Measurement Reactivity in a Randomized Clinical Trial Using Self-Reported Data.
Jahaira Capellan, Mary H Wilde, Feng Zhang
PMID 27860292WHAT IT FOUND
Both groups improved in a catheter self-management trial, and some control participants said the calendar and repeated interviews made them pay more attention to their catheters.
Only blockage differed in the first 6 months, favoring the intervention.
Key findings
01Both groups improved from baseline over 12 months for catheter-associated urinary tract infection, blockage, and dislodgement, and group differences appeared only for blockage in the first 6 months, favoring the intervention.
02Missing event dates were rare and similar across groups: 1.8% of first four blockage reports and 3 infection dates were missing, so the authors judged calendar use comparable.
03Control participants more often commented about the interviews (23% versus 6% in the intervention group), and some said the questions made them pay attention, monitor fluid intake, and check catheter position.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The authors did not systematically assess how often participants used the calendar, so other reasons for control-group improvement cannot be ruled out. They asked only one short open-ended question at the end, so the comments may not fully capture participants' experience. They did not interview randomly selected participants from each group at the end of the study, which might have clarified the mechanisms. The control group received the same calendar and repeated interviews as the intervention group, so the analysis cannot separate the teaching visits from measurement effects.
The easy way to misread this
Do not conclude that the self-management teaching was useless because both groups improved. The calendar and repeated interviews may have made control participants monitor their catheters more, which can reduce the apparent difference between groups.