Intermittent catheterization (IC) is a recommended management strategy for many patients with bladder emptying dysfunction. However, initiation can be challenging. Survey data (1) from men initiating IC indicate that emotional barriers such as anxiety, fear of injury, embarrassment, and uncertainty about performing the procedure correctly are common and may negatively affect confidence, adherence, and long-term outcomes. Structured clinical onboarding approaches may support healthcare professionals in addressing these barriers during early IC training.

The aim of this study was to develop a structured, clinically applicable best-practice onboarding framework to support healthcare professionals in addressing psychological and practical barriers when initiating intermittent catheterization in men.

An evidence-informed clinical guidance framework was developed using findings from a cross-sectional survey exploring patient-reported barriers to IC initiation in men, combined with expert input from a multidisciplinary working group consisting of four specialist continence nurses from three countries. The framework was iteratively refined within the advisory group to support clarity, clinical relevance, and usability during routine nurse-led IC training consultations. It was structured as a stepwise clinical support tool covering preparation, the first catheterization experience, and early follow-up. External evaluation with specialist continence nurses across multiple countries is planned, with clinicians applying the framework in routine practice with patients initiating IC; results from this evaluation will be reported separately.

The resulting framework outlines a structured three-stage onboarding process: Before, During, and After IC initiation (see figure 1 and figure 2). The framework emphasizes early identification of emotional barriers, patient-centred communication, and psychological safety during the learning process. It includes practical recommendations for assessing readiness, delivering step-by-step training, supporting the first catheterization experience, and providing structured follow-up to reinforce confidence and independence. Key elements include normalization of emotional responses, patient-led pacing, reassurance regarding technique and safety, and proactive follow-up aligned with early skill consolidation. Initial feedback from the advisory group supported the clarity and clinical applicability of the framework and highlighted its potential usefulness for structuring IC training and addressing common psychological barriers during initiation.

Integrating structured emotional onboarding into routine IC training may help healthcare professionals better address common psychological barriers experienced by men during treatment initiation. This framework provides a practical, stepwise approach that can support more consistent delivery of patient-centred IC training and may improve confidence and engagement during early therapy. Ongoing multicountry clinical evaluation will further assess its usability and implementation in routine care.

This structured onboarding framework provides a clinically applicable approach to supporting men during IC initiation. By integrating emotional readiness assessment alongside technical training, the framework has the potential to improve patient confidence, facilitate successful initiation, and support long-term adherence to intermittent catheterization.

Sheward, N., Lindholm, S. and Ringberg, J., 2026. Barriers to initiating intermittent self-catheterization: A comparative survey of women’s and men’s experiences. Poster EGP03 presented at the 26th Meeting of the European Association of Urology Nurses (EAUN26), London, UK.

Continence 19S (2026) 102505
DOI: 10.1016/j.cont.2026.102505