Related Experiment Video
Updated: Jan 7, 2026
Author Spotlight: Repetitive Transcranial Magnetic Stimulation Combined with Movement Observation in Cerebral Palsy
Published on: August 9, 2024
Clean intermittent catheterization determinants and caregiver adherence in pediatric patients with spinal dysraphism
Azadeh Wickham1, Cynthia L Russell2, Steven R Chesnut2
1Children's Mercy Hospital, Division of Urology, 2401 Gillham Road, Kansas City, MO, 64108, USA.
Insights
Caregiver adherence to clean intermittent catheterization (CIC) in children with spinal dysraphism (SD) and spinal cord injury (SCI) is crucial. Factors like discreetness and psychological well-being significantly impact adherence rates.
Area of Science:
- Pediatric Urology
- Neuroscience
- Rehabilitation Medicine
Background:
- Clean intermittent catheterization (CIC) is standard for neurogenic lower urinary tract dysfunction (NLUTD) in children with spinal dysraphism (SD) and spinal cord injury (SCI).
- CIC protocols present significant burdens for caregivers, impacting adherence.
Purpose of the Study:
- To determine CIC adherence rates in children with SD and SCI.
- To examine the relationship between caregiver determinants and CIC adherence.
- To explore how personal experiences influence caregiver adherence to CIC.
Main Methods:
- Stratified sampling of adult caregivers for children with SD and SCI.
- Utilized the Clean Intermittent Catheterization Caregiver Questionnaire (CIC-cgQ) for determinants.
- Employed the Intermittent Catheterization Adherence Scale (ICAS) for adherence measurement.
- Conducted interviews to understand caregiver perceptions.
Main Results:
- A 65% non-adherence rate to CIC was observed among caregivers.
- Higher composite scores on the CIC-cgQ correlated significantly with increased adherence (r=0.604, p<0.01).
- Key determinants positively associated with adherence included ease of use, convenience, discreetness, and psychological well-being.
Conclusions:
- Significant caregiver non-adherence to CIC in pediatric SD and SCI populations.
- Discreetness and psychological well-being are critical determinants influencing adherence.
- Findings offer insights for improving CIC protocols and support for caregivers.
Introduction:
Clean intermittent catheterization (CIC) is the standard of care for treating neurogenic lower urinary tract dysfunction (NLUTD), the most common bladder dysfunction in children diagnosed with spinal dysraphism (SD) and spinal cord injury (SCI). However, CIC protocols are complex, imposing significant psychological, emotional, and financial burdens on caregivers.
Purpose:
The study aimed to describe the rate of CIC adherence levels in children with SD and SCI, examine the correlation between caregiver determinants of CIC and adherence levels to the CIC protocol, and explore how personal experiences with CIC influence caregivers' adherence behaviors.
Methods:
Stratified sampling was used to identify adult caregivers of a child diagnosed with SD and SCI. Clean Intermittent Catheterization Caregiver Questionnaire (CIC-cgQ) was used to measure CIC determinants. The Intermittent Catheterization Adherence Scale (ICAS) measured caregiver adherence levels to CIC protocol. Caregivers were interviewed to ascertain perceptions of determinants.
Results:
Sixty adult caregivers of children diagnosed with SD and SCI participated in the study. Adherence levels revealed that 21 (35 %) participants exhibited high CIC adherence, 16 (27 %) demonstrated average adherence, and 23 (38 %) displayed low adherence. A statistically significant positive association was observed between the Clean Intermittent Catheterization-Caregiver Questionnaire composite score and adherence levels (rs =0.604, p < 0.01, 95 % CI [0.39, 0.75]), indicating that higher determinant scores correlated with increased adherence. Furthermore, positive associations were identified between adherence levels and specific determinants: ease of use (rs =0.364, p < 0.01, 95 % CI [0.11, 0.57]), convenience (rs = 0.305, p < 0.01, 95 % CI [0.05, 0.53]), discreetness (rs = 0.374, p < 0.01, 95 % CI [0.12, 0.58]), and psychological well-being (rs = 0.643, p < 0.01, 95 % CI [0.48, 0.78]). The qualitative interviews highlighted three key themes: CIC treatment knowledge, support, and community resources.
Discussion:
This study identified a 65 % CIC non-adherence rate among caregivers of children with SD and SCI. It also found an association between caregiver CIC determinants and adherence levels, integrated with participants' experiences. Higher CIC composite scores correlated with higher adherence levels. Discreetness and psychological well-being were significant caregiver CIC determinants associated with adherence, further supported by caregiver experiences. Study limitations include the single clinical setting, which may limit generalizability, and potential self-report bias.
Conclusion:
The findings offer new insights into this vulnerable population, potentially impacting the future of research, practice, and policy, particularly regarding CIC determinants of discreetness and psychological well-being.
More Related Videos
09:57A Protocol to Set Up Needle-Free Connector with Positive Displacement on Central Venous Catheter in Intensive Care Unit
Published on: July 13, 2019
09:37Evaluation of Respiratory Muscle Activation Using Respiratory Motor Control Assessment RMCA in Individuals with Chronic Spinal Cord Injury
Published on: July 19, 2013
Related Concept Videos
01:27Parentral Nutrition: Centeral and Peripheral Parental Nutrition
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
01:29Endocarditis IV: Nursing Management