Borzyskowski Malgorzata, Cox Antony, Edwards Melinda, Owen Amanda
United Medical and Dental Schools, Guy's, Kings, and St Thomas' Hospitals, London, UK.
Dev Med Child Neurol. 2004 Mar;46(3):160-7.
Clean intermittent catheterization (CIC) is the mainstay of management in neuropathic vesicourethral dysfunction, both to improve continence and, more importantly, to preserve renal function. We looked at the effects of this procedure on children, adolescents, and their families. In particular, we wished to see if there were any differences between those who successfully catheterized and those who did not. Forty families were enrolled into the study. Ages of children and adolescents (23 females, 17 males) ranged from 1 to 20 years. Most participants (n=31) had spina bifida. Other causes of bladder dysfunction included transverse myelitis, spinal cord injury, and spinal neuroblastoma. Parents were assessed using the Effects of Handicap on Parents semi-structured interview, the Socioemotional Functioning Interview, and a semi-structured interview, specifically designed for the study, which looked at family characteristics and experience related to diagnosis and catheterization. In addition, the Rutter Parental 'A' Scale Questionnaire was used to screen for emotional and behavioural disorders in the child. Results showed that CIC by carer or self-catheterization itself did not cause major emotional and behavioural problems but the bladder problem may act as a focus that puts considerable strain family relationships. Although most parents disliked CIC they complied with the suggested management. It is important that all those involved understand the aims of management and success can be achieved by combined input from medical, psychological, and specialist nursing staff. The problem is lifelong and continued support from a multidisciplinary team is essential.
清洁间歇性导尿（CIC）是神经源性膀胱尿道功能障碍治疗的主要方法，既能改善尿失禁，更重要的是能保护肾功能。我们研究了该操作对儿童、青少年及其家庭的影响。特别是，我们想看看成功导尿的人和未成功导尿的人之间是否存在差异。40个家庭参与了这项研究。儿童和青少年（23名女性，17名男性）的年龄在1至20岁之间。大多数参与者（n = 31）患有脊柱裂。膀胱功能障碍的其他原因包括横贯性脊髓炎、脊髓损伤和脊髓神经母细胞瘤。使用《残疾对父母的影响》半结构化访谈、《社会情感功能访谈》以及专门为该研究设计的半结构化访谈对父母进行评估，该访谈考察了与诊断和导尿相关的家庭特征和经历。此外，使用《鲁特父母“A”量表问卷》筛查儿童的情绪和行为障碍。结果表明，由照顾者进行的CIC或自我导尿本身不会导致严重的情绪和行为问题，但膀胱问题可能成为给家庭关系带来相当大压力的一个焦点。尽管大多数父母不喜欢CIC，但他们遵守了建议的治疗方案。所有相关人员理解治疗目标非常重要，并且通过医疗、心理和专科护理人员的联合投入可以实现成功治疗。这个问题是终身的，多学科团队的持续支持至关重要。
