Urinary catheters: what type do men and their nurses prefer?

OBJECTIVES Urinary catheters are used frequently, but the relative risks and benefits of different types of devices are not clear. We sought to determine the beliefs of both older male patients and nursing staff about the relative merits and problems of condom and indwelling catheters. DESIGN Patient and nurse survey using convenience sampling. SETTING A University-affiliated Veterans Affairs medical center. PARTICIPANTS Men hospitalized on medical, rehabilitation and nursing home units using either an indwelling or a condom catheter were invited to participate as were all members of the nursing staff on these units. Of 116 eligible patients, 104 were interviewed (response rate = 90%). Of 107 eligible nursing staff members, 99 completed the questionnaires (response rate = 92%). INTERVENTION AND MEASUREMENTS Consenting patients were interviewed personally about their urinary catheter. The nursing staff were asked to complete a self-administered questionnaire. RESULTS Patients were mostly older and predominantly hospitalized on the medical service. Compared with those using an indwelling catheter, patients using a condom catheter were more likely to believe that their catheter was comfortable (86 vs 58%, P = .04) and less likely to believe it was painful (14 vs 48%, P = .008) or to restrict their activity (24 vs 61%, P = .002). The nursing staff had a mean of 13 years nursing experience, and the majority worked in the nursing home unit. Most of the nursing staff respondents believed that condom catheters were less painful and restrictive for patients and were easier to apply, but they also believed that they fell off and leaked more often and required more nursing time. CONCLUSIONS Both patients and nursing staff prefer condom to indwelling catheters for patient comfort, but they recognize that dislodgment and leaking are major drawbacks of condom catheters. A more secure condom catheter would greatly improve the management of male incontinence.