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Facilitators and Barriers to Implementing Evidence-Based Clean Intermittent Catheterization After Radical

Lu Xing^1,2, Biru Luo^2,3, Yuqing Song^1,2

¹Department of Pelvic Floor Medicine Center Nursing, West China Second University Hospital, Sichuan University, Chengdu 610041, China.

Journal of Clinical Medicine

|July 15, 2026

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Implementing best evidence for clean intermittent catheterization (CIC) after radical hysterectomy (RH) faces barriers like healthcare provider competence and patient factors. Targeted strategies are needed for effective evidence translation in clinical practice.

Area of Science:

Oncology Nursing
Evidence-Based Practice
Urogynecology

Background:

Radical hysterectomy (RH) often necessitates clean intermittent catheterization (CIC) for postoperative urinary management.
Effective implementation of best evidence for CIC in RH patients is crucial for optimal outcomes.
Understanding facilitators and barriers is key to improving clinical practice.

Purpose of the Study:

To analyze perceived facilitators and barriers to the clinical application of best evidence for CIC in patients post-RH.
To identify factors influencing the adoption of evidence-based CIC practices in gynecological oncology care.

Main Methods:

Convergent parallel mixed-methods design involving patients, healthcare providers, and managers.
Quantitative data collection via questionnaires (156 providers, 300 patients).

Keywords:

barriers cervical cancer clean intermittent catheterization mixed-methods study radical hysterectomy

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Qualitative data collection through interviews (11 healthcare workers, 12 patients) analyzed via directed content analysis.

Main Results:

Evidence applicability and clinical need influenced implementation.
Healthcare provider competence, willingness, concerns, and awareness were key barriers, despite a positive attitude.
Patient-related factors were significant barriers, while a supportive environment and resources facilitated adoption.
Existing workflows impacted evidence uptake.

Conclusions:

Facilitators and barriers to CIC best evidence application in RH patients are complex and multifactorial.
Targeted interventions are essential for successful evidence translation into clinical practice.
Addressing provider, patient, and environmental factors is crucial for enhancing CIC care post-RH.