Skip to content
Home Browse Management strategies for lower urinary tract symptoms (LUTS) among...
ALL Metrics
-
Views
67
Downloads
Get PDF
Get XML
Cite
Export
Track
▬
✚
Study Protocol

Management strategies for lower urinary tract symptoms (LUTS) among people with multiple sclerosis (MS): a qualitative study of the perspectives of people with MS and healthcare professionals

[version 1; peer review: 2 approved]
Hawra B. Al Dandan
https://orcid.org/0000-0002-0807-7323
1,2, Rose Galvin
https://orcid.org/0000-0002-8171-224X
1,3,4, Doreen McClurg5, Susan Coote
https://orcid.org/0000-0001-7077-0164
1,3
Hawra B. Al Dandan
https://orcid.org/0000-0002-0807-7323
1,2, Rose Galvin
https://orcid.org/0000-0002-8171-224X
1,3,4, Doreen McClurg5, Susan Coote
https://orcid.org/0000-0001-7077-0164
1,3
PUBLISHED 18 Nov 2019
Author details Author details
OPEN PEER REVIEW
REVIEWER STATUS

Abstract

Background: Neurogenic lower urinary tract dysfunction (NLUTD) is defined as a lower urinary tract dysfunction secondary to confirmed pathology of the nervous system. NLUTD is common in people with multiple sclerosis (MS), with prevalence estimates ranging from 49% to 92%. Managing NLUTD is complex and can be comprised of pharmacological and non-pharmacological interventions. Qualitative research exploring perspectives of people with MS and healthcare professionals on living with and managing NLUTD symptoms is sparse. This study aims to explore the perspectives of people with MS and healthcare professionals on managing NLUTD symptoms.
Methods: A qualitative descriptive approach will be applied in this study using audio-recorded semi structured interviews for people with MS and healthcare professionals. The Consolidated Criteria for Reporting Qualitative Studies (COREQ) guidelines will be used to standardize the conduct and reporting of the research. People with MS will be recruited through a gatekeeper at MS Ireland. Healthcare professionals will be recruited through gatekeepers at Irish Practice Nurses Association, Continence Foundation of Ireland, Irish Society of Chartered Physiotherapists, and Physiotherapists Interested in MS Group. Interviews will be transcribed and exported to NVivo software package (Version 12) for analysis. Data will be collectively synthesised using thematic analysis.
Conclusion: It is anticipated that exploring perspectives of people with MS and healthcare professionals on managing symptoms (including current practice) of NLUTD in MS will assist in the development of an evidence-based and stakeholder informed intervention for NLUTD in people with MS.

Keywords

Multiple sclerosis, Neurogenic bladder, management strategies, qualitative study

Corresponding author: Hawra B. Al Dandan
Competing interests: No competing interests were disclosed.
Grant information: Health Research Board Ireland [ILP-HSR-2017-014], an Investigator Led Projects 2017 award to Dr Rose Galvin.
HD is funded by an unrestricted grant from Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia [IRUD1702].
The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Copyright:  © 2019 Al Dandan HB et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
How to cite: Al Dandan HB, Galvin R, McClurg D and Coote S. Management strategies for lower urinary tract symptoms (LUTS) among people with multiple sclerosis (MS): a qualitative study of the perspectives of people with MS and healthcare professionals [version 1; peer review: 2 approved]. HRB Open Res 2019, 2:31 (https://doi.org/10.12688/hrbopenres.12960.1) First published: 18 Nov 2019, 2:31 (https://doi.org/10.12688/hrbopenres.12960.1) Latest published: 18 Nov 2019, 2:31 (https://doi.org/10.12688/hrbopenres.12960.1)

Introduction

Neurogenic lower urinary tract dysfunction (NLUTD) is defined as lower urinary tract symptoms secondary to neurological disease or central nervous system (CNS) injury1–4 that results in disturbance of ascending or descending pathways to the bladder5. The International Continence Society (ICS) classify NLUTD based on clinical symptoms including storage phase symptoms, voiding phase symptoms, and post-micturition symptoms1. A systematic review of literature demonstrates that lower urinary tract dysfunction is prevalent among people with MS with a pooled prevalence of 68.41% using self-report outcome measures and 62.18% when using the objective measure of urodynamics6. Storage phase symptoms such as frequency, urgency, and/or nocturia appear to be the most prevalent symptoms among people with MS. However, both storage and voiding complaints have been estimated at 50% among people with MS7,8.

NLUTD among people with MS is associated with significant morbidity that results in activity limitations and reduced health-related quality of life9–13. Previous research has demonstrated that the presence of bladder related symptoms is associated with worse physical functioning among people with MS regardless of disease duration9,10. Previous studies also showed a significant correlation between urinary symptoms and a negative impact on emotional health, ability to perform household chores, and physical recreation11,13. In addition, urinary incontinence has been identified as a factor associated with increased risk of falling among people with MS aged from 45 – 90 years old14.

Management of NULTD is complex and can be comprised of pharmacological and non-pharmacological interventions. In this study we are interested in focusing on non-pharmacological treatments. There is evidence to support the use of pelvic floor muscle exercises, electrotherapy and education as management strategies for neurogenic bladder15–24. A recent review found some promising evidence to support the use of a new, non-invasive tibial nerve stimulation as an option for NLUTD among people with MS25. Qualitative studies involving perspectives of healthcare professionals and patients on therapeutic interventions play an essential role in incorporating practice-based evidence in to evidence-based practice to improve health outcomes26,27. A thorough understanding of people with MS and healthcare professionals’ views of various treatment options for urinary symptoms among people with MS will assist in the development of an intervention that aims to improve management of urinary symptoms among people with MS.

Despite the high prevalence of NLUTD among people with MS, there are a lack of qualitative studies exploring the views of people with MS and healthcare professionals on the management of LUTS and their views on using transcutaneous tibial nerve stimulation (TTNS) as an option to reduce urinary symptoms. A review of qualitative studies relating to NLUTD in MS identified three older studies focused on self-management strategies of urinary incontinence among women28,29 and men30 with MS. The studies demonstrated the strategies undertaken by patients to control their symptoms of incontinence with no detailed information provided for all types of LUTD. A further qualitative study explored how bladder dysfunction interferes with quality of life in MS12. In terms of healthcare professionals, two qualitative studies were identified. One study explored healthcare professionals beliefs toward bladder dysfunction in MS and how beliefs affect their practice and knowledge regarding bladder dysfunction31, while the second study showed that healthcare professionals require clear evidence-based guidelines focusing on catheter design, appropriate training on the use of single and multi-use catheter to facilitate patient selection of the catheter that is most applicable to their needs32. Therefore, to date no qualitative studies have been identified that focuses on the experiences and current practices of healthcare professionals including TTNS in managing NLUTD in MS. The aims of this study are to: 1) explore the experiences of people with MS in managing NLUTD; 2) explore the views of people with MS on TTNS in managing their NLUTD; 3) explore the healthcare professionals’ role (current practice) in managing NLUTD among people with MS; 4) explore healthcare professionals’ views on TTNS as an option to manage NLUTD in MS.

Methods

The conduct and reporting of this study is in accordance with Consolidated criteria for reporting qualitative research (COREQ)33. Ethical approval has been granted by the Faculty of Education and Health Sciences Research Ethics Committee at the University of Limerick [Ref 2019_05_18_EHS].

Research team roles

All interviews will be conducted, transcribed, and analysed by Hawra Al Dandan (HD), a physiotherapist and a PhD candidate at the University of Limerick. HD has completed a qualitative research methodology module that focused on data analysis and she completed an advanced training workshop for Nvivo software. HD contributed to the conceptualization of this research, and will contribute to data curation, data analysis, writing both in the original draft preparation, and in the editing and review of manuscript. Dr Rose Galvin (RG) is a senior lecturer in physiotherapy and experienced researcher in quantitative and qualitative research. RG will provide critical feedback on the transcribed interviews, data analysis, and writing of the manuscript. Prof. Susan Coote (SC) is an associate professor in physiotherapy and experienced researcher in quantitative and qualitative research methods in people with multiple sclerosis. SC has contributed to the conceptualisation of this study and will play a role in providing feedback of the data analysis stage and editing and review of the manuscript. Prof. Doreen McClurg (DM) is a professor of physiotherapy and experienced quantitative and qualitative researcher in bladder and bowel dysfunction among people with MS. DM has contributed to the conceptualisation of this study and will provide feedback on the data analysis, editing and review of the manuscript, and will contribute to the dissemination stage.

Study design

A qualitative descriptive (QD) approach was chosen for this study. This approach explores general beliefs and views of naturalistic inquiry that expose the experiences described by target populations. It is a common method to gain an insight into a specific topic from the perspectives of participants34–36. QD has been recommended for use in health care contexts among healthcare professionals and patients because it provides first insight into patient’s and clinicians’ views and experiences within a specific topic36.

Sampling

A mixed purposive sampling technique will be used in this study37. Purposive sampling allows the selection of information-rich cases for the purposes of a specific study, which results in an in-depth understanding rather than generalisations34,37–40. For people with MS, criterion purposive sampling will be used based on predefined inclusion/exclusion criteria37. A representative sample of participants will be sought to participate based on sex, type of MS, disability level, and duration of urinary symptoms.

For healthcare professionals, snow-ball purposive sampling will be used37. It is a non-random sampling technique known as referral sampling where existing research participants recruit a further participant who is information-rich in the field from their acquaintances, and so on41 to ensure continuation of sampling through social networking40,42,43.

Sample size

Sample size will be informed by data saturation44. It is anticipated that 10–15 interviews will be conducted with people with MS, and 5–10 interviews will be conducted with healthcare professionals.

Recruitment of research participants

For people with MS, recruitment letters and the study information sheet with contact details for the study investigators will be sent through a gatekeeper at MS Ireland45. People with MS will be included if they meet the following inclusion criteria: >=18 years old; have at least one bladder related symptom. People with MS will be excluded if they are unwilling or unable to give informed consent; have an indwelling urethral catheter or indwelling suprapubic catheter; or are pregnant during the data collection phase.

For healthcare professionals, emails will be distributed to healthcare professionals through gatekeepers at Irish Practice Nurses Association, Continence Foundation of Ireland, Irish Society of Chartered Physiotherapists, and the Physiotherapists Interested in MS Group. In Ireland, these are the core healthcare professionals who interact with individuals with MS who may have urinary symptoms. The study information sheet and contact details for the study investigators will be attached in the body of the email45. Healthcare professionals will be eligible if they are treating or have treated bladder related symptoms among people with MS. Completion of the written informed consent form45 will be a prerequisite for study participants as articulated in the Health Research Regulations 2018.

Data collection

Telephone interview has been shown to be an effective method for collection of qualitative data, this includes data related to sensitive topics due to the following benefits: obtaining rich data; more flexibility for scheduling; convenience for participants including clinicians; enhanced access to geographically dispersed areas; less time-consuming for the researcher and participant in terms of travel; and more cost-effective46,47. Audio recording, semi-structured interviews and written notes will be undertaken for the purposes of this study38,40,48–50. One interview will be conducted for each participant by HD, with no prior established relationship with participants. The interviews will be conducted in a private room in the School of Allied Health at the University of Limerick. An independent researcher will present during the interview as a note-taker. Each interview is expected to last approximately 30 minutes for people with MS and up to 60 minutes for healthcare professionals.

Interview guide

The interview questions were developed by the researchers by reviewing existing literature relating to patient and carer experiences of incontinence among MS51. The interview questions were based on the principles of constructing semi-structured interviews reported in the literature38. Open-ended interview questions were chosen as they allow the participants to explore and discuss their experiences in managing bladder related symptoms. The interview guide is available as extended data of this manuscript45.

Data will be handled confidentially and will be stored in accordance with Data Protection Policy at the University of Limerick and in line with the Health Research Regulations 2018. All recordings will be stored anonymously, securely and confidentially in the principal investigator office in the School of Allied Health at the University of Limerick. RG the Principal Investigator and the co-investigators HD, SC and DM will have access to the data collected. At the end of each interview, HD will transfer the audio recordings to a password-protected laptop and anonymised transcripts will be saved in the same laptop. Upon completion of transcription of interviews, pseudonyms will be placed instead of the participants’ actual names. Audio recordings will be deleted once transcription has been completed. The data will be stored for seven years then all hard copies will be shredded, and electronic files will be deleted permanently. Prior to the analysis stage, participants will be offered the opportunity to review the transcript document for comments, and corrections to ensure accuracy of the interview transcripts40.

Data analysis

In this study, NVivo software package (version 12) will be used to import transcripts, organize, store, and retrieve data to be ready for analysis. Data will be collectively synthesized using a reflexive thematic analysis, inductive approach52–54. In this approach, the coding process is data driven rather than by researchers’ pre-existing theories or researcher’s analytical prejudices. This type of analysis provides six systematic phases, which will be conducted by HD with critical review and feedback from RG. Phase 1 includes familiarization with collected data, while phase 2 includes an in-depth engagement with data and extraction of initial codes by highlighting the actual words from participants. Phases 3 and 4 involve generating themes by sorting different codes to form potential themes and then reviewing the link between the themes and the original dataset. These phases also involve refining themes to code any additional data. In phases 5 and 6, themes will be defined collectively by giving a name to each theme through review and consultation between study investigators. Finally, a narrative report will be provided by HD and reviewed by RG to ensure a clear audit trail of methodology during the research process.

According to the recent literature54, the approach to reflexive thematic analysis highlights the active role of the researchers as the primary tool to ensure a good quality study. The approach sees coding as a flexible, organic and subjective process that aims to reflect how the researchers are conceptualizing the data. To this end, the coding process captures the relationship of the data to the research questions and serves to generate distinctive themes that capture patterns of shared meaning across the dataset, underpinned by a central organizing concept and generating an interpretative rather than descriptive analytic report. In the current study, methodological rigour will be addressed by: adhering to a 15-point checklist of criteria for good thematic analysis55; the use of a reflective report, which is considered an essential step in qualitative research to enhance transparency and trustworthiness; sharing the coding process with the study research team; and by using field notes to document initial impressions during data collection56,57.

Dissemination

Subsequent to the analysis stage, key themes and a summary of findings will be shared with participants. While this qualitative study will inform the intervention of a future pilot study for neurogenic bladder among people with MS, the results will also be submitted for publication. Abstracts will be submitted to relevant national and international conferences. Locally, the study results will be shared with healthcare professionals who participated in the study and with the Physiotherapists Interested in MS Group. For people with MS, the results will be submitted to MS Ireland newsletters through a gatekeeper at MS Ireland.

Study status

The study is due to commence in November 2019.

Conclusion

To the authors’ knowledge, no studies have been conducted to explore the experiences and perspectives of healthcare professionals and people with MS in management strategies of NLUTD in MS. It is anticipated that understanding and exploring management strategies and current practice of NLUTD among people with MS will assist in the development of an intervention that may serve to improve management of urinary symptoms among people with MS.

Data availability

Underlying data

No underlying data is associated with this article.

Extended data

Open Science Framework: Management strategies for lower urinary tract symptoms (LUTS) among people with multiple sclerosis (MS): a qualitative study of the perspectives of people with MS and healthcare professionals. https://doi.org/10.17605/OSF.IO/64ETG45

This project contains the following extended data:

  • - Appendices.docx (recruitment letters, participant information sheets, consent forms and demographic data sheets for people with MS and healthcare professionals)

  • - Interview Guide.docx (interview guide for people with MS and healthcare professionals)

Data are available under the terms of the Creative Commons Zero “No rights reserved” data waiver (CC0 1.0 Public domain dedication).

References

  • 1.  Gajewski JB, Schurch B, Hamid R, et al.: An International Continence Society (ICS) report on the terminology for adult neurogenic lower urinary tract dysfunction (ANLUTD). Neurourol Urodyn. 2018; 37(3): 1152–1161. PubMed Abstract | Publisher Full Text
  • 2.  Manack A, Motsko SP, Haag-Molkenteller C, et al.: Epidemiology and healthcare utilization of neurogenic bladder patients in a US claims database. Neurourol Urodyn. 2011; 30(3): 395–401. PubMed Abstract | Publisher Full Text
  • 3.  Welk B, Morrow SA, Madarasz W, et al.: The conceptualization and development of a patient-reported neurogenic bladder symptom score. Res Rep Urol. 2013; 5: 129–37. PubMed Abstract | Publisher Full Text | Free Full Text
  • 4.  Jaggi A, Fatoye F: PUK25 - Real World Treatment Patterns In The Neurogenic Bladder Population: A Systematic Literature Review. Value in Health. 2017; 20(9): A492–A492.
  • 5.  McCombe PA, Gordon TP, Jackson MW: Bladder dysfunction in multiple sclerosis. Expert Rev Neurother. 2009; 9(3): 331–340. PubMed Abstract | Publisher Full Text
  • 6.  Al Dandan HB, Coote S, McClurg D: The Prevalence of Lower Urinary Tract Symptoms among People with Multiple Sclerosis: A Systematic Review and Meta-Analysis. Int J MS Care. 2019; (in press).
  • 7.  de Sèze M, Ruffion A, Denys P, et al.: The neurogenic bladder in multiple sclerosis: review of the literature and proposal of management guidelines. Mult Scler. 2007; 13(7): 915–928. PubMed Abstract | Publisher Full Text
  • 8.  Panicker J, Haslam C: Lower urinary tract dysfunction in MS: management in the community. Br J Community Nurs. 2009; 14(11): 474, 476, 478–480. PubMed Abstract | Publisher Full Text
  • 9.  Nortvedt MW, Riise T, Myhr KM, et al.: Reduced quality of life among multiple sclerosis patients with sexual disturbance and bladder dysfunction. Mult Scler. 2001; 7(4): 231–235. PubMed Abstract | Publisher Full Text
  • 10.  Nortvedt MW, Riise T, Frugård J, et al.: Prevalence of bladder, bowel and sexual problems among multiple sclerosis patients two to five years after diagnosis. Mult Scler. 2007; 13(1): 106–112. PubMed Abstract | Publisher Full Text
  • 11.  Vitkova M, Rosenberger J, Krokavcova M, et al.: Health-related quality of life in multiple sclerosis patients with bladder, bowel and sexual dysfunction. Disabil Rehabil. 2014; 36(12): 987–992. PubMed Abstract | Publisher Full Text
  • 12.  Browne C, Salmon N, Kehoe M: Bladder dysfunction and quality of life for people with multiple sclerosis. Disabil Rehabil. 2015; 37(25): 2350–2358. PubMed Abstract | Publisher Full Text
  • 13.  Khan F, Pallant JF, Shea TL, et al.: Multiple sclerosis: prevalence and factors impacting bladder and bowel function in an Australian community cohort. Disabil Rehabil. 2009; 31(19): 1567–1576. PubMed Abstract | Publisher Full Text
  • 14.  Finlayson ML, Peterson EW, Cho CC: Risk factors for falling among people aged 45 to 90 years with multiple sclerosis. Arch Phys Med Rehabil. 2006; 87(9): 1274–1279; quiz 1287. PubMed Abstract | Publisher Full Text
  • 15.  McClurg D, Ashe RG, Marshall K, et al.: Comparison of pelvic floor muscle training, electromyography biofeedback, and neuromuscular electrical stimulation for bladder dysfunction in people with multiple sclerosis: a randomized pilot study. Neurourol Urodyn. 2006; 25(4): 337–348. PubMed Abstract | Publisher Full Text
  • 16.  McClurg D, Ashe RG, Lowe-Strong AS: Neuromuscular electrical stimulation and the treatment of lower urinary tract dysfunction in multiple sclerosis--a double blind, placebo controlled, randomised clinical trial. Neurourol Urodyn. 2008; 27(3): 231–237. PubMed Abstract | Publisher Full Text
  • 17.  McClurg D, Lowe-Strong A, Ashe R: Pelvic floor training for lower urinary tract dysfunction in MS. Nurs Times. 2009; 105(7): 45–47. PubMed Abstract
  • 18.  Fowler CJ, Panicker JN, Drake M, et al.: A UK consensus on the management of the bladder in multiple sclerosis. J Neurol Neurosurg Psychiatry. 2009; 80(5): 470–7. PubMed Abstract | Publisher Full Text
  • 19.  Lúcio AC, Campos RM, Perissinotto MC, et al.: Pelvic floor muscle training in the treatment of lower urinary tract dysfunction in women with multiple sclerosis. Neurourol Urodyn. 2010; 29(8): 1410–1413. PubMed Abstract | Publisher Full Text
  • 20.  Lúcio AC, Perissinoto MC, Natalin RA, et al.: A comparative study of pelvic floor muscle training in women with multiple sclerosis: its impact on lower urinary tract symptoms and quality of life. Clinics (Sao Paulo). 2011; 66(9): 1563–1568. PubMed Abstract | Publisher Full Text | Free Full Text
  • 21.  Lúcio A, Dʼancona CA, Perissinotto MC, et al.: Pelvic Floor Muscle Training With and Without Electrical Stimulation in the Treatment of Lower Urinary Tract Symptoms in Women With Multiple Sclerosis. J Wound Ostomy Continence Nurs. 2016; 43(4): 414–419. PubMed Abstract | Publisher Full Text
  • 22.  De Ridder D, Van Der Aa F, Debruyne J, et al.: Consensus guidelines on the neurologist's role in the management of neurogenic lower urinary tract dysfunction in multiple sclerosis. Clin Neurol Neurosurg. 2013; 115(10): 2033–2040. PubMed Abstract | Publisher Full Text
  • 23.  Panicker JN, Fowler CJ, Kessler TM: Lower urinary tract dysfunction in the neurological patient: clinical assessment and management. Lancet Neurol. 2015; 14(7): 720–732. PubMed Abstract | Publisher Full Text
  • 24.  Tornic J, Panicker J: The Management of Lower Urinary Tract Dysfunction in Multiple Sclerosis. Curr Neurol Neurosci Rep. 2018; 18(8): 54. PubMed Abstract | Publisher Full Text | Free Full Text
  • 25.  Schneider MP, Gross T, Bachmann LM, et al.: Tibial Nerve Stimulation for Treating Neurogenic Lower Urinary Tract Dysfunction: A Systematic Review. Eur Urol. 2015; 68(5): 859–867. PubMed Abstract | Publisher Full Text
  • 26.  Leeman J, Sandelowski M: Practice-based evidence and qualitative inquiry. J Nurs Scholarsh. 2012; 44(2): 171–179. PubMed Abstract | Publisher Full Text
  • 27.  Kidd MO, Bond CH, Bell ML: Patients' perspectives of patient-centredness as important in musculoskeletal physiotherapy interactions: a qualitative study. Physiotherapy. 2011; 97(2): 154–162. PubMed Abstract | Publisher Full Text
  • 28.  Koch T, Kelly S: Identifying strategies for managing urinary incontinence with women who have multiple sclerosis. J Clin Nurs. 1999; 8(5): 550–559. PubMed Abstract | Publisher Full Text
  • 29.  Koch T, Kralik D, Eastwood S, et al.: Breaking the silence: women living with multiple sclerosis and urinary incontinence. Int J Nurs Pract. 2001; 7(1): 16–23. PubMed Abstract | Publisher Full Text
  • 30.  Koch T, Kralik D, Kelly S: We just don't talk about it: men living with urinary incontinence and multiple sclerosis. Int J Nurs Pract. 2000; 6(5): 253–260. Publisher Full Text
  • 31.  Browne C, Kehoe M, Salmon N: How Beliefs About Bladder Dysfunction Among Health-Care Professionals Influence Clinical Practice Development: Perspectives of Allied Health Professionals, Nurses, and Managers. Int J MS Care. 2017; 19(4): 191–198. PubMed Abstract | Publisher Full Text | Free Full Text
  • 32.  McClurg D, Coyle J, Long A, et al.: A two phased study on health care professionals' perceptions of single or multi-use of intermittent catheters. Int J Nurs Stud. 2017; 72: 83–90. PubMed Abstract | Publisher Full Text
  • 33.  Tong A, Sainsbury P, Craig J: Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007; 19(6): 349–357. PubMed Abstract | Publisher Full Text
  • 34.  Sandelowski M: Whatever happened to qualitative description? Res Nurs Health. 2000; 23(4): 334–340. PubMed Abstract | Publisher Full Text
  • 35.  Sandelowski M: What's in a name? Qualitative description revisited. Res Nurs Health. 2010; 33(1): 77–84. PubMed Abstract | Publisher Full Text
  • 36.  Neergaard MA, Olesen F, Andersen RS, et al.: Qualitative description - the poor cousin of health research? BMC Med Res Methodol. 2009; 9(1): 52. PubMed Abstract | Publisher Full Text | Free Full Text
  • 37.  Suri H: Purposeful sampling in qualitative research synthesis. Qualitative Research Journal. 2011; 11(2): 63–75. Publisher Full Text
  • 38.  McIntosh MJ, Morse JM: Situating and Constructing Diversity in Semi-Structured Interviews. Glob Qual Nurs Res. 2015; 2: 2333393615597674. PubMed Abstract | Publisher Full Text | Free Full Text
  • 39.  Marshall MN: Sampling for qualitative research. Fam Pract. 1996; 13(6): 522–526. PubMed Abstract | Publisher Full Text
  • 40.  Fossey E, Harvey C, McDermott F, et al.: Understanding and evaluating qualitative research. Aust N Z J Psychiatry. 2002; 36(6): 717–732. PubMed Abstract | Publisher Full Text
  • 41.  Cohen N, Arieli T: Field research in conflict environments: Methodological challenges and snowball sampling. J Peace Res. 2011; 48(4): 423–435. Publisher Full Text
  • 42.  Wilkes LM, Mohan S: Nurses in the clinical area: relevance of a PhD. Collegian. 2008; 15(4): 135–141. PubMed Abstract | Publisher Full Text
  • 43.  Noy C: Sampling Knowledge: The Hermeneutics of Snowball Sampling in Qualitative Research. Int J Soc Res Methodol. 2008; 11(4): 327–344. Publisher Full Text
  • 44.  Dworkin SL: Sample size policy for qualitative studies using in-depth interviews. Arch Sex Behav. In: Springer; 2012; 41(6): 1319–1320. PubMed Abstract | Publisher Full Text
  • 45.  Al-Dandan H: Management strategies for Lower Urinary Tract Symptoms (LUTS) among people with Multiple sclerosis (MS): a qualitative study of the perspectives of people with MS and healthcare professionals. OSF. 2019. http://www.doi.org/10.17605/OSF.IO/JQMKG
  • 46.  Drabble L, Trocki KF, Salcedo B, et al.: Conducting qualitative interviews by telephone: Lessons learned from a study of alcohol use among sexual minority and heterosexual women. Qual Soc Work. 2016; 15(1): 118–133. PubMed Abstract | Publisher Full Text | Free Full Text
  • 47.  Musselwhite K, Cuff L, McGregor L, et al.: The telephone interview is an effective method of data collection in clinical nursing research: a discussion paper. Int J Nurs Stud. 2007; 44(6): 1064–1070. PubMed Abstract | Publisher Full Text
  • 48.  Maykut P, Morehouse R: Beginning Qualitative Research: A Philosophical and Practical Guide. Routledge Ltd; 2002. Publisher Full Text
  • 49.  Giacomini MK, Cook DJ: Users' guides to the medical literature: XXIII. Qualitative research in health care A. Are the results of the study valid? Evidence-Based Medicine Working Group. JAMA. 2000; 284(3): 357–362. PubMed Abstract | Publisher Full Text
  • 50.  Dicicco-Bloom B, Crabtree BF: The qualitative research interview. Med Educ. 2006; 40(4): 314–321. PubMed Abstract | Publisher Full Text
  • 51.  Dibley L, Coggrave M, McClurg D, et al.: "It's just horrible": a qualitative study of patients' and carers' experiences of bowel dysfunction in multiple sclerosis. J Neurol. 2017; 264(7): 1354–1361. PubMed Abstract | Publisher Full Text
  • 52.  Braun V, Clarke V: Using thematic analysis in psychology. Qual Res Psychol. 2006; 3(2): 77–101. Publisher Full Text
  • 53.  Clarke V, Braun V: Using thematic analysis in counselling and psychotherapy research: A critical reflection. Counselling & Psychotherapy Research. 2018; 18(2): 107–110. Publisher Full Text
  • 54.  Braun V, Clarke V, Hayfield N, et al.: Thematic Analysis. In: Liamputtong P, ed. Handbook of Research Methods in Health Social Sciences. Singapore: Springer Singapore; 2019: 843–860. Publisher Full Text
  • 55.  Braun V, Clarke V: Successful qualitative research: a practical guide for beginners. Los Angeles, California: SAGE; 2013. Reference Source
  • 56.  Shenton AK: Strategies for Ensuring Trustworthiness in Qualitative Research Projects. Educ Inform. 2004; 22(2): 63. Publisher Full Text
  • 57.  Malterud K: Qualitative research: standards, challenges, and guidelines. Lancet. 2001; 358(9280): 483–488. PubMed Abstract | Publisher Full Text

Comments on this article Comments (0)

Version 1
VERSION 1 PUBLISHED 18 Nov 2019
Comment
Author details Author details
Competing interests
Grant information
Article Versions (1)
Copyright
Download
 
Export To
metrics
VIEWS
676
 
downloads
67
Citations
SEE MORE DETAILS
CITE
how to cite this article
Al Dandan HB, Galvin R, McClurg D and Coote S. Management strategies for lower urinary tract symptoms (LUTS) among people with multiple sclerosis (MS): a qualitative study of the perspectives of people with MS and healthcare professionals [version 1; peer review: 2 approved]. HRB Open Res 2019, 2:31 (https://doi.org/10.12688/hrbopenres.12960.1)
NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article.
track
receive updates on this article
Track an article to receive email alerts on any updates to this article.

Open Peer Review

Current Reviewer Status: ?
Key to Reviewer Statuses VIEW
ApprovedThe paper is scientifically sound in its current form and only minor, if any, improvements are suggested
Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit.
Not approvedFundamental flaws in the paper seriously undermine the findings and conclusions
Version 1
VERSION 1
PUBLISHED 18 Nov 2019
Views
28
Cite
Reviewer Report 25 Mar 2020
Nicole Zhang, Hartwick College, Oneonta, NY, USA 
Christine W. Bradway, School of Nursing, University of Pennsylvania, Philadelphia, PA, USA 
Approved
VIEWS 28
https://doi.org/10.21956/hrbopenres.14043.r27231
Overall, the study addressed a paucity in the literature. Surely, more qualitative data regarding lower urinary tract symptoms (LUTS) in clients with multiple sclerosis is an important area of research. As the authors allude to, this information would be useful ... Continue reading
CITE
CITE
HOW TO CITE THIS REPORT
Zhang N and Bradway CW. Reviewer Report For: Management strategies for lower urinary tract symptoms (LUTS) among people with multiple sclerosis (MS): a qualitative study of the perspectives of people with MS and healthcare professionals [version 1; peer review: 2 approved]. HRB Open Res 2019, 2:31 (https://doi.org/10.21956/hrbopenres.14043.r27231)
The direct URL for this report is:
https://hrbopenresearch.org/articles/2-31/v1#referee-response-27231
NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article.
Report a concern
Views
25
Cite
Reviewer Report 11 Mar 2020
Apostolos Apostolidis, Aristotle University, Thessaloniki, Greece;  Papageorgiou General Hospital, Thessaloniki, Greece 
Approved
VIEWS 25
https://doi.org/10.21956/hrbopenres.14043.r27128
This is definitely an original research topic, involving both patients and physicians, who are commonly not properly communicating neither upon studies design nor when applying treatment for LUTS. The qualitative study design is analytically presented, and admittedly, all the design ... Continue reading
CITE
CITE
HOW TO CITE THIS REPORT
Apostolidis A. Reviewer Report For: Management strategies for lower urinary tract symptoms (LUTS) among people with multiple sclerosis (MS): a qualitative study of the perspectives of people with MS and healthcare professionals [version 1; peer review: 2 approved]. HRB Open Res 2019, 2:31 (https://doi.org/10.21956/hrbopenres.14043.r27128)
The direct URL for this report is:
https://hrbopenresearch.org/articles/2-31/v1#referee-response-27128
NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article.
Report a concern
  • Author Response 23 Mar 2020
    Hawra Al dandan, School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
    23 Mar 2020
    Author Response
    Dear Dr Apostolos Apostolidis, 

    Many thanks for your feedback related to the protocol and my sincere apology for such delay in my response. As you know the previous week was so difficult ... Continue reading
    Report a concern
  • Respond or Comment
COMMENTS ON THIS REPORT
  • Author Response 23 Mar 2020
    Hawra Al dandan, School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
    23 Mar 2020
    Author Response
    Dear Dr Apostolos Apostolidis, 

    Many thanks for your feedback related to the protocol and my sincere apology for such delay in my response. As you know the previous week was so difficult ... Continue reading
    Report a concern

Comments on this article Comments (0)

Version 1
VERSION 1 PUBLISHED 18 Nov 2019
Comment

Open Peer Review

Reviewer Status

Alongside their report, reviewers assign a status to the article:

Approved
The paper is scientifically sound in its current form and only minor, if any, improvements are suggested
Approved with reservations
A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit.
Not approved
Fundamental flaws in the paper seriously undermine the findings and conclusions

Reviewer Reports

Invited Reviewers
1 2
Version 1
18 Nov 19 		read read
  1. Apostolos Apostolidis, Aristotle University, Thessaloniki, Greece; Papageorgiou General Hospital, Thessaloniki, Greece
  2. Nicole Zhang, Hartwick College, Oneonta, USA
    Christine W. Bradway, University of Pennsylvania, Philadelphia, USA

Comments on this article

All Comments(0)

Add a comment
Sign up for content alerts
keyboard_arrow_left Back to all reports
keyboard_arrow_left Back to all reports
Alongside their report, reviewers assign a status to the article:
Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested
Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit.
Not approved - fundamental flaws in the paper seriously undermine the findings and conclusions

Are you a HRB-funded researcher?

Submission to HRB Open Research is open to all HRB grantholders or people working on a HRB-funded/co-funded grant on or since 1 January 2017. Sign up for information about developments, publishing and publications from HRB Open Research.

You must provide your first name
You must provide your last name
You must provide a valid email address
You must provide an institution.

Thank you!

We'll keep you updated on any major new updates to HRB Open Research

Sign In
If you've forgotten your password, please enter your email address below and we'll send you instructions on how to reset your password.

The email address should be the one you originally registered with F1000.
Email address not valid, please try again

You registered with F1000 via Google, so we cannot reset your password.

To sign in, please click here.

If you still need help with your Google account password, please click here.

You registered with F1000 via Facebook, so we cannot reset your password.

To sign in, please click here.

If you still need help with your Facebook account password, please click here.

Code not correct, please try again
Email us for further assistance.
Server error, please try again.