Psychological factors and intermittent self-catheterisation
This article explores the factors less widely discussed in research that relate to the psychological aspects of those who may be eligible for or using intermittent self-catheterisation (ISC). Guidance indicates that cognition and ability to consent should be considered, and research indicates that a person is more likely to cope with ISC if they exhibit resilience and other positive attributes; further, a person's quality of life (QoL) is impacted by factors, such as social isolation, which need to be considered. This article takes an in-depth look at the available information on these factors.
Intermittent self-catheterisation (ISC) is considered a highly effective way to manage urinary incontinence issues, and, as stated by the National Institute for Health and Care Excellence (NICE) (2015), it is considered the gold standard for urine drainage.
ISC is mostly used for voiding problems that result from disturbances or injury to the nervous system, non-neurogenic bladder dysfunction or intravesical obstruction with incomplete bladder emptying. In a hospital, ISC is often used for diagnostic evaluation, for example, in order to obtain a sample or to facilitate urodynamics (NICE, 2015). Before starting a patient on ISC, their symptom severity profile, renal function, risk assessment, psychological and physical ability to perform ISC and residual urine status should be considered (NICE, 2015). The patient should not be initiated on ISC based solely on the residual urine status. ISC is preferred to an indwelling urethral or suprapubic catheter for patients who have a bladder emptying dysfunction or spinal cord injury. It is a preferable way to facilitate the voiding of urine, as it helps to prevent infection. The patient can regularly void the bladder in a clean way without a device remaining indwelling, where the possibility of bladder infection increases.
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