RESUMO
PURPOSE: The purpose of this study was to propose a systematic teaching and learning strategy for Brazilian caregivers of children with neurogenic bladder dysfunction(NBD), by using an illustrated booklet written in Portuguese. DESIGN: Descriptive study. SUBJECTS AND SETTING: Caregivers of children requiring clean intermittent catheterization (CIC) were approached when attending the pediatric urology outpatient clinic of Hospital de Base in Sao Jose do Rio Preto city, Brazil. METHODS: After educational sessions, a supervised procedure was done, with the child's caregiver observing the technique. RESULTS: Twenty-three caregivers of children with NBD provided feedback on a CIC teaching booklet. The children were all cared for at the pediatric urology outpatient clinic of a teaching hospital in Sao Jose do Rio Preto city, Brazil. The booklet was evaluated as "excellent" concerning organization and the quality of the illustrations by the majority of the caregivers. All caregivers stated that they had developed the ability to perform CIC successfully; 61% evaluated their learning process as "excellent," whereas 39% evaluated it as "good." CONCLUSION: The booklet successfully reached the goals and now is implemented in orientations about CIC.
Assuntos
Cuidadores , Pais , Educação de Pacientes como Assunto/métodos , Materiais de Ensino/normas , Bexiga Urinaria Neurogênica/prevenção & controle , Cateterismo Urinário/métodos , Adolescente , Adulto , Idoso , Atitude Frente a Saúde , Brasil , Cuidadores/educação , Cuidadores/psicologia , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Lactente , Controle de Infecções , Masculino , Pessoa de Meia-Idade , Pesquisa em Educação em Enfermagem , Pesquisa em Avaliação de Enfermagem , Folhetos , Pais/educação , Pais/psicologia , Autoeficácia , Inquéritos e Questionários , Cateterismo Urinário/enfermagem , Cateterismo Urinário/psicologiaRESUMO
OBJECTIVE: To determine the effect of cranberry prophylaxis on rates of bacteriuria and symptomatic urinary tract infection in children with neurogenic bladder receiving clean intermittent catheterization. DESIGN: Double-blind, placebo-controlled, crossover study of 15 children receiving cranberry concentrate or placebo concentrate for 6 months (3 months receiving one concentrate, followed by 3 months of the other). Weekly home visits were made. During each visit, a sample of bladder urine was obtained by intermittent catheterization. Signs and symptoms of urinary tract infection and all medications were recorded, and juice containers were counted. RESULTS: During consumption of cranberry concentrate, the frequency of bacteriuria remained high. Cultures of 75% (114 of 151) of the 151 samples obtained during consumption of placebo were positive for a pathogen (>/=10(4) colony-forming units/mL) compared with 75% (120 of 160) of the 160 samples obtained during consumption of cranberry concentrate. Escherichia coli remained the most common pathogen during placebo and cranberry periods. Three symptomatic infections each occurred during the placebo and cranberry periods. No significant difference was observed in the acidification of urine in the placebo group versus the cranberry group (median, 5.5 and 6.0, respectively). CONCLUSION: The frequency of bacteriuria in patients with neurogenic bladder receiving intermittent catheterization is 70%; cranberry concentrate had no effect on bacteriuria in this population.