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J Clin Nurs. 2011 Nov;20(21-22):3152-62. doi: 10.1111/j.1365-2702.2011.03779.x. Epub 2011 Aug 10.

A qualitative study exploring the emotional responses of female patients learning to perform clean intermittent self-catheterisation.

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Faculty of Health, Life & Social Sciences, University of Lincoln, Lincoln, UK.



This paper is a report of a study exploring the lived experiences and emotional responses of female patients learning to perform clean intermittent self-catheterisation (CISC).


There is general consensus that CISC should be considered in preference to in-dwelling catheterisation wherever feasible. Published literature has tended to focus on quality of life issues and technical and physical aspects. There has been less investigation into patients' initial perceptions of CISC and into their subsequent experiences of learning the technique.


This qualitative study used a phenomenological research design.


A series of semi-structured, in-depth interviews were held with a purposive sample of adult female patients performing CISC aged 34-64 years. Interviews were tape recorded and transcribed verbatim. Data were analysed using the 'Framework' method.


This study identified six recurrent themes: grief and loss, lack of knowledge (regarding female anatomy, bladder dysfunction and catheters), negative associations and stigma, psychological aversion and embarrassment, nursing approaches and coping mechanisms.


Loss of normal bladder function may represent a devastating event and trigger emotional responses associated with grief and loss. Patients may experience a range of reactions whilst learning CISC, including embarrassment and aversion, which may not dissipate over time. However, psychological distress is not inevitable and varies enormously between individuals. The nursing approach is vital, as individualised, empathic care is recognised and valued.


This study adds to an emerging body of knowledge providing an enhanced understanding of the lived experiences of patients learning CISC. Nurses need to be alert to a range of potential emotional responses. This will facilitate the adoption of individualised teaching and learning strategies, designed to optimise the patient's assimilation of CISC into their lifestyle, promoting physical health, psychological wellbeing and independent living.

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