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

Ramm, Dianne and Kane, Ros (2011) 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. In: 5th UDINE-C International Scientific Conference: Developing a focus for nursing through better understanding and implementation of safety, productivity and quality improvement, 25-27 May 2011, Belgrade, Serbia.

Proceedings of conference: this paper at pages 52-57
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Item Type:Conference or Workshop contribution (Paper)
Item Status:Live Archive


Aim: This paper represents a report of a study designed to explore the experiences of female community continence
link 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.
Background: There is general consensus that CISC should be considered in preference to indwelling catheterisation
wherever feasible. Published literature has tended to focus on quality of life issues and technical and physical
aspects. There has been less investigation into patients’ initial perceptions of CISC, and into their subsequent
experiences 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.
Design: This qualitative study used a phenomenological research design.
Method: A series of semi-structured, in-depth interviews were held with a self-selected sample of female continence
link nurses and adult female patients performing CISC aged 34-64 years. Interviews were tape recorded
and transcribed verbatim. Data were analysed using the ‘Framework’ method and recurrent themes identified.
Results: The lived experiences of nurses in relation to the catheterisation of female patients were categorized
into themes: the nurses’ emotional responses, their own and others’ coping mechanisms, visualisation of the female
urethra, 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.
Conclusion: Nurse recognised that although they felt competent in providing sensitive, individualised care for
patients requiring in-dwelling catheterisation, they lacked the underpinning skills and knowledge to enable them
to 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.
For the patients, loss of normal bladder function may represent a devastating event, and trigger emotional responses
associated with grief and loss. Patients may experience a range of reactions whilst learning CISC, including
embarrassment and aversion, which may not dissipate over time. However, psychological distress is not
inevitable, and varies enormously between individuals. The nursing approach is vital, as individualised, empathic
care is recognised and valued.

Keywords:female catheterisation, clean intermittent self-catheterisation, CISC, phenomenology, incontinence, bladder dysfunction
Subjects:B Subjects allied to Medicine > B710 Community Nursing
B Subjects allied to Medicine > B700 Nursing
Divisions:College of Social Science > School of Health & Social Care
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ID Code:13619
Deposited On:26 Mar 2014 15:10

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