RESUMO
AIMS: To compare the impact of the different routes for clean intermittent catheterization on the quality of life of children with lower urinary tract dysfunction. METHODS: In this cross-sectional study, all children and adolescents under treatment in our clinic from August 2011 to May 2012 who were on CIC for bladder dysfunction were included. To evaluate the technical difficulty and the discomfort associated with the procedure we used a standard visual analog scale. Quality of life was measured using the Pediatric Quality of Life Inventory Version 4.0. RESULTS: A total of 70 children including 38 (54.3%) boys and 32 (45.7%) girls with a mean age of 11.8 ± 3.6 years (range 5 to 18 years) were evaluated. The mean daily number of catheterizations was 4.2 ± 1.1. CIC was performed through the urethra in 51 (72.9%) subjects and a stoma in 19 (27.1%). A 45 (64.3%) were assisted by a caregiver to perform a catheterization. No differences in both difficulty and discomfort for performing CIC were observed between groups. Children who performed CIC through a stoma had a better quality of life scores for the physical (P = 0.015) and social functioning domains (P = 0.011). CONCLUSION: The quality of life of children and adolescents performing CIC appears to be affected by the route of catheterization, with a worse performance for those using urethral catheterization.
Assuntos
Cateterismo Uretral Intermitente/métodos , Sintomas do Trato Urinário Inferior/terapia , Qualidade de Vida , Adolescente , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Cateterismo Uretral Intermitente/psicologia , Sintomas do Trato Urinário Inferior/psicologia , Masculino , Escala Visual AnalógicaRESUMO
OBJECTIVE: To identify the influence of social determinants of health on the life conditions of patients who use intermittent urinary catheters. METHOD: This was a descriptive study conducted in a rehabilitation center with 243 neurogenic bladder patients who used clear intermittent urinary catheters. The study was carried out between March 2012 and October 2015, using interviews based on semi-structured instruments, and data analysis using descriptive statistics. RESULTS: Most of the patients were men, between 16 and 64 years old, single, with an elementary education level, and a monthly household income of 2 to 3 minimum wages. The results show that the social determinants of health were related to socioeconomic, demographic, and health factors. CONCLUSION: The findings indicate a complex relationship between social determinants of health and the life conditions of patients who use clean intermittent urinary catheters, presenting greater vulnerability related to some aspects of health conditions.
Assuntos
Cateterismo Uretral Intermitente/psicologia , Pacientes/psicologia , Qualidade de Vida/psicologia , Determinantes Sociais da Saúde , Cateteres Urinários/normas , Adolescente , Adulto , Brasil , Feminino , Humanos , Cateterismo Uretral Intermitente/efeitos adversos , Cateterismo Uretral Intermitente/métodos , Entrevistas como Assunto/métodos , Masculino , Pessoa de Meia-Idade , Autocuidado/métodosRESUMO
ABSTRACT Objective: To identify the influence of social determinants of health on the life conditions of patients who use intermittent urinary catheters. Method: This was a descriptive study conducted in a rehabilitation center with 243 neurogenic bladder patients who used clear intermittent urinary catheters. The study was carried out between March 2012 and October 2015, using interviews based on semi-structured instruments, and data analysis using descriptive statistics. Results: Most of the patients were men, between 16 and 64 years old, single, with an elementary education level, and a monthly household income of 2 to 3 minimum wages. The results show that the social determinants of health were related to socioeconomic, demographic, and health factors. Conclusion: The findings indicate a complex relationship between social determinants of health and the life conditions of patients who use clean intermittent urinary catheters, presenting greater vulnerability related to some aspects of health conditions.
RESUMEN Objetivo: Identificar la influencia de factores de los determinantes sociales de salud en las condiciones de vida de pacientes usuarios de cateterismo urinario intermitente. Método: Investigación descriptiva realizada en centro de Rehabilitación. Participaron 243 pacientes con vejiga neurogénica, usuarios de cateterismo urinario intermitente limpio. Estudio realizado entre marzo de 2012 y octubre de 2015, aplicando entrevista apoyada por instrumento semiestructurado, y análisis por estadística descriptiva. Resultados: La mayoría de los pacientes era de sexo masculino, edad entre 16 y 64 años, solteros, con enseñanza primaria e ingresos familiares entre 2 y 3 salarios mínimos. Los determinantes sociales de salud encontrados estuvieron relacionados a aspectos socioeconómicos, demográficos y condiciones de salud. Conclusión: Los hallazgos señalan una compleja relación entre los determinantes sociales de salud y las condiciones de vida de estos pacientes usuarios de cateterismo urinario intermitente limpio, presentando vulnerabilidad en relación a algunos aspectos de las condiciones de salud.
RESUMO Objetivo: Identificar a influência de fatores dos determinantes sociais de saúde nas condições de vida de pacientes usuários de cateterismo urinário intermitente. Método: Pesquisa descritiva realizada em um Centro de Reabilitação com 243 pacientes com bexiga neurogênica, usuários de cateterismo urinário intermitente limpo. O período do estudo foi de março/2012 a outubro/2015, utilizando-se entrevista com apoio de um instrumento semiestruturado e análise por estatística descritiva. Resultados: A maioria dos pacientes era do gênero masculino, idade entre 16 e 64 anos, solteiros, com ensino fundamental e renda familiar mensal de 2 a 3 salários mínimos. Os determinantes sociais de saúde encontrados foram relacionados aos aspectos socioeconômicos, demográficos e condições de saúde. Conclusão: Os achados assinalam para uma complexa relação entre os determinantes sociais de saúde e as condições de vida desses pacientes usuários de cateterismo urinário intermitente limpo, apresentando uma vulnerabilidade com relação a alguns aspectos das condições de saúde.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pacientes/psicologia , Qualidade de Vida/psicologia , Cateterismo Uretral Intermitente/psicologia , Cateteres Urinários/normas , Determinantes Sociais da Saúde , Autocuidado/métodos , Brasil , Entrevistas como Assunto/métodos , Cateterismo Uretral Intermitente/efeitos adversos , Cateterismo Uretral Intermitente/métodos , Pessoa de Meia-IdadeRESUMO
PURPOSE: Intermittent catheterization (IC) often is essential for individuals with spina bifida/myelomeningocele (SBM) and neurogenic bladder. This study aimed to identify and analyze the factors that influence the use of IC. DESIGN AND METHODS: Descriptive study with convenience sampling. Data were collected using printed (Brazil) and online (Germany) questionnaires, and analyzed using multivariate logistical regression and analysis of variance. The study included 100 Brazilian and 100 German patients, aged 0-55 years, with SBM who utilized IC. FINDINGS: Intermittent catheterization was used by 188 of the 200 patients. Three variables were important for predicting who did or did not use IC: no discontinuation of IC, absence of technical difficulty, and daily frequency of IC. CONCLUSIONS AND CLINICAL RELEVANCE: Findings suggest that difficulties with IC use experienced by spina bifida patients and their family members that predicted full discontinuation tended to be personal variables, rather than demographic or medical characteristics.
Assuntos
Cateterismo Uretral Intermitente/estatística & dados numéricos , Disrafismo Espinal/terapia , Adolescente , Adulto , Brasil , Criança , Pré-Escolar , Feminino , Alemanha , Humanos , Lactente , Cateterismo Uretral Intermitente/psicologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Enfermagem em Reabilitação/métodos , Disrafismo Espinal/enfermagem , Disrafismo Espinal/psicologia , Inquéritos e Questionários , Bexiga Urinaria Neurogênica/enfermagem , Bexiga Urinaria Neurogênica/terapiaRESUMO
A major complication for individuals with spina bifida (SB) is managing their neurogenic bladder. For many, this process evokes negative feelings associated with guilt, dependence, and lack of self-worth. PURPOSE: The aim of the study was to compare feelings that hinder the performing of intermittent bladder catheterization reported by individuals with SB and their families in two countries of different sociocultural characteristics: Brazil and Germany. DESIGN AND METHODS: Quantitative and comparative study with convenience sampling. The sample comprised 200 SB patients and their caregivers, 100 from Brazil and 100 from Germany. FINDINGS: When asked about the existence of negative feelings or ideas that may hinder the performance of key person responsible for IC, 155 (77.5%) participants did not report such feelings. On the other hand, 45 (22.5%) reported emotional difficulties; among these participants, 31 (69%) were Brazilians and 14 (31%) were Germans. CONCLUSIONS AND CLINICAL RELEVANCE: Although emotional factors are important to the adjustment of using IC methods for bladder management, the majority of people with SB and their caregivers seem to report no major emotional difficulties with this process. Yet a considerable group of participants did report such emotional difficulties associated with fear and shame. Knowing more about the factors associated with such negative feelings can facilitate interactions, provide mutual aid, and assist with resolution of practical concerns related to intermittent bladder catheterization.
Assuntos
Cuidadores/psicologia , Cateterismo Uretral Intermitente/normas , Disrafismo Espinal/psicologia , Bexiga Urinaria Neurogênica/terapia , Adolescente , Adulto , Brasil , Criança , Pré-Escolar , Medo/psicologia , Feminino , Alemanha , Humanos , Lactente , Cateterismo Uretral Intermitente/psicologia , Masculino , Pessoa de Meia-Idade , Qualidade de Vida/psicologia , Vergonha , Disrafismo Espinal/enfermagem , Estatísticas não Paramétricas , Bexiga Urinaria Neurogênica/psicologiaRESUMO
PURPOSE: To determine adherence rate and variables associate with patients' adherence to Clean Intermittent Self Catheterization (CISC). MATERIALS AND METHODS: Patients refereed to CISC training program between July 2006 and May 2008, were prospectively evaluated with urodynamic, 3 days bladder diary (BD) and WHOQoL-bref questionnaire. After training to perform CISC, patients were evaluated at 2 weeks, monthly for 6 months and at 12 months with clinical visits and BD. Patients were considered adherent if they were performing at least 80 percent of the initial recommendation. RESULTS: Sixty patients (50.4 ± 19.9 years old) were trained to perform CISC (21 female and 39 male). Out of them, 30 (50 percent) had neurogenic and 30 (50 percent) had a non-neurogenic voiding dysfunction. The adherence rate at 6 and 12 months was 61.7 percent, 58 percent, respectively. Patients < 40 years old had adherence rate of 86 percent. Women and neurogenic patients had higher adherence rate than their counterparts (p = 0.024 and p = 0.016, respectively). In the WHOQoL-bref, patients that adhere to the program had a significant higher score on psychological and social relationships domains. There was not difference in pre and post training WHOQoL-bref scores. Educational background, marriage status, detrusor leak point pressure, Bladder Capacity, number of leakage episodes did not play a role on the adherence rate. CONCLUSION: Patients in CISC program present a reasonable adherence after one year. Women, neurogenic voiding dysfunction and patients under 40 years old were significantly more adherents. The psychological and social relationship status seems to positively interfere on adherence. CISC did not affect patient's QoL evaluated by WHOQoL-bref.
Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cateterismo Uretral Intermitente/psicologia , Cooperação do Paciente/estatística & dados numéricos , Qualidade de Vida/psicologia , Autocuidado/psicologia , Retenção Urinária/terapia , Seguimentos , Estudos Prospectivos , Cooperação do Paciente/psicologia , Inquéritos e Questionários/normasRESUMO
PURPOSE: To determine adherence rate and variables associate with patients' adherence to Clean Intermittent Self Catheterization (CISC). MATERIALS AND METHODS: Patients referred to CISC training program between July 2006 and May 2008, were prospectively evaluated with urodynamic, 3 days bladder diary (BD) and WHOQoL-brief questionnaire. After training to perform CISC, patients were evaluated at 2 weeks, monthly for 6 months and at 12 months with clinical visits and BD. Patients were considered adherent if they were performing at least 80% of the initial recommendation. RESULTS: Sixty patients (50.4 ± 19.9 years old) were trained to perform CISC (21 female and 39 male). Out of them, 30 (50%) had neurogenic and 30 (50%) had a non-neurogenic voiding dysfunction. The adherence rate at 6 and 12 months was 61.7%, 58%, respectively. Patients < 40 years old had adherence rate of 86%. Women and neurogenic patients had higher adherence rate than their counterparts (p = 0.024 and p = 0.016, respectively). In the WHOQoL-brief, patients that adhere to the program had a significant higher score on psychological and social relationships domains. There was not difference in pre and post training WHOQoL-brief scores. Educational background, marriage status, detrusor leak point pressure, Bladder Capacity, number of leakage episodes did not play a role on the adherence rate. CONCLUSION: Patients in CISC program present a reasonable adherence after one year. Women, neurogenic voiding dysfunction and patients under 40 years old were significantly more adherents. The psychological and social relationship status seems to positively interfere on adherence. CISC did not affect patient's QoL evaluated by WHOQoL-brief.