Effectiveness of Nurse-Led-Intervention on Quality-of-Life Among Patients With Long-Term Indwelling Urinary Catheter

Abstract

Long-term indwelling urinary catheters can lead to various health problems among patients resulting in impaired quality of life. Nurses are vital in providing access to resources, education, and support services, such as catheter care training, family support groups, and psychological counselling. They can empower patients with long-term indwelling urinary catheters to manage their condition effectively and enhance their quality of life. The objective of the study was to develop and implement booklet-based nurse-led intervention on patients with long-term indwelling urinary catheters and to assess the effectiveness of the urinary catheter care package (UCCP) on catheter care practices among caregivers and quality of life among patients. A randomised controlled trial was conducted at a tertiary care centre in Northern India. After obtaining informed consent from each participant, a total enumeration sampling technique was used for sampling ensuring the inclusion of all eligible participants followed by computer-generated day-wise randomization. Fifty participants (patient and caregiver dyad) in each group were selected. Participants in the intervention group were given booklet-based nurse-led intervention while standard care was given to participants in the control group. Data were collected using a validated semi-structured interview schedule consisting of (a) a socio-demographic profile of patients and their caregivers, (b) a clinical profile of patients, (c) an ICIQ-LTCQOL (Quality of life questionnaire) to assess the quality of life among patients, and (d) observation checklist to assess catheter care practices among caregivers. Statistical analysis was done using SPSS version 22.0 employing descriptive and inferential methods. The mean age of patients was 54.88 ± 20.14 years and 53.56 ± 18.93 years in the control and intervention group, respectively. Majority of patients were male, with 86.0% in the control group vs. 80.0% in the intervention group (p = 0.424). Majority of patients had urine retention as a chief complaint for long-term placement of indwelling urinary catheter in both the control group and intervention group, that is, 76.0% and 60.0%, respectively (p = 0.086). At follow up, the mean catheter function and concern score was 19.44 ± 3.45 in the control group vs. 10.17 ± 2.08 in the intervention group (p < 0.001). At follow up, the mean lifestyle impact score was 11.19 ± 2.36 in the control group vs. 8.30 ± 3.79 in the intervention group (p = < 0.001). Mean pain, discomfort and soreness score was 1.47 ± 0.65 in the control and 0.67 ± 0.59 in the intervention group at follow-up (p = 0.001). There was significant decrement in the mean catheter function and concern score, mean lifestyle impact score, and mean pain, discomfort and soreness score among the intervention group as compared to the control group at follow up (p = < 0.001). At follow up, the mean overall QoL score was 33.53 ± 5.04 in control and 19.73 ± 3.98 in the intervention group. There was significant improvement in overall QoL among the intervention group as compared to the control group at follow-up (p = < 0.001). At follow-up, the mean urinary catheter care practices score among caregivers was 5.06 ± 3.02 in control and 14.28 ± 1.09 in the intervention group. There was a significant improvement in the mean practice score among the intervention group as compared to the control group at follow up (p < 0.001). The study has shown that Booklet-based Nurse-led intervention significantly improved catheter care practices among caregivers and quality of life among patients with long-term indwelling urinary catheters.