Division of Urology, Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Baylor Scott & White Institute for Rehabilitation, Dallas, Texas, USA.
Neurourol Urodyn. 2021 Nov;40(8):2008-2019. doi: 10.1002/nau.24786. Epub 2021 Sep 13.
Patient satisfaction is paramount to health-related quality of life (HR-QoL) outcomes. High quality, quantitative data from the US describing patients' actual experiences, difficulties, and HR-QoL while on an intermittent self-catheterization (ISC) regimen is very scarce. Our objective was to better understand patient practices with and attitudes towards ISC.
This is a cross-sectional, multi-centered, clinical study of adult men and women performing ISC in the United States. Data collected included demographics, medical history, catheter characteristics, specific self-catheterization habits and two validated HR-QoL questionnaires: The Intermittent Self-Catheterization Questionnaire (ISC-Q) and the Intermittent Catheterization Difficulty Questionnaire (ICDQ).
Two hundred participants were recruited from six sites; 70.0% were male, 73.5% were Caucasian with a median age was 51.0 years (range 19-90 years). The ISC-Q showed that the vast majority of participants reported ease with ISC (82.0% satisfaction score) had confidence in their ability to perform ISC (91.9% satisfaction score); yet, many felt self-conscious about doing so (58.3% satisfaction score) and had concerns about long-term adverse effects (58.1% satisfaction score). The ICDQ indicated little to no difficulty for most participants with all routine ISC practices. A small minority of participants reported some difficulty with a "blocking sensation" during initiation of catheterization, leg spasticity, and painful catheterization. Multivariate linear regression results are also reported.
DISCUSSION/CONCLUSION: Participants are confident with ISC and have little overall difficulty, which may be a product of successful education and/or catheter design. urinary tract infections (UTIs) were common (yet variable) and may contribute to the noted long-term ISC concerns. Limitations exist including various selection biases leading to concerns of external validity. Future educational interventions in this population may further improve HR-QoL, optimize UTIs prevention, and diminish concerns with long-term ISC.
患者满意度是与健康相关的生活质量（HR-QoL）结果的关键。美国很少有高质量、定量的数据描述患者在间歇性自我导尿（ISC）方案期间的实际体验、困难和 HR-QoL。我们的目的是更好地了解患者在 ISC 方面的实践和态度。
这是一项在美国进行的成人男性和女性进行 ISC 的横断面、多中心临床研究。收集的数据包括人口统计学、病史、导管特征、特定的自我导尿习惯以及两个经过验证的 HR-QoL 问卷：间歇性自我导尿问卷（ISC-Q）和间歇性导尿困难问卷（ICDQ）。
从六个地点招募了 200 名参与者；70.0%为男性，73.5%为白种人，中位年龄为 51.0 岁（范围 19-90 岁）。ISC-Q 显示，绝大多数参与者报告 ISC 容易（满意度得分为 82.0%），对自己进行 ISC 的能力有信心（满意度得分为 91.9%）；然而，许多人对此感到难为情（满意度得分为 58.3%），并担心长期的不良影响（满意度得分为 58.1%）。ICDQ 表明，大多数参与者在进行所有常规 ISC 实践时几乎没有困难。少数参与者报告在开始导尿时出现“阻塞感”、腿部痉挛和导尿疼痛方面存在一些困难。还报告了多变量线性回归结果。
讨论/结论：参与者对 ISC 有信心，整体难度较小，这可能是成功的教育和/或导管设计的结果。尿路感染（UTIs）很常见（但各不相同），可能是导致长期 ISC 担忧的原因。存在一些局限性，包括各种选择偏差，导致对外部有效性的担忧。在这一人群中进行未来的教育干预可能会进一步提高 HR-QoL，优化 UTI 的预防，并减少对长期 ISC 的担忧。
