A qualitative study exploring the experiences and emotional responses of female community continence link workers and female patients in relation to performing clean intermittent self-catheterisation

摘要

Aim: This paper represents a report of a study designed to explore the experiences of female community continenceudlink nurses in relation to female catheterisation and their psychological and educational preparedness to teach it. The lived experiences and emotional responses of female patients learning to perform Clean Intermittent Self-Catheterisation (CISC) are also examined.udBackground: There is general consensus that CISC should be considered in preference to indwelling catheterisationudwherever feasible. Published literature has tended to focus on quality of life issues and technical and physicaludaspects. There has been less investigation into patients’ initial perceptions of CISC, and into their subsequentudexperiences of learning the technique. There has also been minimal investigation into how community continence link nurses feel about female CISC and into their perceived ability to teach it.udDesign: This qualitative study used a phenomenological research design.udMethod: A series of semi-structured, in-depth interviews were held with a self-selected sample of female continenceudlink nurses and adult female patients performing CISC aged 34-64 years. Interviews were tape recordedudand transcribed verbatim. Data were analysed using the ‘Framework’ method and recurrent themes identified.udResults: The lived experiences of nurses in relation to the catheterisation of female patients were categorizedudinto themes: the nurses’ emotional responses, their own and others’ coping mechanisms, visualisation of the femaleudurethra, the approach adopted by their mentor and their knowledge deficit around CISC. Six recurrent themes were also identified from the patient sample: grief and loss, lack of knowledge (regarding female anatomy, bladder dysfunction and catheters), negative associations and stigma, psychological aversion and embarrassment, nursing approaches and coping mechanisms.udConclusion: Nurse recognised that although they felt competent in providing sensitive, individualised care forudpatients requiring in-dwelling catheterisation, they lacked the underpinning skills and knowledge to enable themudto assess patients and feel confident in teaching CISC. Explicit recognition of their own and others’ psychological coping mechanisms promotes an individualised approach which translates into an enhanced experience for the patient.udFor the patients, loss of normal bladder function may represent a devastating event, and trigger emotional responsesudassociated with grief and loss. Patients may experience a range of reactions whilst learning CISC, includingudembarrassment and aversion, which may not dissipate over time. However, psychological distress is notudinevitable, and varies enormously between individuals. The nursing approach is vital, as individualised, empathicudcare is recognised and valued.