title: A qualitative descriptive study of self-management issues in people with long-term intermittent urinary catheters.
abstract: OBJECTIVE
  The study was to identify and describe issues of intermittent urinary catheter users for future self-management research and/or training programmes.
  
  
  BACKGROUND
  Limited studies were found of how people using clean intermittent catheterization manage their daily routines or troubleshoot problems. Self-management research related to intermittent catheterization could lead to improved compliance with the method and better quality of life.
  
  
  METHODS
  This qualitative descriptive study involved in-depth tape-recorded telephone interviews in 2008-2009 with 34 people in the United States of America using permanent intermittent catheterization, mostly individuals with spinal cord injury or multiple sclerosis. Recruitment was through Internet sites where individuals could link to the study website and then contact the researchers. The sample included 13 men and 21 women aged 21-72 years (mean 42 years). Content analysis for qualitative data involved iterative comparisons of transcripts, summaries and memos. Coding, key quotes and tables were developed to determine themes.
  
  
  RESULTS
  Six major themes were identified: Knowing the Body, Practising Intermittent Catheterization, Limited Options in Catheters and Equipment, Inaccessible Bathrooms, Hassles, and Adjustment in Making Intermittent Catheterization a Part of Life. While some persons had choices in catheters, many did not because of insurance constraints. Some individuals developed knowledge of how to balance the procedure with fluid intake and activities.
  
  
  CONCLUSIONS
  The lack of acceptable bathrooms can interfere with being able to go to work, travel or be with friends and family. All using intermittent catheterization should have adequate insurance coverage when this is needed. Research into training programmes could incorporate knowledge of experienced users.
authors.affiliation: School of Nursing, University of Rochester, New York, USA. mary_wilde@urmc.rochester.edu
authors.forename: Mary H
authors.initials: MH
authors.lastname: Wilde
authors.forename: Judith
authors.initials: J
authors.lastname: Brasch
authors.forename: Yi
authors.initials: Y
authors.lastname: Zhang
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D055499:Catheter-Related Infections / Q000453:epidemiology / Q000517:prevention & control; D057785:Catheters / Q000009:adverse effects / Q000191:economics; D005260:Female; D006801:Humans; D019458:Insurance Coverage; D057928:Intermittent Urethral Catheterization / Q000009:adverse effects / Q000379:methods / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010353:Patient Education as Topic; D036301:Qualitative Research; D011788:Quality of Life; D012648:Self Care / Q000379:methods / Q000523:psychology*; D057545:Social Stigma; D013119:Spinal Cord Injuries / Q000451:nursing; D013997:Time Factors; D014038:Toilet Facilities / Q000592:standards; D016055:Urinary Retention / Q000628:therapy*; D055815:Young Adult