Intermittent self-catheterization service provision: perspectives of people with spinal cord injury

Intermittent self-catheterization (ISC) is a recommended treatment for people with a neuropathic bladder due to spinal injury. The majority of the literature to date has focused on the safety and the complication rates of ISC and use of different catheters. The aim of this paper explores the lived experience of people with spinal cord injury carrying ISC and the impact of service provision on rehabilitation. A qualitative approach was used based on grounded theory. Fifteen users (11 men and 4 women) of ISC took part in semi-structured interviews during 2009. Ages ranged from 24 to 68 years. The sample was recruited from the regional spinal unit. Thematic analysis was used to analyse the emergent themes. The results of the core theme, the patients' journey, related to the patients' perspectives of health service provision. Incontinence was the biggest problem to impact on quality of life. Successful bladder management was considered crucial to independence. The services provided by professionals in relation to ISC impacted on the rehabilitation process and patients' journey through the care system and independence. Service provision during acute rehabilitation was excellent; however, follow-up support was poor and failed to meet expectations. The findings of this study have potential to help professionals to identify factors in relation to the service provision important to spinal cord injured patients when learning and living with ISC. The information could be used to help those who may be resistant to ISC or have difficulty complying with the treatment and to aid with the teaching, advice giving and ongoing care.