Clean intermittent catheterization in patients following spinal cord injury: A prospective study evaluating the correlation between education and incidence of complications
Authors:
Alena Kyrianová 1; Vladimír Šámal 2; Jaroslav Šrám 1; Jan Mečl 2
Authors‘ workplace:
Spinální jednotka, Krajská nemocnice Liberec, a. s.
1; Urologické oddělení, Krajská nemocnice Liberec, a. s.
2
Published in:
Ces Urol 2013; 17(4): 263-272
Category:
Original article
Overview
Aim:
Modern health care relies on the involvement of the patient in the treatment process. Implementation of new medical and nursing practices necessitates that sufficient time is devoted to patient education. Well managed educational process is beneficial for both the patients and their caregivers and may lead to a reduction in the incidence of treatment-induced complications. The aim of this study was to evaluate the effect of the method of education on the incidence of complications associated with clean intermittent catheterization (CIC) in patients after spinal injury.
Methods:
This is a prospective randomized study. The study group consisted of 53 patients with neurogenic voiding dysfunction after spinal trauma, in whom bladder emptying using CIC was indicated. Following randomization, the patients in the first group were educated in CIC using a detailed demonstration with pictures. The second group was instructed using the standard method of education – verbal instruction. In addition to a voiding diary, weekly urine culture was performed in patients in both study groups. We monitored the time to the first occurrence of urinary tract infection, time to the occurrence of asymptomatic bacteriuria, the total duration of urinary tract infection and the incidence of urethral injury.
Results:
In the group of patients with the detailed picture education, the time to first episode of urinary infection was significantly longer than in patients who received verbal education (p < 0.000). We did not find a statistically significant difference between the two groups in the time to onset of asymptomatic bacteriuria and total duration of urinary tract infection. One urethral injury occurred in the picture education group.
Conclusions:
We have demonstrated that detailed education, using pictures, leads to a significant increase in the time to the first occurrence of urinary infection. We did not find a statistically significant difference in the time of onset of asymptomatic bacteriuria or in total duration of urinary tract infection.
Key words:
education, clean intermittent catheterization, lower urinary tract dysfunction, complication, urinary tract infection.
Sources
1. Lapides J, Diokno AC, Silber SM, Lowe BS. Clean intermittent self-catheterization in the treatment of urinary tract disease. J Urol 1972; 107: 458–461.
2. Krhut J, Zachoval R, Ženíšek J, Hanuš T, Zámečník L. Intermitentní katetrizace močového měchýře – indikace, technika a komplikace. Čas. Lék. čes. 2005; 144(10): 674–677.
3. Hansen R, Sorensen F, Kristensen J. Bladder emptying over a period of 10–45 years after a traumatic spinal cord injury. Spinal Cord 2004; 42: 631–637.
4. Wyndaele J, Madersbacher H, Kovindha A. Conservative treatment of the neuropathic bladder in spinal cord injured patients. Spinal Cord 2001; 39: 294–300.
5. Bittner L, Kordulová P. Čistá intermitentní katetrizace. Urologie pro praxi 2012; 4: 13.
6. Le Breton F, et al. Therapeutic education and intermittent self-catheterization: recommendations for an educational program and a literature review. Ann Phys Rehabil Med 2012; 55(3): 201–212.
7. Parsons BA, Narshi A, Drake MJ. Success rates for learning intermittent self-catheterisation according to age and gender. Int Urol Nephrol 2012; 44(4): 1127–1131.
8. Cobussen-Boekhorst HJ, et al. Teaching children clean intermittent self-catheterization (CISC) in a group setting. J Pediatr Urol 2010; 6(3): 288–293.
9. Matoušová M. Evakuace močového měchýře pomocí ČIK (čisté intermitentní katetrizace): Bakalářská práce. České Budějovice: Jihočeská univerzita v Českých Budějovicích. Zdravotně sociální fakulta. 2009
10. Bastable SB. Nurse as Educator. Sudbury: Jones and Bartlett Publishers 2005.
11. Pilloni S, Krhut J, Mair D, Madersbacher H, Kessler T. Intermittent catheterization in older people? A valuable alternative to an indwelling catheter? Age and ageing 2005; 34: 57–60.
12. Stensballe J, Looms D, Nielsen P, Tvede M. Hydrophilic coated catheters for intermittent catheterization reduce urethral micro trauma: A prospective, randomized, participant blinded, crossover study of three different type of catheters. Eur Urol 2005; 48: 978–983.
13. Cardenas D, Moore K, Danels McC, Scelza W, Graves D, Brooks M, Busch A. Intermittent catheterization with a hydrophilic-coated catheter delays urinary tract infection in acute spinal cord injury: A prospective, randomized, multiceter trial. PM and R 2011; 3(5): 408–417.
14. Šámal V, Kyrianová A, Šrám J, Mečl J, Fogl J. Čistá intermitentní katetrizace v léčbě neurogenních dysfunkcí dolních močových cest po spinálním poranění. Porovnání výsledků při použití hydrofilních a standardních PVC katétrů. Ces Urol 2011; 15(4): 229–236.
15. Massa L, Hoffman J, Cardenas D. Validity, accuracy, and predictive value of urinary tract infection signs and symptoms in individuals with spinal cord injury on intermittent catheterization. J Spinal Cord Med 2009; 32(5): 568–573.
Labels
Paediatric urologist Nephrology UrologyArticle was published in
Czech Urology
2013 Issue 4
Most read in this issue
- Ureteral endometriosis
- Abdominoscrotal hydrocele
- Patients’ quality of life in select dialysis centers in Slovakia
- Clean intermittent catheterization in patients following spinal cord injury: A prospective study evaluating the correlation between education and incidence of complications