negative impacts. Positive impacts were related to improvement in lower urinary tract symptoms, whereas the negative impacts resulted from the practical difficulties encountered, and the psychological and cultural context of worry and stigma. The factors influencing variations in quality of life impacts were sex, lifestyle, frequency and duration of carrying out self-catheterization, technical difficulties, type of catheter, co-morbidities and individual predispositions. CONCLUSION: The model has the potential to help professionals to identify the factors likely to influence response to clean intermittent self-catheterization, and could be used as a tool to help identify those who may have difficulty complying with the treatment or to aid advice-giving on situations that may cause difficulties.
