title: Intermittent catheterization difficulty questionnaire (ICDQ): A new tool for the evaluation of patient difficulties with clean intermittent self-catheterization.
abstract: OBJECTIVE
  Once a catheterization technique has been learned and acquired, psychological barriers have been overcome and a specific catheter has been selected, a patient will need to use clean intermittent self-catheterization (CISC) on a long-term basis. Over this long period of time, several technical or anatomical difficulties and local complications may be observed. The aim of this study was to construct and validate a specific test, referred to as the ICDQ (intermittent catheterization difficulty questionnaire), in order to evaluate and quantify patients' difficulties during CISC.
  
  
  METHODS
  The questionnaire was validated in neurogenic patients. Thirteen items were chosen, concerning ease of catheter insertion and withdrawal, the presence of pain, limb spasticity, urethral sphincter spasms, and local urethral bleeding during catheterization. The frequency and intensity of these difficulties were scored. The comprehension, relevance, psychological and time consumption acceptance and face validity were evaluated. Reliability (internal consistency and test-retest reliability using the Intraclass Correlation Coefficient [ICC]) was carried out.
  
  
  RESULTS
  The ICDQ was validated in 70 neurogenic patients (mean age 51.6 ± 13, 44 females, 26 males). Comprehension and acceptance of the questionnaire were good. Cronbach's alpha was α = 0.88. The ICC demonstrated good test-retest reliability.
  
  
  CONCLUSIONS
  The ICDQ is a valid test for the evaluation of catheter use, and of patients' difficulties during CISC. However, in order to facilitate CISC, we propose the interpretation of ICDQ results, drug combinations such as the use of alpha-blockers or botulinum toxin injections in the external urethral sphincter, or a change of catheter.
authors.affiliation: Service de Neuro-Urologie et Explorations Périnéales, Hôpital Tenon, APHP, GREEN (Group of clinical REsEarch in Neurourology, University Pierre and Marie Curie), Paris, France.
authors.forename: Amandine
authors.initials: A
authors.lastname: Guinet-Lacoste
authors.affiliation: Service de Neuro-Urologie et Explorations Périnéales, Hôpital Tenon, APHP, GREEN (Group of clinical REsEarch in Neurourology, University Pierre and Marie Curie), Paris, France.
authors.forename: Marylène
authors.initials: M
authors.lastname: Jousse
authors.affiliation: Service de Neuro-Urologie et Explorations Périnéales, Hôpital Tenon, APHP, GREEN (Group of clinical REsEarch in Neurourology, University Pierre and Marie Curie), Paris, France.
authors.forename: Eliane
authors.initials: E
authors.lastname: Tan
authors.affiliation: Service de Neuro-Urologie et Explorations Périnéales, Hôpital Tenon, APHP, GREEN (Group of clinical REsEarch in Neurourology, University Pierre and Marie Curie), Paris, France.
authors.forename: Murielle
authors.initials: M
authors.lastname: Caillebot
authors.affiliation: Service de Neuro-Urologie et Explorations Périnéales, Hôpital Tenon, APHP, GREEN (Group of clinical REsEarch in Neurourology, University Pierre and Marie Curie), Paris, France.
authors.forename: Frédérique
authors.initials: F
authors.lastname: Le Breton
authors.affiliation: Service de Neuro-Urologie et Explorations Périnéales, Hôpital Tenon, APHP, GREEN (Group of clinical REsEarch in Neurourology, University Pierre and Marie Curie), Paris, France.
authors.forename: Gérard
authors.identifier: http://orcid.org/0000-0002-2960-9931
authors.initials: G
authors.lastname: Amarenco
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D057928:Intermittent Urethral Catheterization / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D015203:Reproducibility of Results; D012648:Self Care / Q000009:adverse effects*; D011795:Surveys and Questionnaires; D001750:Urinary Bladder, Neurogenic / Q000503:physiopathology*
keywords: clean intermittent self-catheterization; complications; difficulty; neurogenic bladder; patient reported outcome; questionnaire