MedPath

Heart Rate Variability and Anxiety During Urinary Bladder Catheterization

Not Applicable
Recruiting
Conditions
Spinal Cord Injuries
Urinary Bladder, Neurogenic
Autonomic Dysreflexia
Anxiety State
Catheter Complications
Interventions
Procedure: Self-catheterization
Procedure: Catheterization performed by urology nurse, participant blinded to time of procedure
Procedure: Catheterization performed by urology nurse, participant aware of time of procedure
Registration Number
NCT05380661
Lead Sponsor
University of British Columbia
Brief Summary

This is a prospective, randomised study investigating the physical and psychological experience of intermittent catheterization in adult individuals following spinal cord injury (SCI).

Detailed Description

Given that intermittent catheterization is the recommended method of bladder management in individuals with SCI, it is crucial that the potentially negative cardiovascular and psychological responses to this procedure are examined. Individuals will undergo self-catheterization, then two standard of care catheterization procedures performed by an experienced urology nurse, while either blinded to or aware of time of catheterization. Continuous cardiovascular monitoring will be in place throughout all three procedures. Assessment of anxiety will be administered pre- and post- each procedure.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
20
Inclusion Criteria
  • Male or female, 18-70 years of age
  • Any chronic traumatic SCI with either motor sensory complete injury (AIS A/B, N=10) or motor sensory incomplete injury (AIS B/D, N=10).
  • At least 1 year post injury, and at least 6 months from any spinal surgery
  • Hand function sufficient to perform intermittent catheterization for management of urinary bladder drainage
  • Must provide informed consent and be able to understand and complete study-related questionnaires (must be able to understand and speak English or have access to an appropriate interpreter as judged by the investigator)
  • Willing and able to comply with clinic visit and study-related procedures
Exclusion Criteria
  • Signs or known current urinary tract infection, or other inflammatory conditions of bladder/urethra
  • Currently taking beta blockers or other medications that may affect heart rate
  • History of ureteral injury
  • History of any urinary diversion procedures, including but not limited to bladder augmentation, cystectomy, neo bladder, pouch reservoir, ileal conduit, Mitrofanoff appendicovesicostomy
  • For women of childbearing potential, currently pregnant
  • A member of the investigational team or his/her immediate family Presence of severe acute medical issue and use of any specific medication or treatment that, in the investigator's judgement, would adversely affect the participant's participation in the study

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Individuals with motor-incomplete SCISelf-catheterizationIndividuals with motor sensory incomplete injury (AIS C/D)
Individuals with motor-incomplete SCICatheterization performed by urology nurse, participant blinded to time of procedureIndividuals with motor sensory incomplete injury (AIS C/D)
Individuals with motor-incomplete SCICatheterization performed by urology nurse, participant aware of time of procedureIndividuals with motor sensory incomplete injury (AIS C/D)
Individuals with motor-complete SCISelf-catheterizationIndividuals with motor sensory complete injury (AIS A/B)
Individuals with motor-complete SCICatheterization performed by urology nurse, participant blinded to time of procedureIndividuals with motor sensory complete injury (AIS A/B)
Individuals with motor-complete SCICatheterization performed by urology nurse, participant aware of time of procedureIndividuals with motor sensory complete injury (AIS A/B)
Primary Outcome Measures
NameTimeMethod
Change in state anxiety in the context of catheterization performed by urology nurse, participant aware of time of procedure (STAIS-5)5 minutes before and 5 minutes after catheterization performed by urology nurse, participant aware of time of procedure

The STAIS-5 will be used to measure participants' state anxiety prior to and after catheterization procedure performed by an experienced urology nurse, while the participant is aware of time of procedure. Sum score of the STAIS-5 will be calculated, which ranges between 5 to 20, with higher score indicating greater state anxiety.

BP during catheterization performed by urology nurse, participant aware of time of procedureDuring catheterization performed by urology nurse, participant aware of time of procedure

Systolic and diastolic BP (mmHg) will be measured 5 minutes prior to and then throughout the standard of care catheterization performed by an experienced urology nurse, while the participant is aware of time of procedure.

Change in state anxiety in the context of catheterization performed by urology nurse, participant blinded to time of procedure (STAIS-5)5 minutes before and 5 minutes after catheterization performed by urology nurse, participant blinded to time of procedure

The STAIS-5 will be used to measure participants' state anxiety prior to and after catheterization procedure performed by an experienced urology nurse, while the participant is blinded to time of procedure. Sum score of the STAIS-5 will be calculated, which ranges between 5 to 20, with higher score indicating greater state anxiety.

BP during catheterization performed by urology nurse, participant blinded to time of procedureDuring catheterization performed by urology nurse, participant blinded to time of procedure

Systolic and diastolic BP (mmHg) will be measured 5 minutes prior to and then throughout the standard of care catheterization performed by an experienced urology nurse, while the participant is blinded to time of procedure.

Blood pressure (BP) during self-catheterizationDuring self-catheterization

Systolic and diastolic BP (mmHg) will be measured continuously (beat-by-beat) via finger photoplethysmography, corrected to brachial pressure. BP will be measured 5 minutes prior to and then throughout the self-catheterization procedure.

Heart rate (HR) during self-catheterizationDuring self-catheterization

HR (BPM) will be recorded continuously via one-lead electrocardiogram. HR will be measured 5 minutes prior to and then throughout the self-catheterization procedure.

HR during catheterization performed by urology nurse, participant blinded to time of procedureDuring catheterization performed by urology nurse, participant blinded to time of procedure

HR (BPM) will be measured 5 minutes prior to and then throughout the standard of care catheterization performed by an experienced urology nurse, while the participant is blinded to time of procedure.

Change in state anxiety in the context of self-catheterization (STAIS-5)5 minutes before and 5 minutes after self-catheterization

The State-Trait Anxiety Inventory - State, 5 item version (STAIS-5) will be used to measure participants' state anxiety prior to and after self-catheterization. Sum score of the STAIS-5 will be calculated, which ranges between 5 to 20, with higher score indicating greater state anxiety.

HR during catheterization performed by urology nurse, participant aware of time of procedureDuring catheterization performed by urology nurse, participant aware of time of procedure

HR (BPM) will be measured 5 minutes prior to and then throughout the standard of care catheterization performed by an experienced urology nurse, while the participant is aware of time of procedure.

Secondary Outcome Measures
NameTimeMethod
Baseline trait anxietyDuring screening

The 7-item General Anxiety Disorder (GAD) scale will be used to measure participants' anxiety. The GAD-7 sum score will be calculated, ranging from 0 to 21, with higher score indicating more severe anxiety symptoms.

Change in state anxiety in the context of self-catheterization (GA-VAS)5 minutes before and 5 minutes after self-catheterization

The Global Anxiety-Visual Analogue Scale (GA-VAS) will be used to measure participants' state anxiety prior to and after self-catheterization. Rating can range between 0 to 10, with higher rating on the GA-VAS indicates greater state anxiety.

Change in state anxiety in the context of catheterization performed by urology nurse, participant blinded to time of procedure (GA-VAS)5 minutes before and 5 minutes after catheterization performed by urology nurse, participant blinded to time of procedure

The GA-VAS will be used to measure participants' state anxiety prior to and after catheterization procedure performed by an experienced urology nurse, while the participant is blinded to time of procedure. Rating can range between 0 to 10, higher rating on the GA-VAS indicates greater state anxiety.

Change in state anxiety in the context of catheterization performed by urology nurse, participant aware of time of procedure (GA-VAS)5 minutes before and 5 minutes after catheterization performed by urology nurse, participant aware of time of procedure

The GA-VAS will be used to measure participants' state anxiety prior to and after catheterization procedure performed by an experienced urology nurse, while the participant is aware of time of procedure. Higher rating on the GA-VAS indicates greater state anxiety.

Change in heart rate variability (HRV) during self-catheterizationDuring self-catheterization

HRV will be calculated from continuous ECG recording

Change in heart rate variability (HRV) during catheterization performed by urology nurse, participant blinded to time of procedureDuring catheterization performed by urology nurse, participant blinded to time of procedure

HRV will be calculated from continuous ECG recording

Change in heart rate variability (HRV) during catheterization performed by urology nurse, participant aware of time of procedureDuring catheterization performed by urology nurse, participant aware of time of procedure

HRV will be calculated from continuous ECG recording

Trial Locations

Locations (1)

Blusson Spinal Cord Centre

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Vancouver, British Columbia, Canada

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