TY - JOUR
T1 - Urologic self-management through intermittent self-catheterization among individuals with spina bifida
T2 - A journey to self-efficacy and autonomy
AU - Castillo, Jonathan
AU - Ostermaier, Kathryn K.
AU - Fremion, Ellen
AU - Collier, Talia
AU - Zhu, Huirong
AU - Huang, Gene O.
AU - Tu, Duong
AU - Castillo, Heidi
N1 - Publisher Copyright:
© 2017 - IOS Press and the authors. All rights reserved.
PY - 2017
Y1 - 2017
N2 - 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.
AB - 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.
KW - Myelomeningocele
KW - Neurogenic bladder
KW - Self-catheterization
KW - Self-management
KW - Spina bifida
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U2 - 10.3233/PRM-170447
DO - 10.3233/PRM-170447
M3 - Article
C2 - 29125508
AN - SCOPUS:85039443830
SN - 1874-5393
VL - 10
SP - 219
EP - 226
JO - Journal of Pediatric Rehabilitation Medicine
JF - Journal of Pediatric Rehabilitation Medicine
IS - 3-4
ER -