Faculty of Health, Life & Social Sciences, University of Lincoln, Lincoln, UK.
J Clin Nurs. 2011 Nov;20(21-22):3152-62. doi: 10.1111/j.1365-2702.2011.03779.x. Epub 2011 Aug 10.
This paper is a report of a study exploring the lived experiences and emotional responses of female patients learning to perform clean intermittent self-catheterisation (CISC).
There is general consensus that CISC should be considered in preference to in-dwelling catheterisation wherever feasible. Published literature has tended to focus on quality of life issues and technical and physical aspects. There has been less investigation into patients' initial perceptions of CISC and into their subsequent experiences of learning the technique.
This qualitative study used a phenomenological research design.
A series of semi-structured, in-depth interviews were held with a purposive sample of adult female patients performing CISC aged 34-64 years. Interviews were tape recorded and transcribed verbatim. Data were analysed using the 'Framework' method.
This study identified six recurrent themes: grief and loss, lack of knowledge (regarding female anatomy, bladder dysfunction and catheters), negative associations and stigma, psychological aversion and embarrassment, nursing approaches and coping mechanisms.
Loss of normal bladder function may represent a devastating event and trigger emotional responses associated with grief and loss. Patients may experience a range of reactions whilst learning CISC, including embarrassment and aversion, which may not dissipate over time. However, psychological distress is not inevitable and varies enormously between individuals. The nursing approach is vital, as individualised, empathic care is recognised and valued.
This study adds to an emerging body of knowledge providing an enhanced understanding of the lived experiences of patients learning CISC. Nurses need to be alert to a range of potential emotional responses. This will facilitate the adoption of individualised teaching and learning strategies, designed to optimise the patient's assimilation of CISC into their lifestyle, promoting physical health, psychological wellbeing and independent living.
本文是一项探索女性患者学习清洁间歇自我导尿（CISC）的生活体验和情绪反应的研究报告。
人们普遍认为，只要可行，CISC 应优先于留置导尿。已发表的文献往往侧重于生活质量问题以及技术和物理方面。对患者最初对 CISC 的看法以及他们随后学习该技术的经验的调查较少。
这项定性研究采用了现象学研究设计。
对 34-64 岁接受 CISC 的成年女性患者进行了一系列有针对性的半结构化深入访谈。采访进行了录音并逐字记录。使用“框架”方法分析数据。
本研究确定了六个反复出现的主题：悲伤和失落、缺乏知识（关于女性解剖结构、膀胱功能障碍和导管）、负面联想和耻辱感、心理厌恶和尴尬、护理方法和应对机制。
正常膀胱功能的丧失可能代表着一场毁灭性的事件，并引发与悲伤和失落相关的情绪反应。患者在学习 CISC 时可能会经历一系列反应，包括尴尬和厌恶，这些反应可能不会随着时间的推移而消散。然而，心理困扰并非不可避免，个体差异极大。护理方法至关重要，因为个性化、富有同情心的护理得到认可和重视。
本研究增加了一个正在出现的知识体系，提供了对学习 CISC 的患者生活体验的更深入理解。护士需要警惕一系列潜在的情绪反应。这将有助于采用个性化的教学和学习策略，旨在优化患者将 CISC 融入其生活方式，促进身体健康、心理健康和独立生活。
