McClurg, Doreen, Bugge, Carol, Elders, Andrew, Irshad, Tasneem, Hagen, Suzanne, Moore, Katherine N, Buckley, Brian and Fader, Mandy (2019) Factors affecting continuation of clean intermittent catheterisation in people with multiple sclerosis: results of the COSMOS mixed-methods study. Multiple Sclerosis Journal, 25 (5), 727-739. (doi:10.1177/1352458518768722).
Abstract
BACKGROUND: Clean intermittent catheterisation (CIC) is often recommended for people with multiple sclerosis (MS).
OBJECTIVE: To determine the variables that affect continuation or discontinuation of the use of CIC.
METHODS: A three-part mixed-method study (prospective longitudinal cohort ( n = 56), longitudinal qualitative interviews ( n = 20) and retrospective survey ( n = 456)) was undertaken, which identified the variables that influenced CIC continuation/discontinuation. The potential explanatory variables investigated in each study were the individual's age, gender, social circumstances, number of urinary tract infections, bladder symptoms, presence of co-morbidity, stage of multiple sclerosis and years since diagnosis, as well as CIC teaching method and intensity.
RESULTS: For some people with MS the prospect of undertaking CIC is difficult and may take a period of time to accept before beginning the process of using CIC. Ongoing support from clinicians, support at home and a perceived improvement in symptoms such as nocturia were positive predictors of continuation. In many cases, the development of a urinary tract infection during the early stages of CIC use had a significant detrimental impact on continuation.
CONCLUSION: Procedures for reducing the incidence of urinary tract infection during the learning period (i.e. when being taught and becoming competent) should be considered, as well as the development of a tool to aid identification of a person's readiness to try CIC.
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Institute for Life Sciences > Institute for Life Sciences (pre 2018 reorg) - Current Faculties > Faculty of Environmental and Life Sciences > School of Health Sciences
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