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An issue but of varying impact: a descriptive study of hip surgery patients’ experiences of bladder emptying and urinary catheterisation
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.ORCID iD: 0000-0003-0460-3864
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.ORCID iD: 0000-0002-8658-3360
Division of Nursing, Karolinska institutet, Stockholm, Sweden.
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Background: The capacity of bladder emptying in connection with hip surgery is affected by pain, medication and confinement to bed. In connection with such surgery urinary catheterisation is often performed, either intermittent or indwelling. Hip surgery patients' experiences of urinary catheterisation and urination have not been studied before.

Objectives: The aim of the study was to describe patients' experiences of bladder emptying and urinary catheterisation in connection with hip surgery.

Design: A qualitative study with descriptive design was conducted among hip surgery patients.

Setting: The study was carried out at an orthopaedic department at a university hospital in Sweden.

Participants: Purposive sample of 30 hip surgery patients, 17 with fractures and 13 with osteoarthritis.

Method: Face-to-face interviews were conducted and analysed with inductive qualitative content analysis.

Results: The main category "An issue but of varying impact" illustrated the patients' experiences of bladder emptying and urinary catheterisation. The findings are reported under five generic categories: ability to urinate, catheter is convenient, bothersome bladder emptying, intrusion upon dignity and concern about complications. Irrespectively of whether the patients were able to urinate or were catheterised, bladder emptying was not as usual. It was described as uncomplicated and experienced as being positive if the patients were able to urinate by themselves or when catheterisation was experienced as convenient. Some patients did not want to be catheterised, approving it only reluctantly. Independently of the method for bladder emptying, the patients in our study would choose the same method next time.

Conclusions: The patients undergoing hip surgery seem to experience bladder emptying as an issue but of varying impact. Both bladder emptying through micturition and bladder emptying through catheterisation are described in positive as well as negative terms.

Keywords [en]
Bladder emptying, Hip arthroplasty, Hip fractures, Nursing, Patient experiences, Qualitative research, Urinary catheterization
National Category
Nursing
Research subject
Nursing Science
Identifiers
URN: urn:nbn:se:oru:diva-22509OAI: oai:DiVA.org:oru-22509DiVA, id: diva2:515292
Available from: 2012-04-12 Created: 2012-04-12 Last updated: 2017-10-17Bibliographically approved
In thesis
1. Urinary catheter policies for short-term bladder drainage in hip surgery patients
Open this publication in new window or tab >>Urinary catheter policies for short-term bladder drainage in hip surgery patients
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis was to evaluate methods for urinary catheter handling in patients undergoing hip surgery. The intention was to gain knowledge in order to provide optimal and cost- effective care regarding urinary catheterisation in this group of patients.

In Study I , 45 of the 86 catheterised patients (52%) contracted nosocomial urinary tract infections (UTIs). Diabetes was a risk factor for developing UTI, and cloxacillin as a perioperative antibiotic prophylaxis seemed to offer a certain protection. Study II was a randomised controlled trial on the effect of clamping (n = 55) or not (n = 58) of the indwelling urinary catheter before removal. No significant differences were found between the groups with respect to time to normal bladder function, need for recatheterisation, or length of hospital stay. Study III was a randomised controlled trial among patients with hip fracture and hip arthroplasty, in which the patients were randomised to intermittent (n = 85) or indwelling (n = 85) urinary catheterisation. No significant differences in nosocomial UTIs (9% vs. 12%) or cost-effectiveness were shown. The patients in the intermittent group regained normal bladder function significantly sooner after surgery. Fourteen percent of the patients in the intermittent group did not need any catheterisation. In Study IV , 30 patients were interviewed about their experiences of bladder emptying and urinary catheterisation. The patients’ views were described through the main category ‘An issue but of varying impact’. Both bladder emptying through micturition and bladder emptying through catheterisation were described as convenient, but also as uncomfortable and an intrusion on dignity. The patients were aware of risks and complications of urinary catheterisation.

In conclusion, this thesis indicates that UTI is common in hip surgery patients. Clamping of indwelling catheters seems not necessary. There is no preference for either intermittent or indwelling urinary catheterisation according to the results of this thesis, either for the development of nosocomial UTI or, for cost-effectiveness, or from the patient perspective. Nurses should be aware that catheterisation might make the patients feel exposed, and it is essential that their practice reflect the best available evidence.

Place, publisher, year, edition, pages
Örebro: Örebro universitet, 2012. p. 75
Series
Örebro Studies in Care Sciences, ISSN 1652-1153 ; 38
Keywords
Urinary catheterisation, nosocomial urinary tract infection, hip fracture, hip arthroplasty, nursing, patient experiences, clamping
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:oru:diva-22505 (URN)978-91-7668-870-0 (ISBN)
Public defence
2012-06-01, Wilandersalen, Universitetssjukhuset, Örebro, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2012-04-12 Created: 2012-04-12 Last updated: 2017-10-17Bibliographically approved

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Hälleberg-Nyman, MariaGustafsson, MargaretaLangius-Eklöf, AnnIsaksson, Ann-Kristin

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