Teaching children clean intermittent self-catheterization (CISC) in a group setting

To teach children to perform clean intermittent self-catheterization (CISC) at our institution, the nurse practitioner uses a step-by-step approach in combination with an instruction model in an outpatient setting. For a small group of children the procedure remains difficult to learn. For them, we developed a multidisciplinary, group-wise training program.

Small groups of children, aged 7-12 years, and their parents consulted our clinic during six meetings. The group training was provided by a pediatric urology nurse practitioner, physiotherapist and behavioural practitioner. Using a tell/show/do method each intervention was instructed group wise. The actual CISC was performed individually within a private setting. Elements of the training were: sharing of mastery and difficulties with other children/parents, cognitive restructuring to enhance understanding and motivation, handling and trying out of devices, relaxation as a response to physical stress, and supporting parental guidance.

The preliminary results of seven children were successful after group-wise intervention. Children were less anxious and more cooperative. Parents could share their difficulties dealing with their child at home and were given suggestions to help their children with CISC.

Group interactions and a multidisciplinary approach seems to be of great help in learning CISC for selected children.