Teaching patients clean intermittent self-catheterisation: key points

Exploring the lived experience of Arab male patients on intermittent catheterization after spinal cord injury: A phenomenological study

BACKGROUND

Intermittent catheterization (IC) has been identified as one of the critical techniques used by spinal cord injury (SCI) patients to cope with emptying the bladder, despite several problems impeding this procedure.

AIM

The study aimed accordingly to explore the lived experience of Arab male patients on IC after their SCI.

DESIGN

This study was carried out by using a descriptive qualitative approach with a phenomenological analysis of data.

METHODS

A qualitative study was carried out on 10 Arab male patients from the Rehabilitation Hospital at King Fahad Medical City (KFMC), Riyadh, Saudi Arabia who were utilizing intermittent catheters following SCI. The interviews were analysed using Husserl's phenomenology and the Colaizzi method of data analysis.

RESULTS

Two major themes and six sub-themes were identified from exploring the patients experience. These themes are as follows: Theme 1: The Way to IC; with two sub-themes: (i) 'service provided and acceptance' and (ii) 'educational experience'; Theme 2: Lifestyle and self-adaptation; with four sub-themes: (i) 'Flexibility and freedom', (ii) 'Physical access to the community', (iii) 'Traveling' and (iv) 'Work and Social life balance'.

CONCLUSION

It is evident that using an intermittent catheter among patients with SCI influenced almost all aspects of the participant's life, including their social lives and body image appearance.

Intermittent self-catheterisation: the community nurse's role in identifying and overcoming the barriers

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.

Barriers affecting patient adherence to intermittent self-catheterisation

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.