A standardized educational Intervention to enhance acceptance and adherence to self-intermittent catheterization: Protocol for a multicenter randomized controlled trial

Abstract

Intermittent catheterization (IC) is the gold-standard management for individuals with non-obstructed urinary retention and neurogenic bladder. Learning IC is physically and psychologically challenging, and several men express fear of practicing IC because of the risk of urethral trauma and urinary infections. This study aims to evaluate the effectiveness of an enhanced educational intervention in improving IC acceptance and adherence compared to standard clinical practice training. This multicenter, parallel-group, randomized controlled trial will enroll 128 male patients, randomly assigned to either the intervention group, receiving standard training plus an informational booklet and video tutorial, or the control group, receiving standard training alone. The primary outcome is the improvement in IC acceptance, measured by the Intermittent Catheterization Acceptance Test (I-CAT) score at three months (T2). Secondary outcomes include adherence levels (I-CAS), urinary symptoms (USQNB-IC), procedural autonomy (Autonomy Checklist), and patient-reported satisfaction (QUEST). Findings from this study will provide evidence-based guidance on optimizing IC education to enhance patient self-management and adherence.

Keywords: Acceptance; Adherence; Assistive technology; Intermittent catheterization; Neurogenic bladder; Patient education; Patient-reported outcomes; Randomized controlled trial; Rehabilitation; Self-catheterization.

Graphical abstract