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Newlands AF, Kramer M, Roberts L, Maxwell K, Price JL, Finlay KA. Evaluating the quality of life impact of recurrent urinary tract infection: Validation and refinement of the Recurrent UTI Impact Questionnaire (RUTIIQ). Neurourol Urodyn 2024; 43:902-914. [PMID: 38385648 DOI: 10.1002/nau.25426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 12/08/2023] [Accepted: 02/05/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND AND AIMS Recurrent urinary tract infection (rUTI) has significant negative consequences for a wide variety of quality of life (QoL) domains. Without adequate validation and assessment of the unique insights of people living with rUTI, clinical results cannot be fully understood. The Recurrent UTI Impact Questionnaire (RUTIIQ), a novel patient-reported outcome measure of rUTI psychosocial impact, has been robustly developed with extensive patient and clinician input to facilitate enhanced rUTI management and research. This study aimed to confirm the structural validity of the RUTIIQ, assessing its strength and bifactor model fit. METHODS A sample of 389 adults experiencing rUTI (96.9% female, aged 18-87 years) completed an online cross-sectional survey comprising a demographic questionnaire and the RUTIIQ. A bifactor graded response model was fitted to the data, optimizing the questionnaire structure based on item fit, discrimination capability, local dependence, and differential item functioning. RESULTS The final RUTIIQ demonstrated excellent bifactor model fit (RMSEA = 0.054, CFI = 0.99, SRMSR = 0.052), and mean-square fit indices indicated that all included items were productive for measurement (MNSQ = 0.52-1.41). The final questionnaire comprised an 18-item general "rUTI QoL impact" factor, and five subfactor domains measuring "personal wellbeing" (three items), "social wellbeing" (four items), "work and activity interference" (four items), "patient satisfaction" (four items), and "sexual wellbeing" (three items). Together, the general factor and five subfactors explained 81.6% of the common model variance. All factor loadings were greater than 0.30 and communalities greater than 0.60, indicating good model fit and structural validity. CONCLUSIONS The 18-item RUTIIQ is a robust, patient-tested questionnaire with excellent psychometric properties, which capably assesses the patient experience of rUTI-related impact to QoL and healthcare satisfaction. Facilitating standardized patient monitoring and improved shared decision-making, the RUTIIQ delivers the unique opportunity to improve patient-centered care.
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Affiliation(s)
- Abigail F Newlands
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | | | - Lindsey Roberts
- School of Psychology, University of Buckingham, Buckingham, UK
| | - Kayleigh Maxwell
- Department of Psychology, Faculty of Natural Sciences, University of Stirling, Stirling, UK
| | | | - Katherine A Finlay
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
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Yun Z, Powell D, Mulgirigama A, Miyazaki J. The emotional impact of uncomplicated urinary tract infections in women in China and Japan: a qualitative study. BMC Womens Health 2024; 24:94. [PMID: 38321435 PMCID: PMC10845586 DOI: 10.1186/s12905-023-02675-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND Uncomplicated urinary tract infections (uUTIs) are one of the most common community-acquired infections, particularly among women. Common symptoms of UTI include dysuria, urinary urgency and increased frequency, and lower abdominal pain. With appropriate treatment, symptoms may resolve in a few days. However, there is a lack of research on the emotional impact of this disease. We conducted a qualitative, interview-based study to gain a greater understanding of the emotional impact of uUTIs in women in China and Japan. METHODS A qualitative, exploratory, in-depth, interview-based study was conducted between 19 November 2020 and 25 February 2021. Women aged ≥ 18 years who experienced ≥ 1 uUTI and received antibiotic treatment in the past year were eligible for inclusion. Participants must have experienced ≥ 1 of the following symptoms during a uUTI episode: urinary urgency, frequency, dysuria, or lower abdominal/suprapubic pain. Participants who reported back pain or fever (indicative of complicated UTI) were excluded. Participants with recurrent or sporadic UTIs were included, with specific screening criteria used to ensure capture of both groups. Following a screening call, a structured, in-depth telephone interview (~ 30 min in duration) was conducted by three female external moderators trained in qualitative interviewing, assisted by an interview guide. Interviews were analysed individually and thematically, with the results presented within the identified themes. RESULTS A total of 65 women with uUTI completed the in-depth telephone interview: 40 (62%) from China and 25 (38%) from Japan. Participants reported that the symptoms of uUTI affected multiple aspects of their lives, and described feelings of embarrassment, frustration, guilt, dread, and loneliness associated with symptoms that interfered with relationships, work and daily activities, and sleep. Participants reported seeking healthcare from several different points of contact, from local pharmacies to hospitals. CONCLUSIONS Our analysis highlights the profound emotional impact of uUTIs in women in China and Japan, and the journey these participants take before their initial interaction with a healthcare professional. These insights emphasise the need to better understand the full impact of uUTI, and the role of healthcare professionals in improved patient education and support.
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Affiliation(s)
- Zhao Yun
- Department of Gynecology and Obstetrics, Peking University People's Hospital, Beijing, China.
| | | | | | - Jun Miyazaki
- Department of Urology, School of Medicine, International University of Health and Welfare, Narita, Japan.
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Bey L, Touboul P, Mondain V. Recurrent cystitis: patients' needs, expectations and contribution to developing an information leaflet - a qualitative study. BMJ Open 2022; 12:e062852. [PMID: 36414289 PMCID: PMC9684995 DOI: 10.1136/bmjopen-2022-062852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES Recurring cystitis (RC) is a common complaint among women. It has a significant impact on patients' quality of life. The physical discomfort and psychological distress related to RC are rarely addressed and women's needs in terms of information and advice have not been sufficiently explored, particularly in France in spite of their frequent episodes of RC. This study aimed to assess women's needs and expectations in view of developing a patient information leaflet to help them understand and better cope with their condition, thus offering them more autonomy and empowering them to self-manage whenever possible. METHOD Qualitative study using recorded semistructured interviews with patients suffering from RC. SETTING Interviews conducted with women suffering from RC in Corsica, France. PARTICIPANTS 26 patients interviewed between January 2018 and April 2018. RESULTS Knowledge of the condition was heterogeneous, but most women reported a major impact on daily life, a high level of anxiety, various management strategies and wished to avoid taking antibiotics, preferring alternative approaches. Patients reported a lack of understanding and sympathy on the part of physicians and society and wished for more autonomy with delayed/back-up prescriptions, a multidisciplinary follow-up and, most of all, appropriate information. CONCLUSION The information leaflet should improve patients' knowledge and capacity for self-care, contribute to standardise practice and limit inappropriate antibiotic use.
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Affiliation(s)
- Louisa Bey
- Infectious Diseases Department, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Pia Touboul
- Public Health Department, Centre Hospitalier Universitaire de Nice, Nice, Provence-Alpes-Côte d'Azur, France
| | - Véronique Mondain
- Infectious Diseases Department, Centre Hospitalier Universitaire de Nice, Nice, France
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Shen AL, Lin HL, Lin HC, Tseng YF, Hsu CY, Chou CY. Urinary tract infection is associated with hypokalemia: a case control study. BMC Urol 2020; 20:108. [PMID: 32690002 PMCID: PMC7372809 DOI: 10.1186/s12894-020-00678-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Accepted: 07/14/2020] [Indexed: 11/29/2022] Open
Abstract
Background Hypokalemia is a common clinical problem. The association between urinary tract infection (UTI) and hypokalemia is not clear. Hypokalemia is common in patients with UTI in clinical observation. The aim of the study is to determine if UTI is associated with hypokalemia. Methods Patients hospitalized with UTI and the control group were retrieved from the Longitudinal Health Insurance Database 2005. The control group was patients hospitalized with other reasons and were matched for the confoundings of UTI and hypokalemia. We analyze the risk of hypokalemia using logistic regression and calculate the odds ratio (OR) and 95% confidence interval (CI) of OR. Results We analyzed 43,719 UTI patients and control patients. Hypokalemia was found in 4540 (10.4%) patients with UTI and 1842 (4.2%) control patients. The percentage of patients with hypokalemia was higher in UTI patients (chi-square, p < 0.001). UTI was associated with hypokalemia and the odds ratio (OR) was 2.27 [95% confidence interval (CI): 2.17–2.41]. Cerebrovascular accident, chronic obstructive pulmonary disease, hypertension, congestive heart failure, diarrhea, medications including thiazides, sulfonamides, xanthines, and laxatives were independently associated with hypokalemia. Recurrent UTI was associated with hypokalemia in UTI patients (OR: 1.13, 95% CI: 1.05–1.23, p < 0.001). Conclusions Urinary tract infection is associated with hypokalemia among inpatients. The association is independent of patients’ comorbidities and medications. Recurrent UTI is associated with increased hypokalemia in UTI patients.
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Affiliation(s)
- Ai-Ling Shen
- Department of Neurology, Sijhih Cathay General Hospital, No.2, Ln. 59, Jiancheng Rd., Sijhih Dist, New Taipei City, 221, Taiwan
| | - Hsiu-Li Lin
- Department of Neurology, Sijhih Cathay General Hospital, No.2, Ln. 59, Jiancheng Rd., Sijhih Dist, New Taipei City, 221, Taiwan.,Graduate Institute of Biomedical Informatics, Taipei Medical University, No. 252, Wu-Xing Street, Taipei, 110, Taiwan
| | - Hsiu-Chen Lin
- Department of Pediatrics, School of Medicine, College of Medicine, Taipei Medical University, No. 252, Wu-Xing Street, Taipei, 110, Taiwan.,Department of Laboratory Medicine, Taipei Medical University Hospital, No. 252, Wu-Xing Street, Taipei, 110, Taiwan
| | - Yuan-Fu Tseng
- Department of Neurology, Sijhih Cathay General Hospital, No.2, Ln. 59, Jiancheng Rd., Sijhih Dist, New Taipei City, 221, Taiwan
| | - Chien-Yeh Hsu
- Graduate Institute of Biomedical Informatics, Taipei Medical University, No. 252, Wu-Xing Street, Taipei, 110, Taiwan.,Department of Information Management, National Taipei University of Nursing and Health Science, No. 365, Mingde Rd, Taipei, 112, Taiwan
| | - Che-Yi Chou
- Division of Nephrology, Asia University Hospital, NO 222, Fuxin Rd, Wufeng Dist, Taichung, 413, Taiwan. .,Department of Post-baccalaureate Veterinary Medicine, Asia University, NO 222, Fuxin Rd, Wufeng Dist, Taichung, 413, Taiwan. .,Division of Nephrology, China Medical University Hospital, Tacihung, Taiwan.
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