title: Self-management intervention for long-term indwelling urinary catheter users: randomized clinical trial.
abstract: BACKGROUND
  People using long-term indwelling urinary catheters experience multiple recurrent catheter problems. Self-management approaches are needed to avoid catheter-related problems.
  
  
  OBJECTIVE
  The aim was to determine effectiveness of a self-management intervention in prevention of adverse outcomes (catheter-related urinary tract infection, blockage, and accidental dislodgement). Healthcare treatment associated with the adverse outcomes and catheter-related quality of life was also studied.
  
  
  METHODS
  A randomized clinical trial was conducted. The intervention involved learning catheter-related self-monitoring and self-management skills during home visits by a study nurse (twice during the first month and at 4 months-with a phone call at 2 months). The control group received usual care. Data were collected during an initial face-to-face home interview followed by bimonthly phone interviews. A total of 202 adult long-term urinary catheter users participated. Participants were randomized to treatment or control groups following collection of baseline data. Generalized estimating equations were used for the analysis of treatment effect.
  
  
  RESULTS
  In the intervention group, there was a significant decrease in reported blockage in the first 6 months (p = .02), but the effect did not persist. There were no significant effects for catheter-related urinary tract infection or dislodgment. Comparison of baseline rates of adverse outcomes with subsequent periods suggested that both groups improved over 12 months.
  
  
  CONCLUSIONS
  A simple-to-use catheter problems calendar and the bimonthly interviews might have functioned as a modest self-monitoring intervention for persons in both groups. A simplified intervention using a self-monitoring calendar is suggested-with optimal and consistent fluid intake likely to add value.
authors.affiliation: Mary H. Wilde, PhD, RN, is Associate Professor; and James M. McMahon, PhD, is Associate Professor, University of Rochester School of Nursing, New York. Margaret V. McDonald, MSW, is Associate Director of Research Studies, Center for Home Care Policy and Research, Visiting Nurse Service of New York. Wan Tang, PhD, is Research Associate Professor; and Wenjuan Wang, PhD, is Postdoctoral Fellow, Department of Biostatistics and Computational Biology, University of Rochester, New York. Judith Brasch, RN, MS, is Project Nurse; and Eileen Fairbanks, RN,MS, PNP, is Health Project Coordinator, University of Rochester School of Nursing, New York. Shivani Shah, MPH, is Research Analyst, Center for Home Care Policy and Research, Visiting Nurse Service of New York. Feng Zhang, RN, BS, is MS/PhD Student, University of Rochester School of Nursing, New York. Ding-Geng (Din) Chen, PhD, is Professor, University of Rochester School of Nursing and Department of Biostatistics and Computational Biology, University of Rochester, New York.
authors.forename: Mary H
authors.initials: MH
authors.lastname: Wilde
authors.forename: James M
authors.initials: JM
authors.lastname: McMahon
authors.forename: Margaret V
authors.initials: MV
authors.lastname: McDonald
authors.forename: Wan
authors.initials: W
authors.lastname: Tang
authors.forename: Wenjuan
authors.initials: W
authors.lastname: Wang
authors.forename: Judith
authors.initials: J
authors.lastname: Brasch
authors.forename: Eileen
authors.initials: E
authors.lastname: Fairbanks
authors.forename: Shivani
authors.initials: S
authors.lastname: Shah
authors.forename: Feng
authors.initials: F
authors.lastname: Zhang
authors.forename: Ding-Geng Din
authors.initials: DG
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D055499:Catheter-Related Infections / Q000517:prevention & control*; D002408:Catheters, Indwelling; D004868:Equipment Failure; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D011788:Quality of Life; D012648:Self Care; D016037:Single-Blind Method; D013997:Time Factors; D016896:Treatment Outcome; D014546:Urinary Catheterization; D062885:Urinary Catheters