Clean intermittent catheterization (CIC) is widely regarded as the preferred approach to bladder management for individuals with neurogenic bladder (NB). Nevertheless, a considerable gap persists between evidence and clinical practice: patients and caregivers frequently encounter self-management barriers that compromise clinical outcomes during CIC. This qualitative study explores these barriers to provide an empirical foundation for developing tailored strategies that improve quality of care.
A descriptive qualitative study.
From August to October 2025, a convenience sampling method was employed to recruit 16 participants individuals with NB or their long-term caregivers from the Department of Rehabilitation Medicine at Zhangzhou Affliated Hospital of FuJian Medical University, FuJian Province. Face-to-face semi-structured interviews were conducted, and thematic analysis was employed for data analysis.
Three themes and eight sub-themes were generated in this study: (1) Cognitive deficits and information dilemmas: barriers to health information delivery, a lack of personalized guidance, and cognitive biases and memory lapses; (2) Challenges in behavioral transformation: insufficient perception of risks and benefits and weakened self-management behaviors; (3) Need for an optimized health support system: greater access to psychological counseling, development of authoritative digital health education resources, and an integrated hospital-community management model.
This study reveals the interconnected cognitive, behavioral, and psychosocial challenges that individuals with NB and their caregivers face in practicing CIC. Our findings underscore a critical need for interventions that address these specific implementation barriers. Future initiatives should focus on developing multidimensional, patient-empowering strategies that integrate personalized digital health education, ultimately to improve the quality and sustainability of CIC self-management.
This study elucidates the complex practical and psychosocial challenges encountered by individuals with NB and their caregivers during CIC. Based on these findings, we propose a multi-pronged framework for improvement, targeting cognitive, behavioral, and systemic dimensions of care. This research lays a critical foundation for designing targeted, empowerment-based interventions and offers a comprehensive, system-level roadmap to bridge the persistent evidence-practice gap in CIC self-management.
The research adheres to Consolidated criteria for reporting qualitative research (COREQ) guidelines.
Frontiers in rehabilitation sciences. 2026 Apr 01*** epublish ***
Lianyu Zou, Xiaomei Wu, Shun Chen, Shuluan Feng, Xiaohua Huang, Weiting Liu
Department of Rehabilitation Medicine, Zhangzhou Affliated Hospital of FuJian Medical University, Zhangzhou, China., The Second People's Hospital Affiliated to Fujian University of Chinese Medicine, Fuzhou, China., School of Nursing and Midwifery, Edith Cowan University, Perth, WA, Australia.