Long‐term urinary catheter users self‐care practices and problems

Abstract

Aims The aims were to characterize a sample of 202 adult community-living long-term indwelling urinary catheter users, to describe self-care practices and catheter problems, and to explore relationships among demographics, catheter practices, and problems. Background Long-term urinary catheter users have not been well studied, and persons using the device indefinitely for persistent urinary retention are likely to have different patterns of catheter practices and problems. Design The study was a cross-sectional descriptive and exploratory analysis. Methods Home interviews were conducted with catheter users who provided information by self-reported recall over the previous two months. Data were analyzed by descriptive statistics and tests of association between demographics, catheter practices, and catheter problems. Results The sample was widely diverse in age (19–96 years), race, and medical diagnosis. Urethral catheters were used slightly more often (56%) than suprapubic (44%), for a mean of 6 yrs. (SD 7 yrs.). Many persons were highly disabled, with 60% having difficulty in bathing, dressing, toileting, and getting out of the bed; 19% also required assistance in eating. A high percentage of catheter problems were reported with: 43% experiencing leakage (bypassing of urine), 31% having had a urinary tract infection, 24% blockage of the catheter, 23% catheter-associated pain, and 12% accidental dislodgment of the catheter. Treatments of catheter-related problems contributed to additional health care utilization including extra nurse or clinic visits, trips to the emergency department, or hospitalization. Symptoms of catheter associated urinary tract infections were most often related to changes in the color or character of urine or generalized symptoms. Conclusions Catheter related problems contribute to excess morbidity and health care utilization and costs. Relevance to clinical practice More research is needed in how to minimize catheter associated problems in long-term catheter users. Information from this study could help inform the development of interventions in this population.

Successful recruitment methods in the community for a two-site clinical trial

“…The information for this report is based on the detailed minutes from 163 team meetings and recruitment reports, as well as personal recollections. A full description of the sample at the beginning of the study has been published (Wilde et al, 2013), and the analysis of major outcomes are underway and will be described elsewhere.…”

Comparing Transurethral and Suprapubic Catheterization for Long-term Bladder Drainage

“…Even fewer studies have looked at the experiences and perceptions of those living with a suprapubic catheter. [11][12][13][14][15] In these studies, the authors say relatively little about how patients compared living with the 2 types of catheters or how the decision was made to have a suprapubic catheter rather than a urethral one. The primary aims of our study were to explore men's and women's perceptions of living with a urethral or suprapubic catheter, to examine how they decided to have a suprapubic catheter, and to compare their experiences of having a suprapubic catheter with their experiences of living with a urethral catheter.…”

Self-Management Intervention for Long-Term Indwelling Urinary Catheter Users

“…While many catheter users have spinal cord injury (SCI) or multiple sclerosis (MS), the population also includes those with other neurological disorders, diabetes, or disease/injury to the bladder region. Unfortunately, indwelling urinary catheters are seldom trouble free (Cottenden et al, 2013; Wilde, McDonald et al, 2013). Data collected in a longitudinal study of 43 long-term catheter users indicated that recurrent problems affect the great majority.…”

“…Prevalence rates during eight months of catheter use were 70% for catheter-associated urinary tract infection (CAUTI) with a rate of 8.4/1000 catheter days; 74% for blockage; and 33% for catheter expulsion or dislodgement (Wilde, et al, 2010). For a two-month period prior to the beginning of this randomized clinical trial (RCT), catheter problems were reported as: 31% for CAUTI, 24% blockage, and 12% dislodgment (Wilde, McDonald et al, 2013). …”

“…These complications are distressing to patients/families (Wilde & Cameron, 2003; Wilde, 2003) and contribute to increased healthcare expenses, such as additional clinic, home care, or emergency department visits or hospitalization (Wilde, McDonald et al, 2013). Interventions to address prevention of CAUTI in long-term catheter users such as the use of silver coated or antimicrobial coatings on the catheter (Parker et al, 2009) installations to the drainage bag (Thompson et al, 1984), or special cleaning of the urinary meatus (Burke, Jacobson, Garibaldi, Conti, & Alling, 1983) have not been successful.…”