21 or any other problems. A teacher’s knowledge of self-catheterisation is likely to be limited; therefore, it is important for teachers to understand what self-catheterisation involves.37 It is also important to ensure that arrangements are made for suitable and discrete storage of catheters at school and outside of the home. School/respite carers, etc., may need a comprehensive training programme if they are performing CIC in school to ensure competence and for insurance purposes if they are performing the catheterisation for the child. Healthcare professionals need to be aware when developing catheterisation routines with children and their families that this may impact the whole family, with parents reporting having less time to spend with their other children.24 A study of children with myelomeningocele showed that sex, age and IQ were not factors associated with successful independent catheterisation but that the length of time needed to complete the toilet activity was significant.39 It is therefore important to consider the time the procedure takes and keep it as quick and simple as possible whilst still being safe. A medical travel document/letter can be helpful when travelling abroad, particularly for customs employees (example in Appendix I). This should provide information regarding the products the patient is carrying with them, as well as details of the healthcare provider should there be any queries. Some catheter companies produce travel cards containing information in a variety of languages, and individual patients’ information can be added in. 4.3.7 Promoting Compliance The potential complications and difficulties previously mentioned all influence compliance, especially during puberty and early adolescence. Good communication, support and positive attitudes from healthcare professionals can help patients overcome resistance.21,27,31 Poor compliance is also shown to be associated with a higher incidence of UTI and Epididymitis. Compliance may be improved by providing information and contacts with patient support organisations and/or peer counsellors. Motivational interviewing and group therapy interventions may also be useful. Patients should be made aware of these possibilities and of relevant patient organisations, websites and booklets. Start catheterisation during infancy for children who may need CIC in later life, e.g. children with neurogenic bladder, bladder exstrophy, boys with severe epispadias with absent bladder neck and girls with epispadias. This can be done twice a day during the first few years, and frequency increases when surgery is considered. This improves compliance and reduces oppositional behaviours. 4.4 Documentation /Patient Information Depending on the country, there are a variety of booklets and aids available, such as DVDs. Information can also be found on websites (examples provided in Appendix F) and YouTube. These should be considered with caution as they are not always clear or accurate and may represent a personal opinion or experience. Non-commercial information booklets are available for adults, and they may be suitable for adolescents and some young adults. There are many information booklets specifically for children that have been developed by hospitals and suppliers of catheter products. When selecting or formulating information booklets, it is important that information leaflets should be clear about why intermittent catheterisation is necessary and how this procedure should be carried out. They should contain an explanation of the anatomy involved (in plain language) and include frequently asked questions and common problems. It is also considered advantageous for healthcare professionals to use a checklist to ensure the children and parents have received all the necessary information about CIC/CISC. An example is shown in Appendix G. Patient organisations also have their patient information materials and websites. They may also help to provide peer support by organising meetings and online contact. More recently, 'voiding diary apps’ have become available for smartphones, developed by suppliers and/or hospitals. Also, there are apps that can ‘read’ text and make it in plain language.
RkJQdWJsaXNoZXIy NjM1NTk=