Is reducing the early postoperative complications of percutaneous suprapubic catheterization affected by the method of healthcare education in low-literacy patients? A prospective randomized comparative study.

Abstract

Background: Suprapubic catheters (SPCs) are associated with a wide spectrum of undesirable symptoms and complications, ranging from skin overgranulation to septicemia. They can be effectively managed through various medical and healthcare interventions. We compared the impact of illustrated brochure healthcare education (IBHE) and verbal-only healthcare education (VOHE) on early postoperative complications of SPC in patients with low literacy levels.

Materials and methods: Eighty patients with low literacy levels who underwent SPC insertion were randomly allocated to receive either IBHE or VOHE between January 2019 and June 2020. Variables, including postoperative complications (within 30 days), were compared. This study was approved by our institutional review board (IRB number: 1780011/2019).

Results: The IBHE and VOHE groups included 40 patients each. The mean age ± standard deviation was 52.75 ± 16.46 and 53.25 ± 17.19 years, respectively. Acute urinary retention was the main presenting symptom (36 [90%] vs. 34 [85%]), and benign prostatic hyperplasia was the main underlying pathology (16 [40%] vs. 15 [37.5%]). The incidence of SPC obstruction (p = 0.000), urine leakage (p = 0.006), falling out (p = 0.003), suprapubic pain (p = 0.012), exit skin manifestations (p = 0.000), bleeding (p = 0.041), change (p = 0.003), and hematuria (p = 0.000) was significantly lower in IBHE than in VOHE. However, catheter-associated bladder discomfort (p = 0.247), bacteriuria (p = 0.154), and gross pyuria (p = 0.625) were not significantly different between the groups. The frequency of Clavien-Dindo grades was significantly higher in the VOHE group than in the IBHE group. Grade I (87.5% vs. 67.5%, p = 0.032) and grade IIIa (2.5% vs. 22.5%, p = 0.007) were significantly more frequent in the highest grade in IBHE and VOHE groups, respectively.

Conclusions: Illustrated brochure healthcare education appears to be a suitable and effective method for educating low-literacy patients undergoing SPC insertion. It significantly reduced the incidence and grade of early postoperative SPC complications compared with VOHE, except for catheter-associated bladder discomfort, bacteriuria, and gross pyuria.