Self-management intervention for long-term indwelling urinary catheter users: randomized clinical trial

Nurs Res. 2015 Jan-Feb;64(1):24-34. doi: 10.1097/NNR.0000000000000071.

Abstract

Background: People using long-term indwelling urinary catheters experience multiple recurrent catheter problems. Self-management approaches are needed to avoid catheter-related problems.

Objectives: The aim was to determine effectiveness of a self-management intervention in prevention of adverse outcomes (catheter-related urinary tract infection, blockage, and accidental dislodgement). Healthcare treatment associated with the adverse outcomes and catheter-related quality of life was also studied.

Methods: A randomized clinical trial was conducted. The intervention involved learning catheter-related self-monitoring and self-management skills during home visits by a study nurse (twice during the first month and at 4 months-with a phone call at 2 months). The control group received usual care. Data were collected during an initial face-to-face home interview followed by bimonthly phone interviews. A total of 202 adult long-term urinary catheter users participated. Participants were randomized to treatment or control groups following collection of baseline data. Generalized estimating equations were used for the analysis of treatment effect.

Results: In the intervention group, there was a significant decrease in reported blockage in the first 6 months (p = .02), but the effect did not persist. There were no significant effects for catheter-related urinary tract infection or dislodgment. Comparison of baseline rates of adverse outcomes with subsequent periods suggested that both groups improved over 12 months.

Discussion: A simple-to-use catheter problems calendar and the bimonthly interviews might have functioned as a modest self-monitoring intervention for persons in both groups. A simplified intervention using a self-monitoring calendar is suggested-with optimal and consistent fluid intake likely to add value.

Trial registration: ClinicalTrials.gov NCT00883220.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Catheter-Related Infections / prevention & control*
  • Catheters, Indwelling*
  • Equipment Failure
  • Female
  • Health Services / statistics & numerical data
  • Hospitalization
  • Humans
  • Male
  • Middle Aged
  • Patient Education as Topic
  • Quality of Life
  • Self Care*
  • Single-Blind Method
  • Time Factors
  • Treatment Outcome
  • Urinary Catheterization*
  • Urinary Catheters*

Associated data

  • ClinicalTrials.gov/NCT00883220