Author Identifier (ORCID)
Weiting Liu: https://orcid.org/0000-0001-6936-8872
Abstract
Background – Clean intermittent catheterization (CIC) is widely regarded as the preferred approach to bladder management for individuals with neurogenic bladder (NB). Nevertheless, a considerable gap persists between evidence and clinical practice: patients and caregivers frequently encounter self-management barriers that compromise clinical outcomes during CIC. This qualitative study explores these barriers to provide an empirical foundation for developing tailored strategies that improve quality of care. Design – A descriptive qualitative study. Methods – From August to October 2025, a convenience sampling method was employed to recruit 16 participants individuals with NB or their long-term caregivers from the Department of Rehabilitation Medicine at Zhangzhou Affliated Hospital of FuJian Medical University, FuJian Province. Face-to-face semi-structured interviews were conducted, and thematic analysis was employed for data analysis. Results – Three themes and eight sub-themes were generated in this study: (1) Cognitive deficits and information dilemmas: barriers to health information delivery, a lack of personalized guidance, and cognitive biases and memory lapses; (2) Challenges in behavioral transformation: insufficient perception of risks and benefits and weakened self-management behaviors; (3) Need for an optimized health support system: greater access to psychological counseling, development of authoritative digital health education resources, and an integrated hospital-community management model. Conclusion – This study reveals the interconnected cognitive, behavioral, and psychosocial challenges that individuals with NB and their caregivers face in practicing CIC. Our findings underscore a critical need for interventions that address these specific implementation barriers. Future initiatives should focus on developing multidimensional, patient-empowering strategies that integrate personalized digital health education, ultimately to improve the quality and sustainability of CIC self-management. Impact – This study elucidates the complex practical and psychosocial challenges encountered by individuals with NB and their caregivers during CIC. Based on these findings, we propose a multi-pronged framework for improvement, targeting cognitive, behavioral, and systemic dimensions of care. This research lays a critical foundation for designing targeted, empowerment-based interventions and offers a comprehensive, system-level roadmap to bridge the persistent evidence-practice gap in CIC self-management. Reporting method – The research adheres to Consolidated criteria for reporting qualitative research (COREQ) guidelines.
Keywords
clean intermittent catheterization, needs, neurogenic bladder, qualitative research, self-management
Document Type
Journal Article
Date of Publication
4-1-2026
Volume
7
Publication Title
Frontiers in Rehabilitation Sciences
Publisher
Frontiers
School
School of Nursing and Midwifery / JBI Affiliated Centre for Evidence Informed Nursing, Midwifery and Health Care Practice / Research Centre of Prevention and Management for Chronic Disease
RAS ID
99241
Funding Information
The author(s) declared that financial support was received for this work and/or its publication. This study was supported by the Fujian Medical University Start-up Fund Project (Grant No. 2023QH1336).
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
Comments
Zou, L., Wu, X., Chen, S., Feng, S., Huang, X., & Liu, W. (2026). Self-management challenges and psychosocial support needs in clean intermittent catheterization: A qualitative study of individuals with neurogenic bladder and caregivers. Frontiers in Rehabilitation Sciences, 7, 1800715. https://doi.org/10.3389/fresc.2026.1800715