Long-term urinary catheter users self-care practices and problems

Authors

  • Mary H Wilde PhD, RN,

    Associate Professor, Corresponding author
    • School of Nursing & Center for Community Health, University of Rochester, Rochester, NY, USA
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  • Margaret V McDonald MSW,

    Associate Director of Research Studies
    1. Center for Home Care Policy and Research, Visiting Nurse Service of New York, New York, NY
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  • Judith Brasch RN, BS,

    Project Nurse
    1. School of Nursing & Center for Community Health, University of Rochester, Rochester, NY, USA
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  • James M McMahon PhD,

    Associate Professor
    1. School of Nursing & Center for Community Health, University of Rochester, Rochester, NY, USA
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  • Eileen Fairbanks MS, RN, PNP,

    Assistant Professor of Clinical Nursing & Project Coordinator
    1. School of Nursing & Center for Community Health, University of Rochester, Rochester, NY, USA
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  • Shivani Shah MPH,

    Research Analyst
    1. Center for Home Care Policy and Research, Visiting Nurse Service of New York, New York, NY
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  • Wan Tang PhD,

    Research Assistant Professor
    1. Department of Biostatistics & Computational Biology and Co-Director, Division of Psychiatric Statistics, University of Rochester, Rochester, NY, USA
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  • Eileen Scheid MS, RN

    Doctoral Student
    1. School of Nursing & Center for Community Health, University of Rochester, Rochester, NY, USA
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Correspondence: Mary H Wilde, Associate Professor Nursing and Center for Community Health, University of Rochester, 601 Elmwood Ave., Box SON, Rochester, NY 14642, USA. Telephone: +1 585-275-9682.

E-mail: mary_wilde@urmc.rochester.edu

Abstract

Aims and objectives

To characterise a sample of 202 adult community-living long-term indwelling urinary catheter users, to describe self-care practices and catheter problems, and to explore relationships among demographics, catheter practices and problems.

Background

Long-term urinary catheter users have not been well studied, and persons using the device indefinitely for persistent urinary retention are likely to have different patterns of catheter practices and problems.

Design

The study was a cross-sectional descriptive and exploratory analysis.

Methods

Home interviews were conducted with catheter users who provided information by self-reported recall over the previous two months. Data were analysed by descriptive statistics and tests of association between demographics, catheter practices and catheter problems.

Results

The sample was widely diverse in age (19–96 years), race and medical diagnosis. Urethral catheters were used slightly more often (56%) than suprapubic (44%), for a mean of six years (SD 7 years). Many persons were highly disabled, with 60% having difficulty in bathing, dressing, toileting and getting out of the bed; 19% also required assistance in eating. A high percentage of catheter problems were reported with: 43% experiencing leakage (bypassing of urine), 31% having had a urinary tract infection, 24% blockage of the catheter, 23% catheter-associated pain and 12% accidental dislodgment of the catheter. Treatments of catheter-related problems contributed to additional health care utilisation, including extra nurse or clinic visits, trips to the emergency department or hospitalisation. Symptoms of catheter-associated urinary tract infections were most often related to changes in the colour or character of urine or generalised symptoms.

Conclusions

Catheter-related problems contribute to excess morbidity and health care utilisation and costs.

Relevance to clinical practice

More research is needed in how to minimise catheter-associated problems in long-term catheter users. Information from this study could help inform the development of interventions in this population.

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