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Impact of practice on quality of life of those living with an indwelling urinary catheter – an international evaluation

Introduction: Patients using indwelling urinary catheters often experience complications that have the potential to negatively impact quality of life. Limited evidence exists to inform and guide urinary catheter management, especially in those with long-term catheters; thus, patient care varies.

Purpose: This study compared the characteristics and quality of life of patients living with a long-term indwelling urinary catheter in the United Kingdom and the United States where catheter care policies differ with respect to types and routes of catheterization and timing of catheter changes. Quality of life was determined by utilizing the International Consultation on Incontinence Long-Term Catheter Quality of Life Questionnaire.

Methods: A cross-sectional study of long-term urinary catheter users in the United Kingdom and the United States, male and female, able to speak and read English, age 18 years or older, using a urethral or suprapubic catheter for more than 1 year. Participants completed a questionnaire, and relevant catheter-related data were extracted from their medical records.

Results: Participants (n = 190, 51% from United States) were recruited, largely from the home health setting. Most (n = 136, 71.6%) were male, with a mean age of 72.8 years. The majority used an indwelling urethral catheter, but this varied by country and was more common in the United Kingdom. The number of urinary tract infections and catheter changes was significantly higher in the United States (p < 0.001). The catheter function score was significantly worse in participants from the United Kingdom, but there was no difference in life impact score between countries.

Conclusions: Approaches to indwelling urinary catheter care differed in the two countries, as did catheter complications and some aspects of quality of life. Further analysis will explore how these factors interact.

Ashley Shepherd, PhD, BA (Hons), RGN1; Diane K. Newman, DNP, ANP-BC, FAAN2; Christine Bradway, PhD, CRNP, FAAN, AGSF3; Sandra Jost, PhD, RN4; Debbie Waddell, PhD, Pg CAP, PgCert Research, BA (Hons), RGN, FHEA5; William Gordon Mackay, PhD, PgCert TLHE, BSc. (Hons), MRSB, FHEA6; Suzanne Hagen, PhD, MSc, BSc (Hons), CStat7

  1. Professor of Nursing and Deputy Dean, Faculty of Health Sciences and Sport, University of Stirling, Scotland, United Kingdom.
  2. Adjunct Professor of Urology in Surgery, Division of Urology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
  3. Professor Emerita of Gerontological Nursing, University of Pennsylvania School of Nursing, Philadelphia, PA.
  4. Chief Nursing Officer, Penn Medicine at Home, University of Pennsylvania Health System, Philadelphia, PA.
  5. Senior Lecturer, Faculty of Health Sciences and Sport, University of Stirling, Scotland, United Kingdom.
  6. Reader in Infection Control, and Research Lead, Biological Sciences, University of the West of Scotland, Scotland, United Kingdom.
  7. Professor, Health Services Research, and Deputy Director, NMAHP Research Unit, Glasgow Caledonian University, Scotland, United Kingdom.
Source: Shepherd, A., Newman, D.K., Bradway, C., Jost, S., Waddell, D., Mackay, W.G., & Hagen, S. (2023). Impact of practice on quality of life of those living with an indwelling urinary catheter – An international evaluation. Urologic Nursing, 43(4), 162-171, 176. https://doi.org/10.7257/2168-4626.2023.43.4.162