Incontinence, Neurogenic Bladder Dysfunction, Urinary Retention
Conditions
Keywords
Intermittent catheterization, Self-catheterization, Patient education, Adherence, Acceptance, Male urology
Brief summary
This multicenter, parallel-group, randomized controlled trial (RELEASE) aims to evaluate the efficacy of two educational approaches on acceptance and adherence to intermittent catheterization (IC) among adult male patients. Participants requiring IC training will be randomized to either an enhanced educational intervention (informational booklet, video tutorial, and standard training) or standard clinical practice training alone. The primary outcome is the change in Intermittent Catheterization Acceptance Test (I-CAT) scores over three months. Secondary outcomes include adherence (I-CAS), urinary symptoms (USQNB-IC), patient autonomy, satisfaction with assistive technology (QUEST), and functional abilities. The study seeks to identify the most effective educational strategy to improve psychological acceptance, promote adherence, and reduce complications in patients performing IC, ultimately supporting patient-centered care and health system efficiency.
Detailed description
This multicenter, randomized controlled trial (RELEASE study) investigates the effectiveness of two different educational approaches to improve acceptance and adherence to intermittent catheterization (IC) among adult male patients who require IC training. Participants will be randomly assigned to one of two groups: an intervention group receiving an enhanced educational program (including an informational booklet, video tutorial, and standard clinical training) and a control group receiving only standard clinical practice training. The study will enroll adult male patients with an indication for self-managed intermittent catheterization and who are physically and cognitively able to learn IC techniques. The primary outcome measure is the change in Intermittent Catheterization Acceptance Test (I-CAT) scores at three months (T2) compared to baseline (T0). Secondary outcomes include adherence measured using the Intermittent Catheterization Adherence Scale (I-CAS), urinary symptoms evaluated with the USQNB-IC, patient autonomy, satisfaction with assistive technology (QUEST 2.0), and overall functional abilities. Additional data such as socio-demographic characteristics and medical history will also be collected. The trial seeks to provide evidence on the most effective educational strategy to support psychological acceptance and sustained adherence to IC, reduce complications, and promote greater patient autonomy. By addressing educational gaps, the study aims to enhance patient-centered care and optimize resource use within the healthcare system.
Interventions
OTHEREnhanced Educational Program for Intermittent Catheterization
Participants in this group receive an enhanced educational program for intermittent catheterization (IC), including an informational booklet, a specifically designed video tutorial, and standard clinical practice training. The program aims to improve psychological acceptance, adherence, and self-efficacy by providing comprehensive and patient-centered educational materials in addition to standard care.
Participants in this group will receive standard clinical practice training for intermittent catheterization (IC), as routinely provided in participating healthcare centers. This training focuses on basic procedural skills and practical education necessary to perform IC independently, without additional enhanced educational materials such as booklets or video tutorials.
Sponsors
Stefania Musco
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
This is a multicenter, parallel-group, randomized controlled trial with two arms. Participants are randomized 1:1 to either an enhanced educational intervention group (informational booklet, video, and standard training) or a control group receiving standard training only. The parallel design allows for direct comparison of outcomes between these two educational strategies.
Eligibility
Sex/Gender
MALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Male patients aged 18 years or older. * Diagnosed with neurogenic bladder requiring self-managed intermittent catheterization (IC). * Currently performing IC or newly prescribed IC. * Able to provide informed consent and understand study instructions. * Able to understand and complete study questionnaires in Italian.
Exclusion criteria
* Presence of cognitive impairment limiting ability to understand or perform IC independently. * Severe upper limb motor deficits preventing independent catheterization. * Active urinary tract infection at baseline. * Participation in another interventional study that could interfere with outcomes. * Any condition that, in the opinion of the investigators, makes the patient unsuitable for study participation.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Intermittent Catheterization Acceptance (I-CAT) Score | Baseline (T0) to 3 months (T2) | Change in psychological acceptance of intermittent catheterization measured using the Intermittent Catheterization Acceptance Test (I-CAT). The I-CAT assesses acceptance attitudes toward IC, including psychological readiness and emotional adaptation. Higher scores indicate greater acceptance. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Adherence to Intermittent Catheterization (I-CAS Score) | Baseline (T0) to 3 months (T2) | Adherence to intermittent catheterization practices measured by the Intermittent Catheterization Adherence Scale (I-CAS). The scale evaluates the frequency and consistency of IC behaviors. Higher scores indicate greater adherence. |
| Urinary Symptoms Severity (USQNB-IC) | Baseline (T0) to 3 months (T2) | Severity of urinary symptoms measured by the Urinary Symptom Questionnaire for Neurogenic Bladder-Intermittent Catheterization (USQNB-IC). This assesses frequency and severity of symptoms related to bladder dysfunction and catheterization. |
| Patient Autonomy Level | Baseline (T0) to 3 months (T2) | Self-reported autonomy in performing intermittent catheterization, assessed through specific questions evaluating confidence and independence in IC management. |
| Satisfaction with Assistive Technology (QUEST 2.0) | 3 months (T2) | Satisfaction with assistive technology measured using the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST 2.0). Higher scores reflect greater satisfaction with IC-related aids and support tools. |
| Overall Functional Abilities | Baseline (T0) to 3 months (T2) | Changes in overall functional abilities assessed through patient self-reports on mobility, self-care, and daily activities impacted by IC. |
Contacts
Primary ContactStefania Musco, MD
Outcome results
None listed