Quality of Life and Autonomy in Patients with Intermittent Bladder Catheterization Trained by Specialized Nurses

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

Evolution of Quality of Life and Treatment Adherence after One Year of Intermittent Bladder Catheterisation in Functional Urology Unit Patients

Objective: To determine patient difficulties and concerns when performing IBC (Intermittent Bladder Catheterisation), as well as the evolution of adherence, quality of life, and emotional state of patients one year after starting IBC. Method: A prospective, observational, multicentre study conducted in 20 Spanish hospitals with a one-year follow-up. Data sources were patient records and the King's Health Questionnaire on quality of life, the Mini-Mental State Examination (MMSE), and the Hospital Anxiety and Depression Scale (HADS). Perceived adherence was measured using the ICAS (Intermittent Catheterization Adherence Scale) and perceived difficulties with IBC were assessed using the ICDQ (Intermittent Catheterization Difficulty Questionnaire). For data analysis, descriptive and bivariate statistics were performed for paired data at three points in time (T1: one month, T2: three months, T3: one year). Results: A total of 134 subjects initially participated in the study (T0), becoming 104 subjects at T1, 91 at T2, and 88 at T3, with a mean age of 39 years (standard deviation = 22.16 years). Actual IBC adherence ranged from 84.8% at T1 to 84.1% at T3. After one year of follow-up, a statistically significant improvement in quality of life (p <= 0.05) was observed in all dimensions with the exception of personal relationships. However, there were no changes in the levels of anxiety (p = 0.190) or depression (p = 0.682) at T3 compared to T0. Conclusions: Patients requiring IBC exhibit good treatment adherence, with a significant proportion of them performing self-catheterisation. After one year of IBC, a significant improvement in quality of life was noted, albeit with a significant impact on their daily lives and their personal and social relationships. Patient support programmes could be implemented to improve their ability to cope with difficulties and thus enhance both their quality of life and the maintenance of their adherence

Análisis de adherencia y supervivencia al sondaje vesical intermitente y factores de riesgo asociados

Intermittent urinary catheterization consists of the periodic drainage of urine through a catheter that is removed immediately after urinary elimination has finished. Compliance with the prescription of the number of daily catheters that the patient must perform, and the infection prevention measures are decisive. This requires training from a nurse, who trains you in performing the technique, in your self-care and in integrating the treatment into your normal life. Objective: To determine the survival of adherence to intermittent bladder catheterization and associated risk factors. Methods: a multicenter prospective observational study in 24 Spanish hospitals, with a follow-up period of 1 year for patients. The sources of information will be the patients' medical records, an information collection notebook developed ad hoc for this study, and a series of validated questionnaires (quality of life, depression and anxiety, adherence to intermittent bladder catheterization). For data analysis, descriptive statistics, univariate survival analysis will be performed to determine the rate of loss of adherence, bivariate and multivariate study between adherence and potential risk factors for abandonment of adherence. All ethical requirements will be met. Scientific and socio-sanitary relevance: knowing the factors that are associated with the loss of adherence, it will be possible to adapt the training programs for patients and carry out an evidence-based practice. In addition, improving adherence to intermittent bladder catheterization will reduce the rate of complications, such as urinary tract infections, and the associated economic impact.El sondaje vesical intermitente consiste en el drenaje periódico de la orina a través de una sonda que se retira inmediatamente finalizada la eliminación urinaria. El cumplimiento de la prescripción del número de sondajes diarios que debe realizarse el paciente y las medidas de prevención de la infección, son determinantes. Esto necesita de la capacitación por parte de una enfermera, quien le entrena en la realización de la técnica, en sus autocuidados y en la integración del tratamiento en su vida habitual. Objetivo: Determinar la supervivencia de adherencia al sondaje vesical intermitente y los factores de riesgo asociados al abandono. Metodología: estudio observacional prospectivo multicéntrico en 24 hospitales españoles, con un periodo de seguimiento de los pacientes de 1 año. Las fuentes de información serán las historias clínicas de los pacientes, un cuaderno de recogida de información desarrollado ad hoc para este estudio y una serie de cuestionarios validados (calidad de vida, depresión y ansiedad, adherencia al sondaje vesical intermitente). Para el análisis de los datos se realizará estadística descriptiva, análisis de supervivencia univariante, para determinar el ritmo de pérdida de adherencia, estudio bivariante y multivariante entre adherencia y los potenciales factores de riesgo de abandono de adherencia. Se cumplirán todos los requisitos éticos. Relevancia científica y sociosanitaria: conociendo los factores que se asocian a la pérdida de adherencia se podrán adaptar los programas de capacitación de los pacientes y hacer una práctica basada en la evidencia. Además, mejorar la adherencia al sondaje vesical intermitente hará disminuir la tasa de complicaciones, como las infecciones urinarias y el impacto económico asociado