University of Rochester, Rochester, New York 14642, USA.
J Wound Ostomy Continence Nurs. 2010 May-Jun;37(3):301-10. doi: 10.1097/WON.0b013e3181d73ac4.
The purpose of this study was to determine the incidence and distribution of catheter-related problems in long-term indwelling urinary catheter users. We also sought to assess appropriateness of catheter use and examine relationships among catheter complications and catheter care practices.
This repeated-measures study involved self-reported data collection by recall at intake and by prospective data collection at 2, 4, and 6 months in long-term urinary catheter users.
Two sampling arms were used: a home care (HC) agency with 10 individuals and the Internet with 33 people having spinal cord injury.
Home visit and follow-up telephone call interviews were used with the participants from the HC agency. Data were self-administered through SurveyMonkey in the Internet sample, and communication was through e-mail, telephone, and postal mail. Analysis included descriptive statistics and generalized estimating equation techniques to adjust for within-subject variation over time.
All study participants had at least 1 catheter-related problem during 8 months, and many had multiple, recurring problems. Catheter-associated urinary tract infection (CAUTI) was reported by 70%, blockage by 74%, leakage by 79%, and accidental dislodgement by 33%. Key tests of associations (generalized estimating equation) predicted that catheter size contributed to CAUTI, with significant covariates of female gender and younger age. The presence of sediment in the urine on the day of the survey predicted catheter blockage.
The incidence of all complications was higher than expected. Problems associated with long-term indwelling catheter use may contribute to excess healthcare utilization adversely affecting both users and their families.
本研究旨在确定长期留置导尿管使用者中导管相关问题的发生率和分布情况。我们还旨在评估导管使用的适宜性，并研究导管并发症与导管护理实践之间的关系。
这是一项重复测量研究，包括通过回顾在入组时和在 2、4 和 6 个月时前瞻性收集长期留置导尿管使用者的自我报告数据。
使用了两个抽样臂：一个家庭护理（HC）机构有 10 人，另一个是互联网组，有 33 人患有脊髓损伤。
使用家访和后续电话访谈对 HC 机构的参与者进行访谈。互联网组的数据通过 SurveyMonkey 自我管理，通过电子邮件、电话和邮件进行沟通。分析包括描述性统计和广义估计方程技术，以调整随时间的个体内变异。
所有研究参与者在 8 个月期间至少发生了 1 次导管相关问题，许多人有多个、反复发生的问题。70%报告了与导管相关的尿路感染（CAUTI），74%报告了堵塞，79%报告了漏尿，33%报告了意外脱落。关联的关键检验（广义估计方程）预测导管大小与 CAUTI 有关，女性性别和年龄较小是显著的协变量。在调查当天尿液中有沉淀物预测了导管堵塞。
所有并发症的发生率都高于预期。与长期留置导尿管使用相关的问题可能会导致过度的医疗保健利用，对使用者及其家属都产生不利影响。
