14. PATIENT PERSPECTIVE/EXPERIENCE WITH INTERMITTENT CATHETERISATION
About 20% of people experience negative feelings with catheterisation. [188] The health benefits of intermittent self-catheterisation (ISC) depend on adherence to the procedure, and how individuals respond to the treatment depends on several factors; those who experienced unpleasant symptoms find ISC beneficial, while others find it intrusive and time-consuming. [189] Managing the procedure increases the independence of the individual and reduces the risk of complications. A survey of 73 patients showed that their choice of catheter was mainly influenced by the nurses’ explanation and comfort of the catheter. [190] However, people who worry about doing self-harm and who have experienced complications with ISC feel a low level of satisfaction with the procedure. [191]
The most common worries are:
- fear of being dependent on intermittent catheterisation
- leakage
- accidentally injuring oneself
- embarrassment
- having sex
- causing an infection
- bleeding
- fear of feeling pain
- confidence about maintaining hygiene.
[125, 135, 150, 188, 191, 192]
Barriers to performing ISC are:
- the need to plan convenient times to catheterise
- preparation before the procedure because of dependency on bathroom access and sanitary facilities [136]
- type and cost of intermittent catheters [136, 137, 193]
Facilitators to ISC are:
- achieving a positive self-image, because ISC aids maintenance of a normal body image [194]
- good teaching instruction [136, 190]
- on-going support when needed [135, 136]
- guidance to choose the right catheter gauge and length, and comfort of insertion [194]
Psychological coping is affected by patients’ initial acceptance or avoidance and denial of ISC. [189] Patients describe the importance of feeling normal when using ISC because this gives them control over their bladder function and makes them independent. [189]
To support positive and active coping strategies that engender a feeling of normalisation, nurses must explore the patients’ perspective to understand how everyday life appears to the individual patient. Such knowledge enables nurses to support patients to overcome potential barriers to adherence to ISC. A small study showed that letting patients or caregivers train with ISC procedures on a low-fidelity simulator increased self-confidence in the procedure. [195]
| Recommendations | LE | GR |
| Explore emotional factors for patients and families during training for bladder IC [188] | 3 | B |
| Explore the everyday life of patients to guide their choice of the right catheter/catheter system for use inside and outside the home [136, 194] | 4 | C |