The Effect of Education on Patients' Attitudes and Anxiety Towards CAUTI Prevention

The Effect of Education on Patients' Attitudes Towards Preventing Catheter-Associated Urinary Tract Infections and Anxiety After Urologic Surgery

This research will be carried out determine the effect of education given to patients after urological surgery on their attitudes and anxiety levels towards preventing catheter-related urinary tract infections.

Urology surgeries are surgical procedures performed to treat diseases of the kidneys, ureters, bladder, prostate, and urethra. Urinary catheterization is a procedure performed to drain urine from the bladder or collect a urine sample using a catheter. A urinary catheter is inserted in 15-25% of hospitalized patients during their hospital stay, and many patients are discharged home with a urinary catheter after urology surgery.

Urinary tract infection (UTI) is the most common healthcare-associated infection, accounting for 36% of all healthcare-associated infections.

Approximately 75% of hospital-acquired urinary tract infections are associated with urinary catheters. A catheter-associated urinary tract infection is defined as a urinary tract infection that occurs when a urinary catheter has been in place for at least two days. Patients discharged with a urinary catheter; They may encounter various problems, including urinary tract infections, bag emptying, catheter changes, clothing adjustments, (hand) hygiene, odor, and catheter kinking. They may also experience physical and psychosocial difficulties related to catheter care. These problems also bring with them the risk of urinary catheter-related complications. Today, nursing practice prioritizes supporting individuals and families in their own self-care by providing them with the necessary knowledge and skills, rather than assuming full responsibility for their care.

Guidelines for preventing catheter-associated urinary tract infections recommend involving patients and their families in their care to prevent these infections.Therefore, nurses, in their role as educators, should provide training to ensure patients maintain their daily activities with their catheters, particularly regarding catheter care.

In this direction, this study will attempt to reveal the effects of post-urological surgery education on patients' attitudes and anxiety levels towards preventing catheter-related urinary tract infections.

This research will be conducted in a prospective, randomized experimental design with pretest-posttest experimental and control groups. The sample size of the study will consist of urology patients who meet the inclusion criteria and agree to participate in the study.The patients to be included in the sample of the study will be randomly divided into two groups as experimental and control groups. The study sample size was calculated using data from a similar study in the literature using the G*Power 3.1.9.7 program for an independent samples t-test, with a test power (power) of 0.80, a confidence level of 95% (1-α), and an effect size of f=0.64, for a total of 62 patients (31 in the experimental group and 31 in the control group), with a minimum of 31 patients in each group.

However, considering data loss, the plan is to include at least 70 patients (35 in the experimental group and 35 in the control group).

Data will be collected using the "Individual Characteristics Form," the "State and Trait Anxiety Inventory," and the "Attitude Scale for Preventing Catheter-Associated Urinary Tract Infections in Patients with Indwelling Urinary Catheters." The "Patient Education Material Evaluation Tool (HEMDA)" will be used to evaluate the educational materials and will be submitted to an expert for review. R ver. 2.15.3 program (R Core Team, 2013) will be used for statistical analysis.

Inclusion Criteria:

• Age 18 and over,
• Male patients,
• Discharged with a urinary catheter after TURP, HOLEP, Internal Urethrotomy, and Open Prostatectomy surgeries at the urology department of the University Hospital where the study will be conducted,
• Possess the cognitive, affective, and psychomotor skills to perform self-care (no coordination problems affecting the upper extremities),
• Are literate,
• Have no visual or auditory communication problems,
• Have no previous psychiatric disorder/diagnosis and are not currently taking medication for psychiatric disorders,
• Individuals who volunteer to participate in the study will be included.

Exclusion Criteria:

• Patients who are under 18 years of age,
• Female patients,
• Patients who have undergone surgeries other than TUR-P, HOLEP, Internal Urethrotomy, and Open Prostatectomy,
• Patients with an oncological diagnosis and ongoing care/treatment, or who have previously received oncological treatment,
• Patients who develop postoperative complications/whose general health deteriorates, who do not wish to participate in the study, or who wish to withdraw/exit from any aspect of the study will not be included in the study.