To describe the age of independence in intermittent self-catheterization (ISC) in a diverse patient population and identify factors associated with ISC in individuals with spina bifida.
Two hundred patients with myelomeningocele or lipomyelomeningocele, who were ⩾ 3 years of age and utilized catheterization for bladder management were included. Data regarding diagnosis, functional level of lesion, race, ethnicity, presence of shunt, method of catheterization, self-management skills, fine motor skills, and cognitive abilities were collected.
Fifty-five percent of individuals were able to perform ISC with a mean age of 9.45 years (SD = 2.97) and 22.7% used a surgically created channel. Higher level of lesion and female gender were associated with a lower rate of ISC. Intellectual disability was present in 15% of the individuals able to perform ISC and in 40% of those not able to perform ISC (p= 0.0005). Existent self-efficacy regarding activities of daily living (i.e. dressing, bathing, skin care) were associated with ISC (p< 0.0001).
The average age of ISC emerged as a target for culturally-appropriate educational interventions to stimulate greater early independence. Future research on factors that may foster an 'independent spirit' early in childhood leading to self-management are warranted.
Journal of pediatric rehabilitation medicine. 2017 Oct 20 [Epub ahead of print]
Jonathan Castillo, Kathryn K Ostermaier, Ellen Fremion, Talia Collier, Huirong Zhu, Gene O Huang, Duong Tu, Heidi Castillo
Developmental Pediatrics, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA., Department of Medicine, Baylor College of Medicine, Houston, TX, USA., Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA., Outcomes and Impact Service, Texas Children's Hospital, Houston, TX, USA., Pediatric Urology, Department of Urology, Baylor College of Medicine, Houston, TX, USA.