The Journal of Urology
Volume 185, Issue 2, February 2011, Pages 578-582

Abstract

Pencil and Paper Test (PP Test): A New Tool for Predicting Ability of Neurological Patients to Practice Clean Intermittent Self-Catherization.

Purpose: The aim of the study is to create and validate a specific test, the « Pencil and Paper Test » (PP test), that allows checking the neurological patient ability to practice Clean Intermittent Self-Catherization (CISC).

Material and Methods: A simple test, including common manoeuvres mimicking the usual manoeuvres carried out during CISC and involving the same cognitive and physical resources needed in this technique, was developed and tested on 118 neurological patients. The « instruments » necessary to perform PP test are limited to a sheet of paper and a pencil. Each item of the PP test was quantified and graded with a total score of 15. A specific learning scale was used to classify the ability outcome to perform CISC, the CIRCLES (Clean InteRmittent Catherization LEarning Scale), ranging from 5 (CISC learning easy and CISC complete) to 0 (CISC learning impossible).

Results: 118 neurological patients were enrolled. There is a strong correlation (r=0.82, p=0.000091) between global PP test score and the ability to perform CISC evaluated by means of the CIRCLES. With a cut off point of PP test fixed at 10 and a cut off point of CIRCLES fixed at 3 (the limit to practice CISC alone), the positive predictive value of the PP test is 85% and its negative predictive value 94%. Cronbach’s alpha is 0.88.

Conclusions: PP test is a valid test to predict the ability to practice CISC for neurological patients.