Urologic self-management through intermittent self-catheterization among individuals with spina bifida: A journey to self-efficacy and autonomy

Jonathan Castillo, Kathryn K. Ostermaier, Ellen Fremion, Talia Collier, Huirong Zhu, Gene O. Huang, Duong Tu, Heidi Castillo

Research output: Contribution to journalArticlepeer-review

21 Scopus citations

Abstract

PURPOSE: To describe the age of independence in intermittent self-catheterization (ISC) in a diverse patient population and identify factors associated with ISC in individuals with spina bifida. METHODS: Two hundred patients with myelomeningocele or lipomyelomeningocele, who were ≥ 3 years of age and utilized catheterization for bladder management were included. Data regarding diagnosis, functional level of lesion, race, ethnicity, presence of shunt, method of catheterization, self-management skills, fine motor skills, and cognitive abilities were collected. RESULTS: Fifty-five percent of individuals were able to perform ISC with a mean age of 9.45 years (SD = 2.97) and 22.7% used a surgically created channel. Higher level of lesion and female gender were associated with a lower rate of ISC. Intellectual disability was present in 15% of the individuals able to perform ISC and in 40% of those not able to perform ISC (p= 0.0005). Existent self-efficacy regarding activities of daily living (i.e. dressing, bathing, skin care) were associated with ISC (p< 0.0001). CONCLUSIONS: The average age of ISC emerged as a target for culturally-appropriate educational interventions to stimulate greater early independence. Future research on factors that may foster an ' independent spirit' early in childhood leading to self-management are warranted.

Original languageEnglish (US)
Pages (from-to)219-226
Number of pages8
JournalJournal of Pediatric Rehabilitation Medicine
Volume10
Issue number3-4
DOIs
StatePublished - 2017
Externally publishedYes

Keywords

  • Myelomeningocele
  • Neurogenic bladder
  • Self-catheterization
  • Self-management
  • Spina bifida

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation

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