Hypothesis / aims of study
The scarcity of studies focused exclusively on women makes it urgent and necessary to understand how intermittent catheterization (IC) affects these population and its consequences for their independence, autonomy, mental health, and daily lives.The qualitative method is particularly suitable for this study, as it allows an in-depth exploration of psychosocial aspects, providing a comprehensive understanding of gender differences, since enables a rich and detailed examination of participants' personal, subjective, and contextual experiences, offering valuable insights into their perceptions and lived experiences
Objectives: To understand the perceptions and lived experiences of women who perform IC due to acute-onset Adult neurogenic lower urinary tract dysfunction (ANLUTD), investigating the impact of this practice on QoL and autonomy.
Study design, materials and methods
The study was conducted through interviews with female IC, from June 2023 to October 2024. Initially, 19 women were contacted; however, the final sample consisted of 13 participants due to withdrawals and refusals (Tabel 1). The interviews were conducted in person at a private office or through the Zoom® application, allowing participants to freely express their experiences and respond to 15 semi-structured questions.
For transcription, the Happy Scribe tool was used, enabling high-quality automatic transcriptions, followed by manual human review to ensure accuracy. Data were analyzed using the MAXQDA software, applying discourse analysis principles. The analytical process identified discursive formations and effects of meaning, allowing for a deeper understanding of the psychosocial complexities and individual experiences.
Results
The analysis of the interviews revealed three main discursive formations:
1. Rupture and Initial Adaptation, highlighting the emotional shock and loss of control following the acute injury.
2. Learning and Normalization, in which women reported initial difficulties but also described the process of acquiring autonomy and integrating CIC into their daily routines.
3. Resignification and New Reality, illustrating the gradual acceptance and adaptation to personal, social, and professional changes imposed by the continuous use of IC.
Participants also discussed challenges in different aspects of life, including the impact on romantic relationships, professional activities, and travel. They emphasized the importance of support networks and creative adaptation strategies to cope with adversities.
Interpretation of results
The findings include effective coping strategies, such as the creation of support networks between patients, family and friends, which have been shown to be essential for the exchange of information and emotional support. The study suggests the implementation of personalized IC training programs within rehabilitation services, preventing patients from seeking information from unreliable sources. In addition, it recommends more gender-sensitive practices, such as workshops, psychological counseling and meetings with spouses, promoting collaborative learning and a safe space to discuss challenges and successes (figure 1). The initial impact generates anxiety, fear, and loss of control, corroborating studies [1], which associate this anxiety with medical and psychosocial concerns, including urinary infections and lack of access to adequate bathrooms.Despite the difficulties, the study indicates that adaptation to IC can lead to the redefinition of autonomy [1-3]. Thus, the study not only expands theoretical knowledge, but also proposes practical applications to improve the quality of life of these women.
Concluding message
The study reinforces the need for more effective healthcare policies and inclusive social strategies that address psychosocial and emotional implications. Beyond the difficulties encountered, participants emphasized the importance of adequate support networks, which are essential for maintaining an active and engaged life. A key aspect of this study is the structuring of themes based on participants' discourse, adopting the discursive formations model. The identified phases can serve as a framework for future research, highlighting the importance of categorizing adaptation and redefinition periods. It also supports the development of more effective and targeted interventions, ensuring that care is consistent and grounded in real-life experiences.