O suporte social e a continuidade do cateterismo vesical intermitente

Abstract

INTRODUCTION: Spinal cord injury (SCI) causes important physical, psychological, and economicalimpacts that affect not only the individual but also the family. One of the physical alterations can be theloss of sphincter control, leading to a bladder neuropathic dysfunction that besides urinary incontinencecan lead to urologic complications and a social non-acceptance. There has been significant improvementin the handling of neuropathic bladder with the introduction of clean intermittent catheterization technique.However, many patients show preocupation on continuing to do this procedure at home, even thoughthey had learnt how to do it during their hospitalization. Several studies show an important correlationbetween health, well-being and social support. Therefore, we aimed to verify if the problems related to thecontinuity of bladder rehabilitation were related to non-appropriate social support. OBJECTIVE:Evaluate the continuity of clean intermittent catheterization technique after hospital discharge and itscorrelation to social support. METHODOLOGY: quantitative transversal study, developed in BeloHorizonte- MG- in one of the hospitals from Rede Sarah de Hospitais de Reabilitação. Before the datacollection, the research was approved by the Institutional Review Board. The sample was composed by49 patients with spinal cord injury that returned for follow-up reassessment, and had received orientationabout intermittent catheterization at home. The data was collected by individual interviews, and analyzedusing SPSS 13.0. RESULTS AND DISCUSSION: The sample was mainly composed by young men(81.6%, age mean score=33.9 years old), that had a spinal cord injury from traffic accidents (car =10,2%;motorbike=20,4%). The majority of the patients (55.1%) were single and living in Minas Gerais (77.6%).Half the sample (49%) had little or no schooling, with low family income of maximum 4 minimum wage(83.7% of patients). The traumatic spinal cord injuries constituted 79.6% of the sample, 46.9% of thoselead to paraplegia and 32.7% to tetraplegia. The majority (65.3%) showed enough physical independenceto perform the catheterization. The average of procedures per day was 4.2. Only 26.5% of them receivedfree equipment for the procedure. Approximately half of the patients 46.9% did some kind of modificationto the technique. The main complications were urolithiasis and dilatation/ hydronephrosis. Urinaryinfection, in the past 3 months, was present in 20.4% of cases. CONCLUSION: The majority of the spinalcord injuries were preventable. The higher abandonment rate of the procedure was during the acutephase. Social Support, in this sample, had no correlation with the continuity of the procedure, but newstudies are important to evaluate if catheterization continuity is correlated to Social support in chroniclepatients. A correct bladder handling with clean intermittent catheterization is important not only to preventurinary complications, but also to guarantee a better quality of life, promoting social inclusion, recoveringautonomy, and favoring self-esteem.