Self-esteem, Comorbid Anxiety, and Depression Among Patients Living with Indwelling Catheters in a Nigerian Teaching Hospital

Abstract

Indwelling urinary catheterization, though essential for managing chronic urological conditions, often associated with psychological distress. Patients commonly experience self-esteem issues, anxiety, and depression, yet these concerns remain under-addressed in Nigerian healthcare settings. This study assessed levels of self-esteem and the prevalence of comorbid anxiety and depression among patients with indwelling catheters in a Nigerian teaching hospital, and explored the influence of sociodemographic factors. A descriptive cross-sectional study was conducted at the University of Medical Sciences Teaching Hospital, Ondo State, involving 525 patients aged 18 years and above with long-term indwelling catheters. Systematic random sampling was used. Data were collected using the Rosenberg SelfEsteem Scale and Hospital Anxiety and Depression Scale (HADS), and analyzed using SPSS v25. Associations were tested using chi-square and binary logistic regression, with significance set at p < 0.05. Among respondents, 25.7% reported low self-esteem and 48.6% had comorbid anxiety and depression. Significant associations were observed with age (χ² = 254.037, p = 0.001), marital status (χ² = 79.730, p = 0.001), educational level (χ² = 124.477, p = 0.001), income (χ² = 34.600, p = 0.001), self-esteem (χ² = 192.421, p = 0.001), and age at first sexual exposure (χ² = 76.590, p = 0.000). Regression analysis revealed that early sexual debut (OR = 2.431), single marital status (OR = 3.846), and undergraduate education (OR = 5.535) were significant predictors of psychological comorbidity (p = 0.001). Conclusively, High rates of psychological distress among catheterized patients highlight the urgent need for integrated mental health screening and psychosocial support within urological care in Nigeria.