The functional limitations of tetraplegic hands for intermittent clean self-catheterisation

Translation and validation of the Intermittent Catheterisation Difficulty Questionnaire (ICDQ) in an Arabic population

Objective: To translate and validate linguistically an Arabic version of the Intermittent Catheterisation Difficulty Questionnaire (ICDQ) adapted to the Tunisian population.

Patients and methods: An Arabic translation and cultural adaptation of the ICDQ was obtained via the reverse translation method after two sets of comprehension tests within two groups of 10 patients. Psychometric validation included testing the questionnaire on a group of 30 patients. Intra-rater reliability was evaluated by the calculation of the intraclass correlation coefficient (ICC) for each item of the questionnaire. Cronbach’s α was used to assess internal consistency.

Results: The study included 30 patients (seven females, 23 males) with a mean (SD) age of 40.6 (15.3) years. The ICC was 0.96, demonstrating excellent intra-rater reliability. Cronbach’s α was 0.96 (>0.9) confirming an excellent correlation between the different items.

Conclusion: This work provides a translated, validated and Tunisian adapted version of the ICDQ that can be used to evaluate Tunisian patients’ difficulties with clean intermittent self-catheterisation in daily practice. We expect that this version will also be helpful for patients in other Arabic and North African countries, although such a hypothesis needs to be confirmed by further studies.

Abbreviations: CISC: clean intermittent self-catheterisation; ICDQ: Intermittent Catheterisation Difficulty Questionnaire; ASIA: American Spinal Injury Association; ICC: intraclass correlation coefficient

Intermittent Self-catheterization in Older Adults: Predictors of Success for Technique Learning

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.

[Continent cutaneous urinary diversion in neurourology]

The management of some neurological patients can require urinary diversion. Continent cystostomy is one of the treatment options proposed in young patients, usually for cosmetic reasons. In this article, the authors describe the main techniques used in this particular indication and then review the literature to define the results of the various techniques used, as well as the modalities of follow-up in these patients in view of the potential complications.