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Published on: June 24, 2025
Self-management intervention for long-term indwelling urinary catheter users: randomized clinical trial
Mary H Wilde1, James M McMahon, Margaret V McDonald
1Mary 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.
A self-management intervention showed a temporary reduction in urinary catheter blockages but did not significantly prevent infections or dislodgments. Both groups improved over time, suggesting self-monitoring may benefit catheter users.
Area of Science:
- Urology
- Nursing Research
- Patient Self-Management
Background:
- Long-term indwelling urinary catheter use is associated with recurrent catheter-related problems.
- Effective self-management strategies are crucial for preventing these adverse outcomes.
- Urinary tract infections, blockages, and accidental dislodgements are common issues.
Purpose of the Study:
- To evaluate the effectiveness of a self-management intervention for preventing adverse outcomes in long-term urinary catheter users.
- To assess the impact of the intervention on healthcare utilization and quality of life.
- To identify potential benefits of self-monitoring skills for catheter management.
Main Methods:
- A randomized clinical trial involving 202 adult long-term urinary catheter users.
- Intervention group received training in self-monitoring and self-management skills with home visits and phone support.
- Control group received usual care; data collected via interviews and analyzed using generalized estimating equations.
Main Results:
- A significant decrease in catheter blockage was observed in the intervention group within the first 6 months (p = .02), but this effect was not sustained.
- No significant differences were found between groups for catheter-related urinary tract infections or accidental dislodgements.
- Both intervention and control groups demonstrated improvement in adverse outcome rates over the 12-month study period.
Conclusions:
- A simple self-monitoring calendar and regular interviews may offer modest benefits for catheter users.
- Further research into simplified self-management interventions, potentially incorporating optimal fluid intake, is warranted.
- The study highlights the need for sustained and effective self-management support for individuals with long-term urinary catheters.
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