title: Perceived barriers and difficulties of intermittent catheterization: In Korean patients with spinal dysraphism and their parents.
abstract: OBJECTIVE
  Integrating regular intermittent catheterization (IC) into daily life is essential for good medical outcomes in patients with neurogenic bladders. The goal is to identify long-term IC-related barriers, or difficulties in Korean patients with spinal dysraphism and their parents.
  
  
  METHODS
  The data were prospectively collected using questionnaires from spinal dysraphism patients from two sources: an online community, and those visiting the outpatient clinic of Seoul National university hospital. The questions included were barriers in general and school life, respectively. Also, an open question was included regarding suggestions for school managers or the government in order to overcome identified IC related difficulties.
  
  
  RESULTS
  A total of 20 patients and 40 parents answered the questionnaire. Common barriers found in general life were related to lack of places, time, or helpers to perform IC. Substantial numbers of adolescent patients also complained that IC could not be adequately performed due to problems related to privacy or lack of understanding at school. However, the number and nature of barriers varied according to the developmental stage and school environments. Almost all IC barriers seemed to be significant in adolescence. Some parents requested that the government provide space and broaden insurance coverage of catheters in order to facilitate IC.
  
  
  CONCLUSIONS
  Various perceived barriers were identified in those who need IC and differences were demonstrated over time. Both dedicated space and time are issues. In addition, patients may benefit from emotional support and enhanced communication with community agencies and government to resolve the problems related with privacy.
authors.affiliation: Department of Nursing, Seoul National University Hospital, Seoul, South Korea.
authors.forename: Seoung-Wha
authors.initials: SW
authors.lastname: Lim
authors.affiliation: Department of Urology, Gachon University Gil Hospital, Incheon, South Korea.
authors.forename: Hahn-Ey
authors.initials: HE
authors.lastname: Lee
authors.affiliation: Division of Urology, Children's Hospital of Philadelphia, Pennsylvania.
authors.forename: Monica
authors.initials: M
authors.lastname: Davis
authors.affiliation: Department of Urology, Seoul National University Hospital, Seoul, South Korea.
authors.forename: Kwanjin
authors.initials: K
authors.lastname: Park
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D002648:Child; D002652:Child Behavior; D002675:Child, Preschool; D005260:Female; D015438:Health Behavior; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D057928:Intermittent Urethral Catheterization / Q000009:adverse effects / Q000523:psychology; D008297:Male; D010290:Parents / Q000523:psychology*; D010349:Patient Compliance; D010361:Patients / Q000523:psychology*; D010465:Perception; D011446:Prospective Studies; D056910:Republic of Korea; D012574:Schools; D016135:Spinal Dysraphism / Q000150:complications* / Q000175:diagnosis / Q000523:psychology; D016896:Treatment Outcome; D001750:Urinary Bladder, Neurogenic / Q000175:diagnosis / Q000209:etiology / Q000523:psychology / Q000628:therapy*; D055815:Young Adult
keywords: intermittent urethral catheterization; neurogenic; patient compliance; spinal dysraphism; urinary bladder