The temporal burden of preparing catheters for re-use in adults with spinal cord injury: a cross-sectional study.

IF 0.7 Q4 CLINICAL NEUROLOGY Spinal Cord Series and Cases Pub Date : 2023-08-01 DOI:10.1038/s41394-023-00596-0
T Miller, L J Roik, T Kalimullina, S Samejima, C Shackleton, R N Malik, R Sachdeva, A V Krassioukov
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Abstract

Study design: Cross-sectional OBJECTIVES: Neurogenic lower urinary tract dysfunction is common among people with spinal cord injury (SCI). Although single-use clean intermittent catheterization is recommended to facilitate routine bladder emptying, catheter re-use is common. Barriers associated with the preparation (i.e., cleaning) of catheters for re-use are unknown. This study examined barriers to catheter re-use in adult individuals with SCI by assessing (1) the time needed to clean a catheter, and (2) the perceived difficulty of the catheter cleaning routine.

Setting: Laboratory METHODS: Twenty individuals with chronic SCI ( ≥ 1 year since injury; Group 1 = 10 with tetraplegia; Group 2 = 10 with paraplegia) completed the study. Using a standardized cleaning procedure (i.e., Milton method), catheter cleaning was timed for each participant. Perceived difficulty was assessed using a 5-point Likert scale. Functional impairment was assessed with the Upper Extremity Motor Score (UEMS).

Results: Significant between-group differences were observed for total cleaning time (Group 1 = 1584.1 ± 179.8 s; Group 2 = 1321.0 ± 93.8 s, p = 0.004) and perceived difficulty [Group 1 = 2.6 (2, 3); Group 2 = 2 (1.7, 2.3), p = 0.028]. Total cleaning time was significantly correlated with UEMS (ρ = -0.709, p ≤ 0.001) and perceived difficulty (ρ = 0.468, p = 0.037). UEMS emerged as an independent predictor of total cleaning time (R2 = 0.745, β = -0.833, p ≤ 0.001).

Conclusions: Preparing catheters for re-use is time-intensive and difficult for people with higher SCI level, severity and more pronounced upper limb motor impairment, which was independently associated with total cleaning time. Performing this routine on a consistent basis would require a substantial time commitment and would have a profoundly negative impact on overall quality of life.

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成人脊髓损伤患者准备重复使用导管的时间负担:一项横断面研究。
研究设计:横断面 研究目的:神经源性下尿路功能障碍在脊髓损伤(SCI)患者中很常见。虽然建议使用一次性清洁间歇性导尿管来促进常规膀胱排空,但导尿管重复使用的情况很普遍。与导尿管重复使用的准备(即清洁)相关的障碍尚不清楚。本研究通过评估 (1) 清洁导尿管所需的时间,以及 (2) 对导尿管清洁工作难度的感知,对患有 SCI 的成人再次使用导尿管的障碍进行了研究:实验室 方法:20 名慢性 SCI 患者(受伤后≥ 1 年;第 1 组 = 10 名四肢瘫痪患者;第 2 组 = 10 名截瘫患者)完成了这项研究。采用标准化清洁程序(即米尔顿法),对每位参与者的导管清洁进行计时。采用 5 点李克特量表对感知难度进行评估。功能障碍用上肢运动评分(UEMS)进行评估:总清洁时间(第 1 组 = 1584.1 ± 179.8 秒;第 2 组 = 1321.0 ± 93.8 秒,p = 0.004)和感知难度[第 1 组 = 2.6 (2, 3);第 2 组 = 2 (1.7, 2.3),p = 0.028]在组间存在显著差异。总清洁时间与 UEMS(ρ = -0.709,p ≤ 0.001)和感知难度(ρ = 0.468,p = 0.037)明显相关。结论:UEMS 是总清洁时间的独立预测因子(R2 = 0.745,β = -0.833,p ≤ 0.001):对于 SCI 水平较高、严重程度较高、上肢运动障碍较明显的患者来说,准备导管以备再次使用既费时又费力,这与总清洁时间有独立关联。持续执行这一例行工作需要投入大量时间,并对整体生活质量产生深远的负面影响。
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来源期刊
Spinal Cord Series and Cases
Spinal Cord Series and Cases Medicine-Neurology (clinical)
CiteScore
2.20
自引率
8.30%
发文量
92
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