Older adults’ and caregivers’ perceptions about urinary tract infection and asymptomatic bacteriuria guidelines: a qualitative exploration
Abstract Objective: To explore older adults’ and caregivers’ knowledge and perceptions of guidelines for appropriate antibiotics use for bacteria in the urine. Design: Semi-structured qualitative interviews. Setting: Infectious disease clinics, community senior living facilities, memory care c...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2023-01-01
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| Series: | Antimicrobial Stewardship & Healthcare Epidemiology |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2732494X23004989/type/journal_article |
| _version_ | 1797404856518967296 |
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| author | Michael J. Durkin Viktoria Schmitz Kevin Hsueh Zoe Troubh Mary C. Politi |
| author_facet | Michael J. Durkin Viktoria Schmitz Kevin Hsueh Zoe Troubh Mary C. Politi |
| author_sort | Michael J. Durkin |
| collection | DOAJ |
| description |
Abstract
Objective:
To explore older adults’ and caregivers’ knowledge and perceptions of guidelines for appropriate antibiotics use for bacteria in the urine.
Design:
Semi-structured qualitative interviews.
Setting:
Infectious disease clinics, community senior living facilities, memory care clinics, and general public.
Participants:
Patients 65 years or older diagnosed with a urinary tract infection (UTI) in the past two years, or caregivers of such patients.
Methods:
We conducted interviews between March and July 2023. We developed an interview guide based on the COM-B (capability, opportunity, motivation-behavior) behavior change framework. We thematically analyzed written transcripts of audio-recorded interviews using inductive and deductive coding techniques.
Results:
Thirty participants (21 patients, 9 caregivers) enrolled. Most participants understood UTI symptoms such as pain during urination and frequent urination. However, communication with multiple clinicians, misinformation, and unclear symptoms that overlapped with other health issues clouded their understanding of asymptomatic bacteriuria (ASB) and UTIs. Some participants worried that clinicians would be dismissive of symptoms if they suggested a diagnosis of ASB without prescribing antibiotics. Many participants felt that the benefits of taking antibiotics for ASB outweighed harms, though some mentioned fears of personal antibiotic resistance if taking unnecessary antibiotics. No participants mentioned the public health impact of potential antibiotic resistance. Most participants trusted information from clinicians over brochures or websites but wanted to review information after clinical conversations.
Conclusion:
Clinician-focused interventions to reduce antibiotic use for ASB should also address patient concerns during clinical visits, and provide standardized high-quality educational materials at the end of the visit.
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| first_indexed | 2024-03-09T03:02:08Z |
| format | Article |
| id | doaj.art-947dd06dddd74e68a51ad5b2361d6c64 |
| institution | Directory Open Access Journal |
| issn | 2732-494X |
| language | English |
| last_indexed | 2024-03-09T03:02:08Z |
| publishDate | 2023-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Antimicrobial Stewardship & Healthcare Epidemiology |
| spelling | doaj.art-947dd06dddd74e68a51ad5b2361d6c642023-12-04T13:13:37ZengCambridge University PressAntimicrobial Stewardship & Healthcare Epidemiology2732-494X2023-01-01310.1017/ash.2023.498Older adults’ and caregivers’ perceptions about urinary tract infection and asymptomatic bacteriuria guidelines: a qualitative explorationMichael J. Durkin0https://orcid.org/0000-0003-4652-7089Viktoria Schmitz1Kevin Hsueh2https://orcid.org/0000-0002-6606-4491Zoe Troubh3Mary C. Politi4https://orcid.org/0000-0001-9103-6495Division of Infectious Diseases, Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO, USADivision of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USADivision of Infectious Diseases, Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO, USADivision of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USADivision of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA Abstract Objective: To explore older adults’ and caregivers’ knowledge and perceptions of guidelines for appropriate antibiotics use for bacteria in the urine. Design: Semi-structured qualitative interviews. Setting: Infectious disease clinics, community senior living facilities, memory care clinics, and general public. Participants: Patients 65 years or older diagnosed with a urinary tract infection (UTI) in the past two years, or caregivers of such patients. Methods: We conducted interviews between March and July 2023. We developed an interview guide based on the COM-B (capability, opportunity, motivation-behavior) behavior change framework. We thematically analyzed written transcripts of audio-recorded interviews using inductive and deductive coding techniques. Results: Thirty participants (21 patients, 9 caregivers) enrolled. Most participants understood UTI symptoms such as pain during urination and frequent urination. However, communication with multiple clinicians, misinformation, and unclear symptoms that overlapped with other health issues clouded their understanding of asymptomatic bacteriuria (ASB) and UTIs. Some participants worried that clinicians would be dismissive of symptoms if they suggested a diagnosis of ASB without prescribing antibiotics. Many participants felt that the benefits of taking antibiotics for ASB outweighed harms, though some mentioned fears of personal antibiotic resistance if taking unnecessary antibiotics. No participants mentioned the public health impact of potential antibiotic resistance. Most participants trusted information from clinicians over brochures or websites but wanted to review information after clinical conversations. Conclusion: Clinician-focused interventions to reduce antibiotic use for ASB should also address patient concerns during clinical visits, and provide standardized high-quality educational materials at the end of the visit. https://www.cambridge.org/core/product/identifier/S2732494X23004989/type/journal_article |
| spellingShingle | Michael J. Durkin Viktoria Schmitz Kevin Hsueh Zoe Troubh Mary C. Politi Older adults’ and caregivers’ perceptions about urinary tract infection and asymptomatic bacteriuria guidelines: a qualitative exploration Antimicrobial Stewardship & Healthcare Epidemiology |
| title | Older adults’ and caregivers’ perceptions about urinary tract infection and asymptomatic bacteriuria guidelines: a qualitative exploration |
| title_full | Older adults’ and caregivers’ perceptions about urinary tract infection and asymptomatic bacteriuria guidelines: a qualitative exploration |
| title_fullStr | Older adults’ and caregivers’ perceptions about urinary tract infection and asymptomatic bacteriuria guidelines: a qualitative exploration |
| title_full_unstemmed | Older adults’ and caregivers’ perceptions about urinary tract infection and asymptomatic bacteriuria guidelines: a qualitative exploration |
| title_short | Older adults’ and caregivers’ perceptions about urinary tract infection and asymptomatic bacteriuria guidelines: a qualitative exploration |
| title_sort | older adults and caregivers perceptions about urinary tract infection and asymptomatic bacteriuria guidelines a qualitative exploration |
| url | https://www.cambridge.org/core/product/identifier/S2732494X23004989/type/journal_article |
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