Parent and child experiences using a hydrophilic or reused PVC catheter for intermittent catheterisation

Abstract

Aims and objectives: To highlight the challenges faced in adjusting to intermittent catheterisation for families and children affected by spina bifida.

Background: Toileting is a particular issue for children with spina bifida resulting in difficulty emptying their bladder. Management of incomplete emptying is intermittent catheterisation, which is now part of routine clinical care. The physical benefits of intermittent catheterisation are critical to renal health, and significant attention has been paid to this; less attention has been given to the personal aspects for the family or older child.

Design: A descriptive study of satisfaction with two products for intermittent catheterisation: polyvinyl chloride and hydrophilic catheters based on data obtained from a randomised controlled trial on urinary tract infections in catheter users.

Methods: At the end of each of the polyvinyl chloride and hydrophilic study arms, parents or older children completed a 'Satisfaction Questionnaire' and then participated in a follow-up interview. Data were analysed for emerging themes.

Conclusions: Three themes emerged: adjustment, ease of use and self-reliance. Key findings include: increased independence and confidence of the child catheterising using the hydrophilic catheter, self-management strategies to successfully manipulate the slippery hydrophilic catheter and reasons for the lack of success, and identification of participants who preferred polyvinyl chloride catheters. Descriptive data revealed potential areas where a hydrophilic catheter could improve the lives of the family and child as well as noting the need for user choice in product selection.

Relevance to clinical practice: Listening to the stories of children and families increases the nurse's ability to act as a guide as families struggle to assist their children in reaching their potential. Incontinence has been demonstrated to be the cause of self-isolation potentially leading to a decreased sense of self-worth. Ambulatory care nurses play a large role in helping families find the routine and resources necessary to reduce the incidence of incontinence, in children with spina bifida.