A Web Based Self Management Intervention for Intermittent Urinary Catheter Use

基于网络的间歇性导尿管使用自我管理干预措施

• 批准号: 8666065
• 负责人: MARY H WILDE
• 金额: $ 19万
• 依托单位: UNIVERSITY OF ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-06-01 至 2016-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8666065
• 关键词: Adherence; Adverse effects; Affect; Behavior; Bladder; Caregivers; Caring; Catheterization; Catheters; Chronic; Chronic Disease; Chronically Ill; Communication; Computers; Consultations; Data; Development; Diabetes Mellitus; Educational Materials; Educational process of instructing; Effectiveness; Effectiveness of Interventions; Electronic Mail; Employment; Employment Opportunities; Equipment; Expenditure; Extravasation; Fluid Balance; Frequencies; Future; Hand; Health; Health Professional; Health Status; Home environment; Home visitation; House Call; Indwelling Catheter; Intake; Internet; Intervention; Intervention Studies; Lead; Learning; Left; Length of Stay; Life; Life Change Events; Liquid substance; Lubrication; Measures; Methods; Modeling; Monitor; National Institute of Nursing Research; Nurses; Online Systems; Outcome; Participant; Patients; Persons; Phase; Phase II Clinical Trials; Pilot Projects; Population; Procedures; Quality of life; Randomized; Rehabilitation therapy; Research; Resort; Resources; Self Efficacy; Self Management; Self Perception; Social Network; Spinal cord injury; Staging; Symptoms; Techniques; Technology; Telephone; Testing; Time; Training; Travel; Universities; Urinary Retention; Urinary tract; Urinary tract infection; Urine; Waiting Lists; base; clinical care; design; diet and exercise; improved; injured; innovative technologies; new technology; peer; prevent; public health relevance; sex; skills; smoking cessation; social; theories; urinary; usability; web site

DESCRIPTION: Clean intermittent catheterization (CIC) is the preferred bladder management method for people with chronic urinary retention, including those with spinal cord injury (SCI). Learning to manage this procedure takes time, and with rehabilitation lengths of stay shorter in recent years, people must learn to develop skill in the method when they return home, at the same time they are adjusting to the life changing event of an SCI. When people are not well prepared for CIC, they may resort to a long-term indwelling catheter or not adhere to optimal CIC frequency, both of which can contribute to urinary tract infection. In addition, decreased CIC capacity can limit their travel and contribute to less than full employment and lower quality of life. Though many are isolated from others with SCI, they are likely to have Internet access, and those using CIC should have enough hand dexterity to use a computer. People using CIC need well developed self-management skills; at a minimum they need to know how to: (1) adhere to their CIC regime; (2) self-monitor fluid intake; (3) notice early symptoms of urinary tract infectin (UTI); (4) perform CIC in a variety of situations with good technique; (5) choose optimal catheter, equipment, and lubrication; and (6) adapt to social needs. While self-management research has been done in people with other chronic conditions, no Web-based intermittent catheter self-management interventions have been developed and tested in people with SCI using CIC. This study will involve exploration, development and testing of a new Internet-based intervention for people with SCI who use CIC. The Specific Aims are: (1) Design and develop a new CIC self-management Internet-based intervention to improve catheter-related outcomes and quality of life in people with SCI; (2) Conduct a Phase 1a/b randomized pilot study to assess the feasibility (i.e., acceptability and usability of the website application) and preliminay effectiveness of the Internet-based intermittent catheter self-management intervention; and (3) Develop and test the reliability of new/modified measures for the intervention related to CIC. The theoretical framework is based on the PI's current self-management intervention in long-term urinary catheter users combined with a conceptual and design framework of the Stanford Chronic Disease Self-management model. Specifically, we will teach awareness, self-monitoring and self-management strategies to CIC uses with SCI in an online format. Nurse telephone consultation for teaching self-management will be combined with peer leaders for online forums. Stages involve: (1) Develop an Internet-based intervention to improve self-management and outcomes related to CIC among people with SCI (2) Pretest the Internet application with five persons with SCI using CIC; and (3) Conduct a web-based six-month intervention pilot study in a randomized group of 30 with SCI using CIC (controls wait listed). Outcomes are: catheter-related adverse health outcomes (e.g., UTI, urine leakage), CIC self- management, CIC self-efficacy, health related expenditures and quality of life. Information from this study will be used to modify the Internet application for a future Phase 2 trial in a larger study.

描述：清洁间歇性导管插入术（CIC）是针对患有慢性尿位术的人（包括脊髓损伤的人（SCI））的首选膀胱管理方法。学习管理此过程需要时间，并且近年来康复长度较短，人们必须学会在返回家园时发展该方法的技能，同时他们可以适应SCI的改变生活。当人们为CIC做好充分准备时，他们可能会诉诸长期留置导管，或者不遵守最佳CIC频率，这两种频率都可能导致尿路感染。此外，CIC容量的降低可以限制其旅行，并导致不足的就业和降低生活质量。尽管许多人与具有SCI的其他人隔离，但它们可能可以访问Internet，并且使用CIC的人应该具有足够的手工敏捷性来使用计算机。使用CIC的人需要良好的自我管理技能；他们至少需要知道如何：（1）遵守其CIC政权； （2）自我监测液的摄入量； （3）注意尿路感染素（UTI）的早期症状； （4）在各种情况下以良好的技术进行CIC； （5）选择最佳导管，设备和润滑； （6）适应社会需求。尽管在患有其他慢性疾病的人中进行了自我管理研究，但在使用CIC的SCI患者中未开发和测试基于网络的间歇性导管自我管理干预措施。这项研究将涉及对使用CIC的SCI患者进行新的基于Internet的干预措施的探索，开发和测试。具体目的是：（1）设计和开发一种新的基于Internet的自我管理的干预措施，以改善SCI患者的导管相关结果和生活质量； （2）进行1A/B期随机试验研究，以评估基于Internet的间歇性导管自我管理干预措施的可行性（即网站申请的可接受性和可用性）和预先有效性； （3）开发和测试与CIC相关的干预措施的新/修改措施的可靠性。理论框架是基于PI目前在长期尿导管使用者中的自我管理干预，并结合了斯坦福慢性疾病自我管理模型的概念和设计框架。具体来说，我们将以在线格式向SCI使用CIC使用的意识，自我监控和自我管理策略。护士电话咨询以进行教学自我管理，将与在线论坛的同伴领导者结合使用。阶段涉及：（1）制定基于Internet的干预措施，以改善SCI患者中与CIC相关的自我管理和结果（2）使用CIC的五个患有SCI的人进行了预测的Internet应用程序； （3）使用CIC进行基于Web的六个月干预试验研究，其中SCI的随机组（对照等待等待）。结果是：导管相关的不良健康结果（例如UTI，尿液泄漏），CIC自我管理，CIC自我效能感，与健康相关的支出和生活质量。该研究的信息将被使用 在较大的研究中修改Internet应用程序以进行未来的2阶段试验。

项目成果

A Web-Based Self-Management Intervention for Intermittent Catheter Users.

针对间歇性导管用户的基于网络的自我管理干预。

• 发表时间: 2015
• 期刊: Urologic nursing
• 作者: Wilde,MaryH;Fairbanks,Eileen;Parshall,Robert;Zhang,Feng;Miner,Sarah;Thayer,Deborah;Harrington,Brian;Brasch,Judith;Schneiderman,Dan;McMahon,JamesM
• 通讯作者: McMahon,JamesM

Feasibility of a Web-Based Self-management Intervention for Intermittent Urinary Catheter Users With Spinal Cord Injury.

针对脊髓损伤间歇性导尿管使用者的基于网络的自我管理干预的可行性。

• DOI: 10.1097/won.0000000000000256
• 发表时间: 2016
• 期刊: Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society
• 作者: Wilde,MaryH;McMahon,JamesM;Fairbanks,Eileen;Brasch,Judith;Parshall,Robert;Zhang,Feng;Miner,Sarah;Thayer,Deborah;Schneiderman,Dan;Harrington,Brian
• 通讯作者: Harrington,Brian

Development of a Web-Based Self-management Intervention for Intermittent Urinary Catheter Users With Spinal Cord Injury.

为患有脊髓损伤的间歇性导尿管使用者开发基于网络的自我管理干预措施。

• DOI: 10.1097/cin.0000000000000182
• 发表时间: 2015
• 期刊: Computers, informatics, nursing : CIN
• 作者: Wilde,MaryH;Fairbanks,Eileen;Parshall,Robert;Zhang,Feng;Miner,Sarah;Thayer,Deborah;Harrington,Brian;Brasch,Judith;McMAHON,JamesM
• 通讯作者: McMAHON,JamesM

Nurses' Own Recordkeeping: The Nursing Minimum Data Set Revisited.

护士自己的记录保存：重新审视护理最低数据集。

• DOI: 10.1097/cin.0000000000000187
• 发表时间: 2015
• 期刊: Computers, informatics, nursing : CIN
• 作者: Halloran,EdwardJ;Halloran,DianeC
• 通讯作者: Halloran,DianeC