title: Pencil and paper test: a new tool to predict the ability of neurological patients to practice clean intermittent self-catheterization.
abstract: OBJECTIVE
  We created and validated the new pencil and paper test, which allows assessment of the ability of patients with a neurological disorder to practice clean intermittent self-catheterization.
  
  
  METHODS
  We developed a simple test including common gestures mimicking the usual maneuvers needed during clean intermittent self-catheterization, and involving the same cognitive and physical resources needed for this technique. We evaluated the test in 118 patients with a neurological condition. Instruments needed to perform the pencil and paper test are limited to a sheet of paper and a pencil. Each test item was quantified and graded with a total score of 15. A specific clean intermittent catheterization learning scale was used to classify the outcome of the ability to perform clean intermittent self-catheterization with a score range of 5--learning easy and self-catheterization complete to 0--learning impossible.
  
  
  RESULTS
  Enrolled in the study were 118 patients with a neurological condition. There was strong correlation between the global pencil and paper test score, and the ability to perform clean intermittent self-catheterization, as evaluated by the learning scale (r = 0.82, p = 0.000091). At a test cutoff of 10 and a clean intermittent self-catheterization cutoff of 3, which was the limit needed to practice self-catheterization alone, the positive predictive value of the pencil and paper test was 85% and its negative predictive value was 94% (Cronbach's α = 0.88).
  
  
  CONCLUSIONS
  The pencil and paper test is a valid way to predict the ability to practice clean intermittent self-catheterization in patients with a neurological disorder.
authors.affiliation: Service de Neuro-Urologie et d’Explorations Périnéales, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Er 6, Université Pierre et Marie Curie, Paris, France. gerard.amarenco@tnn.aphp.fr
authors.forename: Gerard
authors.initials: G
authors.lastname: Amarenco
authors.forename: Amandine
authors.initials: A
authors.lastname: Guinet
authors.forename: Marylene
authors.initials: M
authors.lastname: Jousse
authors.forename: Delphine
authors.initials: D
authors.lastname: Verollet
authors.forename: Samer Sheikh
authors.initials: SS
authors.lastname: Ismael
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D003950:Diagnostic Techniques, Urological; D004521:Educational Measurement / Q000379:methods; D005260:Female; D006801:Humans; D057928:Intermittent Urethral Catheterization / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000150:complications / Q000175:diagnosis; D015588:Observer Variation; D010353:Patient Education as Topic / Q000592:standards*; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012648:Self Care / Q000379:methods*; D012737:Sex Factors; D013647:Task Performance and Analysis; D001750:Urinary Bladder, Neurogenic / Q000150:complications / Q000628:therapy*