Patients with spinal cord injury often face difficulties related to neurogenic lower urinary tract dysfuntion (NLUTD).¹ The management of NLUTD is crucial for their daily life activities.² In order to understand the decision-making process of these patients when presented with clean intermittent catheterization as a treatment method for NLUTD,³ we conducted a cross-sectional observational study. The study involved 30 patients, mostly men with an average age of 32.43 years, who were receiving treatment in a public hospital specializing in rehabilitation in the Federal District. We used two research instruments for data collection: a sociodemographic and clinical questionnaire and the Brazilian version of the Decisional Conflict Scale.^{4 5} The collected data were analyzed using inferential and descriptive statistics of central tendency and dispersion through absolute and relative frequencies, mean, and standard deviation. The study protocol was approved by the Research Ethics Committee of the Health Department of the Federal District. The results of the study showed that decisional conflict was identified in half of the patients, mainly among those with a shorter duration of spinal cord injury and catheterization period. Lack of information and support for performing the procedure were the main factors causing decision-making conflicts. Patients who performed self-catheterization faced fewer decision-making conflicts than those who underwent assisted catheterization. In conclusion, the study suggests that the duration of injury and catheterization period can influence the acquisition of skills and knowledge required for catheterization, resulting in decisional conflicts among patients. Decision support and assisted self-care can help to reduce decisional conflicts and improve patient engagement.

References

1. Lee J, Varghese J, Brooks R, Turpen BJ. A Primary care provider’s guide to accessibility after spinal cord injury. Top Spinal Cord Inj Rehabil. 2020;26(2):79–84.

2. Faleiros F, Braga DCO, Schoeller SD, Henriques SH, Cunha NBF, Videira LGN, et al. Surveying people with spinal cord injuries in Brazil to ascertain research priorities. Nature: Sci Rep. 2023;13(654):1–8.

3. Garvelink MM, Boland L, Klein K, Nguyen DV, Menear M, Bekker HL, et al. Conflict Scale Findings among Patients and Surrogates Making Health Decisions Part II. Medical Decision Making. 2019;39(4):315–326.

4. O’Connor AM. Validation of a decisional conflict scale. Med Decis Making. 1995;15(1):25–30.

5. Antunes CMTB, Bampi LN, Azevedo FMA, Hua FY. Adaptation and cross-cultural validation of the Decisional Conflict Scale for use in Brazil. REAS. 2021;13(12):1–9.