Factors affecting quality of life in patients with neurogenic bladder: a quasi-experimental study on the role of intermittent catheterization, bladder symptom, illness perception, and depressive symptoms

Abstract

Patients with neurogenic bladder have been reported to suffer from decreased Quality of Life (QoL) and increased psychological distress. Studies have found that intermittent catheterization had a beneficial effect on various aspects of patients’ disease, such as decreasing the number of urinary tract infections, and increasing their mobility, thus leading to a better Quality of Life (QoL). However, such studies are lacking in China, especially in comparing the QoL of neurogenic patients undergoing intermittent or indwelling catheterization. This study aimed to investigate the effectiveness of intermittent catheterization in improving QoL, bladder symptom, and depression symptoms in patients with neurogenic bladder, and to identify whether demographic factors, clinical history, and disease perception were associated with QoL of neurogenic patients undergoing urinary catheterization. This is an 8-week quasi-experimental study comparing neurogenic bladder patients undergoing intermittent (n = 52) and indwelling (n = 52) catheterization. Data were collected at pre-test during baseline and at post-test after 8 weeks. Results of the mixed-model ANOVA showed that compared to the indwelling catheterization group, after 8 weeks, patients with intermittent catheterization had significantly higher QoL in the environmental domain, lower depressive symptoms, and less deterioration in bladder symptom than the indwelling catheterization group (p < 0.05). The multiple linear regression models after 8 weeks showed that sociodemographic factors, disease history, catheterization method, and illness perception among neurogenic patients were significantly associated with psychological and environmental QoL. This study highlights the importance of intermittent catheterization in improving QoL, depressive symptoms, and slowing the decrease of bladder symptoms among neurogenic patients. The study identifies illness perception as a factor associated with environmental QoL, and therefore illness perception can be considered as an intervention point in programmes that address neurogenic bladder patients’ well-being.