A Qualitative Secondary Analysis of Patient Health-Related Quality of Life in Bloodstream Infections by Source: Intra-abdominal, Urinary Tract, and Acute Bacterial Skin and Skin Structure Infection.

Abstract

Despite the prevalence of intra-abdominal infections, urinary tract infections, and skin/skin structure infections, the relative impact of these syndromes on patient health-related quality of life (HRQoL) is unclear. This qualitative secondary analysis used data from an interview-based HRQoL qualitative study of bloodstream infections by source of infection to inform the potential development, adaptation, and use of HRQoL measures. Interview transcripts from eligible participants (aged ≥18 years) with intra-abdominal, urinary tract, and skin/skin structure infections as the source of bloodstream infection were selected from parent study data collected between May 2017 and September 2018. Interviews were conducted at 6 to 8 weeks postdischarge with participants enrolled at a single, tertiary academic medical center in the United States. We assessed patients' perspectives using episode profile and content analysis to identify key concepts that impacted HRQoL during the course of illness, treatment, and follow-up care. We analyzed 31 interview transcripts and identified 6 key concepts with a short- or long-term impact on HRQoL: (1) preinfection characteristics, (2) self-management after discharge, (3) overall health context, (4) fear of recurrent infection, (5) social support and caregivers' availability, and (6) follow-up and recovery. The concepts' impact varied by syndrome. Patient-reported perspectives expanded our understanding of the experiences of patients with bloodstream infections by source of infection. Future studies will require measuring patient-reported HRQoL in a way that captures what is meaningful to patients with different types of infection.