The temporal burden of preparing catheters for re-use in adults with spinal cord injury: a cross-sectional study

T. Miller; L. J. Roik; T. Kalimullina; S. Samejima; C. Shackleton; R. N. Malik; R. Sachdeva; A. V. Krassioukov

doi:10.1038/s41394-023-00596-0

The temporal burden of preparing catheters for re-use in adults with spinal cord injury: a cross-sectional study

T. Miller
, L. J. Roik
, T. Kalimullina
, S. Samejima
, C. Shackleton
, R. N. Malik
, R. Sachdeva
, A. V. Krassioukov

Rehabilitation Medicine

Producción científica: Article › revisión exhaustiva

3 Citas (Scopus)

Resumen

Study design: Cross-sectional Objectives: Neurogenic lower urinary tract dysfunction is common among people with spinal cord injury (SCI). Although single-use clean intermittent catheterization is recommended to facilitate routine bladder emptying, catheter re-use is common. Barriers associated with the preparation (i.e., cleaning) of catheters for re-use are unknown. This study examined barriers to catheter re-use in adult individuals with SCI by assessing (1) the time needed to clean a catheter, and (2) the perceived difficulty of the catheter cleaning routine. Setting: Laboratory Methods: Twenty individuals with chronic SCI (≥ 1 year since injury; Group 1 = 10 with tetraplegia; Group 2 = 10 with paraplegia) completed the study. Using a standardized cleaning procedure (i.e., Milton method), catheter cleaning was timed for each participant. Perceived difficulty was assessed using a 5-point Likert scale. Functional impairment was assessed with the Upper Extremity Motor Score (UEMS). Results: Significant between-group differences were observed for total cleaning time (Group 1 = 1584.1 ± 179.8 s; Group 2 = 1321.0 ± 93.8 s, p = 0.004) and perceived difficulty [Group 1 = 2.6 (2, 3); Group 2 = 2 (1.7, 2.3), p = 0.028]. Total cleaning time was significantly correlated with UEMS (ρ = −0.709, p ≤ 0.001) and perceived difficulty (ρ = 0.468, p = 0.037). UEMS emerged as an independent predictor of total cleaning time (R ² = 0.745, β = −0.833, p ≤ 0.001). Conclusions: Preparing catheters for re-use is time-intensive and difficult for people with higher SCI level, severity and more pronounced upper limb motor impairment, which was independently associated with total cleaning time. Performing this routine on a consistent basis would require a substantial time commitment and would have a profoundly negative impact on overall quality of life.

Idioma original	English
Número de artículo	39
Publicación	Spinal cord series and cases
Volumen	9
N.º	1
DOI	https://doi.org/10.1038/s41394-023-00596-0
Estado	Published - dic 2023

Nota bibliográfica

Publisher Copyright:
© 2023, The Author(s), under exclusive licence to International Spinal Cord Society.

Financiación

FundingTM is supported by a Michael Smith Health Research BC postdoctoral fellowship and the Rick Hansen Foundation (RHF). TK is supported by a Canada Graduate Scholarship (Master’s) through the Canadian Institutes for Health Research (CIHR) and a WorkSafeBC research trainee award. SS is supported by a Paralyzed Veterans of America (PVA) postdoctoral fellowship, the RHF and the Wings for Life Spinal Cord Research Foundation (WFLSCRF). CS is supported by a PVA postdoctoral fellowship, a CIHR postdoctoral fellowship and the RHF. RM is supported by a PVA postdoctoral fellowship and the RHF. RS is supported by the WFLSCRF and the US Department of Defense. AVK is the Endowed Chair in the Division of Physical Medicine and Rehabilitation within the Faculty of Medicine at the University of British Columbia. This study was supported by a grant from Coloplast A/S, Humlebæk, Denmark (grant number: COLO-AK-NLUTD-SCI: F18-03036, AVK – Principle investigator). The funder had no role in the collection or interpretation of data nor the decision to publish with this journal.

Financiadores	Número del financiador
Coloplast A/S, Humlebæk, Denmark	F18-03036
U.S. Department of Defense
Paralyzed Veterans of America
Wings for Life Spinal Cord Research Foundation
Rick Hansen Foundation
Canadian Institutes of Health Research
Michael Smith Foundation for Health Research

ASJC Scopus subject areas

Neurology
Clinical Neurology

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title = "The temporal burden of preparing catheters for re-use in adults with spinal cord injury: a cross-sectional study",

abstract = "Study design: Cross-sectional Objectives: Neurogenic lower urinary tract dysfunction is common among people with spinal cord injury (SCI). Although single-use clean intermittent catheterization is recommended to facilitate routine bladder emptying, catheter re-use is common. Barriers associated with the preparation (i.e., cleaning) of catheters for re-use are unknown. This study examined barriers to catheter re-use in adult individuals with SCI by assessing (1) the time needed to clean a catheter, and (2) the perceived difficulty of the catheter cleaning routine. Setting: Laboratory Methods: Twenty individuals with chronic SCI (≥ 1 year since injury; Group 1 = 10 with tetraplegia; Group 2 = 10 with paraplegia) completed the study. Using a standardized cleaning procedure (i.e., Milton method), catheter cleaning was timed for each participant. Perceived difficulty was assessed using a 5-point Likert scale. Functional impairment was assessed with the Upper Extremity Motor Score (UEMS). Results: Significant between-group differences were observed for total cleaning time (Group 1 = 1584.1 ± 179.8 s; Group 2 = 1321.0 ± 93.8 s, p = 0.004) and perceived difficulty [Group 1 = 2.6 (2, 3); Group 2 = 2 (1.7, 2.3), p = 0.028]. Total cleaning time was significantly correlated with UEMS (ρ = −0.709, p ≤ 0.001) and perceived difficulty (ρ = 0.468, p = 0.037). UEMS emerged as an independent predictor of total cleaning time (R 2 = 0.745, β = −0.833, p ≤ 0.001). Conclusions: Preparing catheters for re-use is time-intensive and difficult for people with higher SCI level, severity and more pronounced upper limb motor impairment, which was independently associated with total cleaning time. Performing this routine on a consistent basis would require a substantial time commitment and would have a profoundly negative impact on overall quality of life.",

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AU - Miller, T.

AU - Roik, L. J.

AU - Kalimullina, T.

AU - Samejima, S.

AU - Shackleton, C.

AU - Malik, R. N.

AU - Sachdeva, R.

AU - Krassioukov, A. V.

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N2 - Study design: Cross-sectional Objectives: Neurogenic lower urinary tract dysfunction is common among people with spinal cord injury (SCI). Although single-use clean intermittent catheterization is recommended to facilitate routine bladder emptying, catheter re-use is common. Barriers associated with the preparation (i.e., cleaning) of catheters for re-use are unknown. This study examined barriers to catheter re-use in adult individuals with SCI by assessing (1) the time needed to clean a catheter, and (2) the perceived difficulty of the catheter cleaning routine. Setting: Laboratory Methods: Twenty individuals with chronic SCI (≥ 1 year since injury; Group 1 = 10 with tetraplegia; Group 2 = 10 with paraplegia) completed the study. Using a standardized cleaning procedure (i.e., Milton method), catheter cleaning was timed for each participant. Perceived difficulty was assessed using a 5-point Likert scale. Functional impairment was assessed with the Upper Extremity Motor Score (UEMS). Results: Significant between-group differences were observed for total cleaning time (Group 1 = 1584.1 ± 179.8 s; Group 2 = 1321.0 ± 93.8 s, p = 0.004) and perceived difficulty [Group 1 = 2.6 (2, 3); Group 2 = 2 (1.7, 2.3), p = 0.028]. Total cleaning time was significantly correlated with UEMS (ρ = −0.709, p ≤ 0.001) and perceived difficulty (ρ = 0.468, p = 0.037). UEMS emerged as an independent predictor of total cleaning time (R 2 = 0.745, β = −0.833, p ≤ 0.001). Conclusions: Preparing catheters for re-use is time-intensive and difficult for people with higher SCI level, severity and more pronounced upper limb motor impairment, which was independently associated with total cleaning time. Performing this routine on a consistent basis would require a substantial time commitment and would have a profoundly negative impact on overall quality of life.

AB - Study design: Cross-sectional Objectives: Neurogenic lower urinary tract dysfunction is common among people with spinal cord injury (SCI). Although single-use clean intermittent catheterization is recommended to facilitate routine bladder emptying, catheter re-use is common. Barriers associated with the preparation (i.e., cleaning) of catheters for re-use are unknown. This study examined barriers to catheter re-use in adult individuals with SCI by assessing (1) the time needed to clean a catheter, and (2) the perceived difficulty of the catheter cleaning routine. Setting: Laboratory Methods: Twenty individuals with chronic SCI (≥ 1 year since injury; Group 1 = 10 with tetraplegia; Group 2 = 10 with paraplegia) completed the study. Using a standardized cleaning procedure (i.e., Milton method), catheter cleaning was timed for each participant. Perceived difficulty was assessed using a 5-point Likert scale. Functional impairment was assessed with the Upper Extremity Motor Score (UEMS). Results: Significant between-group differences were observed for total cleaning time (Group 1 = 1584.1 ± 179.8 s; Group 2 = 1321.0 ± 93.8 s, p = 0.004) and perceived difficulty [Group 1 = 2.6 (2, 3); Group 2 = 2 (1.7, 2.3), p = 0.028]. Total cleaning time was significantly correlated with UEMS (ρ = −0.709, p ≤ 0.001) and perceived difficulty (ρ = 0.468, p = 0.037). UEMS emerged as an independent predictor of total cleaning time (R 2 = 0.745, β = −0.833, p ≤ 0.001). Conclusions: Preparing catheters for re-use is time-intensive and difficult for people with higher SCI level, severity and more pronounced upper limb motor impairment, which was independently associated with total cleaning time. Performing this routine on a consistent basis would require a substantial time commitment and would have a profoundly negative impact on overall quality of life.

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The temporal burden of preparing catheters for re-use in adults with spinal cord injury: a cross-sectional study

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ASJC Scopus subject areas

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