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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

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Paediatric urologist Nephrology Urology
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