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Blanc BFL, Rodríguez-Almagro J, Lorenzo-García C, Alcaraz-Zomeño E, Fernandez-Llorente G, Baixauli-Puig M, Martín-Bermejo MV, Estudillo-González F, Ortega-Checa MA, Lluesma-Martinez V, Ferrández-Franco G, Benito-Santos B, Rodríguez-Díaz M, Torres-Bacete A, Guerrero-Andrades MC, Louis-Lauture MP, Jiménez-Mayorga I, Serrano-Abielar R, Garrido-Mora MA, Barcia-Barrera F, Asensio-Malo G, Morcillo-Marín M, Tendero-Ruiz S, Hernández-Martínez A. Quality of Life and Autonomy in Patients with Intermittent Bladder Catheterization Trained by Specialized Nurses. J Clin Med 2021; 10:3909. [PMID: 34501357 PMCID: PMC8432259 DOI: 10.3390/jcm10173909] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 08/19/2021] [Accepted: 08/26/2021] [Indexed: 11/16/2022] Open
Abstract
Intermittent bladder catheterization (IBC) involves regular urine draining using a catheter, which is removed immediately after urinary elimination. It allows for the patient's urological health to be managed and their renal function to be preserved, and it promotes autonomy. Compliance with the prescribed number of daily catheterizations, which must be conducted by the patient, and infection prevention measures are crucial. To identify the patients requiring IBC, and to determine their adherence (whether they followed the prescribed guidelines and their difficulty in carrying out the procedure, as well as to assess how the IBC influences their quality of life and state of mind after receiving self-care training from a specialized nurse), we carried out a prospective, multicenter observational study in 24 Spanish hospitals with one month of monitoring and a sample of 99 patients. The sources of information were the patients' clinical records, the King's Health Questionnaire, the Mini-Mental State Examination (MMSE), and the hospital anxiety and depression scale (HADS). Descriptive and bivariate statistics were used to analyses the paired data. After recruitment (n = 99), 79 patients completed the questionnaire at a mean age of 35.2 years (SD = 20.5 years). In total, 53.5% (53) of the sample consisted of men and 32.3% (32) had neurological damage as the reason for prescription; 67% (67.7) performed self-catheterization and 86.7% adhered to the IBC. After one month of monitoring, a statistically significant improvement in quality of life was observed in all criteria, with the exception of personal relationships (p < 0.005), as well as an improvement in anxiety and depression levels (p < 0.001). Patients who require IBC show good adherence to the IBC with a significant percentage of self-catheterization. After one month of IBC, a significant improvement in the patients' quality of life and mood was observed. These results could be attributed to adequate patient training and adequate personalization of the IBC materials by the specialized nurses.
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Affiliation(s)
| | - Julián Rodríguez-Almagro
- Department of Nursing, Physiotherapy and Occupational Therapy, Ciudad Real Faculty of Nursing, University of Castilla-La Mancha, 13071 Ciudad Real, Spain;
| | - Carlos Lorenzo-García
- Department of Nursing, Hospital Universitario Clínico San Carlos, 28040 Madrid, Spain;
| | - Elena Alcaraz-Zomeño
- Department of Nursing, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain;
| | | | | | | | | | | | - Vicenta Lluesma-Martinez
- Department of Nursing, Hospital Universitari I Politecnic La Fe, 46026 Valencia, Spain; (M.A.O.-C.); (V.L.-M.)
| | | | - Begoña Benito-Santos
- Department of Nursing, Hospital General Universitario de Alicante, 03010 Alicante, Spain; (G.F.-F.); (B.B.-S.)
| | - Mónica Rodríguez-Díaz
- Department of Nursing, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain;
| | | | | | | | | | - Rosario Serrano-Abielar
- Department of Nursing, Hospital Universitario Puerta de Hierro Majadahonda, 28222 Madrid, Spain;
| | | | | | - Gemma Asensio-Malo
- Department of Nursing, Hospital Universitari de Bellvitge, 08907 Barcelona, Spain;
| | | | - Silvia Tendero-Ruiz
- Department of Nursing, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain;
| | - Antonio Hernández-Martínez
- Department of Nursing, Physiotherapy and Occupational Therapy, Ciudad Real Faculty of Nursing, University of Castilla-La Mancha, 13071 Ciudad Real, Spain;
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Bragge P, Guy S, Boulet M, Ghafoori E, Goodwin D, Wright B. A systematic review of the content and quality of clinical practice guidelines for management of the neurogenic bladder following spinal cord injury. Spinal Cord 2019; 57:540-549. [PMID: 30971756 DOI: 10.1038/s41393-019-0278-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 03/12/2019] [Accepted: 03/14/2019] [Indexed: 11/09/2022]
Abstract
INTRODUCTION Neurogenic bladder following acute spinal cord injury (SCI) increases urinary tract infection (UTI) risk and affects quality of life and health system costs. OBJECTIVES This study aimed to identify, describe and evaluate quality of clinical practice guidelines (CPGs) for managing neurogenic bladder following SCI. METHODS A comprehensive search covered six electronic databases (PubMed, Web of Science, Health Systems Evidence, Cochrane, CINAHL, Epistomonikos) and 12 CPG portals. Inclusion criteria were English language CPG; includes recommendations for managing neurogenic bladder in adults; all phases of care; published 2011 onwards in peer-reviewed journal/CPG portal. For eligible CPGs, key characteristics including years covered by CPG searching and number of neurogenic bladder recommendations were extracted. Quality appraisal used the AGREE II instrument. Appraiser agreement was assessed using the intraclass correlation coefficient. RESULTS Searching yielded 4028 citations and eight relevant CPGs. Collectively the CPGs contained 304 recommendations. Over half (160) pertained to assessment, surgery or education. Most surgery recommendations were from older CPGs; more recent CPGs emphasised conservative therapy. Methodological quality across CPGs was good in the domains of 'clarity of presentation' (84% mean domain score), 'scope and purpose' (72%) and 'editorial independence' (68%). There were shortcomings in the domains of 'rigor of development' (52%) 'stakeholder involvement' (42%) and 'applicability' (33%). CONCLUSION CPGs for the management of neurogenic bladder following SCI are generally robust in stating their scope and clearly presenting recommendations. Only three CPGs attained domain scores over 70% pertaining to methodological rigor. Future CPGs should also focus on providing implementation / audit resources and incorporating patient perspectives.
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Affiliation(s)
- Peter Bragge
- BehaviourWorks Australia, Monash Sustainable Development Institute, Monash University, Melbourne, Australia.
| | - Stacey Guy
- Lawson Health Research Institute, London, Ontario, Canada
| | - Mark Boulet
- BehaviourWorks Australia, Monash Sustainable Development Institute, Monash University, Melbourne, Australia
| | | | - Denise Goodwin
- BehaviourWorks Australia, Monash Sustainable Development Institute, Monash University, Melbourne, Australia
| | - Breanna Wright
- BehaviourWorks Australia, Monash Sustainable Development Institute, Monash University, Melbourne, Australia
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