Intermittent catheterisation is widely regarded as the preferred method of bladder management for many individuals with SCI. While its clinical benefits are well established, successful long-term use depends on much more than technical competence. Through in-depth interviews with individuals using IC in Riyadh, Saudi Arabia, we explored how participants navigated the physical, emotional, social, and practical realities associated with this essential aspect of daily life.
A key finding from our study was that adaptation to intermittent catheterisation is an ongoing process rather than a single event. Participants described an initial period marked by uncertainty, fear, embarrassment, and concerns regarding independence. Learning the technical procedure was only one component of adjustment; equally important were the psychological and social adaptations required to incorporate IC into everyday routines.
Privacy emerged as a recurring theme throughout the interviews. Participants frequently discussed difficulties performing catheterisation outside the home, concerns regarding accessible facilities, and anxiety about maintaining privacy in public settings. These challenges often influenced social participation, travel, employment, and overall confidence. Such findings highlight the importance of considering environmental and societal factors when supporting individuals with SCI.
Participants also described the practical challenges associated with long-term bladder management, including dependence on caregivers, concerns about complications, and the need to plan daily activities around catheterisation schedules. Despite these difficulties, many participants demonstrated remarkable resilience and adaptability.
Several coping strategies emerged from the interviews. Participants spoke about establishing structured routines, developing confidence through repeated practice, seeking support from family members, and drawing on personal determination to overcome challenges. Education and ongoing support from healthcare professionals were also viewed as essential factors that facilitated successful adaptation and promoted independence.
Another important finding was the significant role of family and social support. Emotional encouragement and practical assistance from family members helped participants navigate challenges and maintain adherence to their bladder management routines. These findings reinforce the value of involving family caregivers, when appropriate, as partners in rehabilitation and long-term care planning.
From a clinical perspective, our findings suggest that effective intermittent catheterisation programs should extend beyond procedural training. Comprehensive care should address psychosocial well-being, patient empowerment, confidence-building, and individualized support. Healthcare professionals should recognize that privacy, dignity, independence, and social participation are outcomes that matter deeply to patients and may influence long-term adherence as much as clinical considerations.
The study also highlights opportunities for healthcare systems to better support individuals with SCI. Improving access to catheterisation supplies, increasing the availability of accessible facilities, and strengthening community-based support services may help reduce barriers and improve quality of life. Patient experiences should remain central when designing interventions and policies intended to optimize long-term bladder management.
What resonated most throughout the interviews was the resilience of participants. Despite significant physical, emotional, and social challenges, many individuals developed practical strategies that enabled them to maintain independence and adapt to life with SCI. Their experiences remind us that successful intermittent catheterisation is not defined solely by clinical outcomes, but also by dignity, confidence, autonomy, and the ability to participate fully in everyday life.
By listening to patients and learning from their experiences, healthcare professionals can develop more patient-centered approaches that support both effective bladder management and improved quality of life for individuals living with spinal cord injury.
Written by: Yacoub Abuzied,1,2 Rasmieh Al-Amer,3 Azura Abdul Halain,2 Salimah Japar2
- Department of Nursing, Rehabilitation Hospital, King Fahad Medical City, Riyadh, Saudi Arabia
- Department of Nursing, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
- Faculty of Nursing, Yarmouk University, Irbid, Jordan