Patient perspectives on indwelling urinary catheters and fluid balances after transsphenoidal pituitary surgery: a qualitative study

• Published in: BMJ open Vol. 13; no. 3; p. e069598
• Main Authors: Nollen, Jeanne-Marie, Brunsveld-Reinders, Anja H, Peul, Wilco C, van Furth, Wouter R
• Format: Journal Article
• Language: English
• Published: England British Medical Journal Publishing Group 20.03.2023; BMJ Publishing Group LTD; BMJ Publishing Group
• Series: Original research
• Subjects: Bladder; Catheters; Catheters, Indwelling; Cerebrospinal fluid; Data analysis; Decision making; Diabetes; Endocrine tumours; Female; Hospitalization; Humans; Interviews; Neuroendocrine tumors; NEUROSURGERY; Nurses; Nursing care; Outpatient care facilities; Patient satisfaction; Patients; Pituitary Gland; Pituitary Neoplasms - surgery; Qualitative Research; Retention; Surgery; Urinary Catheterization; Urinary Catheters; Urinary tract infections; Water-Electrolyte Balance; Endocrine tumours; QUALITATIVE RESEARCH; NEUROSURGERY
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2022-069598

ObjectivesTo explore the perceptions and experiences of patients who underwent transsphenoidal pituitary gland and (para)sellar tumour surgery regarding indwelling urinary catheters (IDUCs) and the postoperative fluid balance.DesignQualitative study using semistructured interviews based on the attitudes, social influence and self-efficacy model and expert knowledge.ParticipantsTwelve patients who underwent transsphenoidal pituitary gland tumour surgery and received an IDUC during or after surgery.SettingOne patient was interviewed in the endocrinology outpatient clinic and 11 patients were interviewed on the neurosurgery ward.ResultsFive major themes emerged: (1) conflicting information and preoperative expectations, (2) IDUCs perceived as patient-friendly during bedrest, particularly for women, (3) little room for patients’ opinions, (4) physical and emotional limitations and (5) fluid balance causes confusion. Information regarding IDUC placement and fluid balance given to patients both preoperatively and postoperatively did not meet their expectations, which led to confusion and uncertainty. The IDUC was perceived as preferable if bedrest was mandatory, preferred particularly by women. Patient could not mobilise freely due to the IDUC and felt ashamed, judged by others and dependent on nurses.ConclusionsThis study provides insight into the challenges patients experience in relation to the IDUC and fluid balance. Perceptions on the necessity of an IDUC varied among patients and were influenced by both physical and emotional impediments. A clear, frequent and daily communication between healthcare professionals and patients to evaluate IDUC and fluid balance use is necessary to increase patient satisfaction.