Patients’ Experiences With Staphylococcus aureus and Gram-negative Bacterial Bloodstream Infections: A Qualitative Descriptive Study and Concept Elicitation Phase To Inform Measurement of Patient-reported Quality of Life

Abstract

Background Although Staphylococcus aureus and Gram-negative bacterial bloodstream infections (SAB/GNB) cause substantial morbidity, little is known regarding patient perceptions’ of their impact on quality of life (QOL). Guidance for assessing QOL and disease-specific measures are lacking. We conducted a descriptive qualitative study to gain an in-depth understanding of patients’ experiences with SAB/GNB and concept elicitation phase to inform a patient-reported QOL outcome measure. Methods Prospective one-time, in-depth, semi-structured, individual, qualitative telephone interview 6-8 weeks following bloodstream infection with either SAB or GNB. Patients were enrolled in an institutional registry (tertiary academic medical center) for SAB or GNB. Interviews were audio-recorded, transcribed, and coded. Directed content analysis identified a priori and emergent themes. Theme matrix techniques were used to facilitate analysis and presentation. Results Interviews were completed with 30 SAB and 31 GNB patients. Most patients were at or near the end of intravenous antibiotic treatment when interviewed. We identified 3 primary high-level concepts: impact on QOL domains, time as a critical index, and sources of variability across patients. Across both types of bloodstream infection, the QOL domains most impacted were physical and functional, which was particularly evident among SAB patients. Conclusion SAB/GNB impact QOL among survivors. In particular, SAB had major impacts on multiple QOL domains. A combination of existing, generic measures that are purposefully selected and disease-specific items, if necessary, could best capture these impacts. Engaging patients as stakeholders and obtaining their feedback is crucial to conducting patient-centered clinical trials and providing patient-centered care.

Palliative care consultation in patients with Staphylococcus aureus bacteremia

“…In addition, a recent study revealed that Staphylococcus aureus bacteremia leads to a significant impact on the quality of life among survivors. 22 Therefore, palliative care consultation may need to be considered more proactively for patients with Staphylococcus aureus bacteremia not only during admission but also in the outpatient setting. Given higher mortality reported in prior studies, the target population would be Staphylococcus aureus bacteremia patients with age >60, MRSA infection, septic shock, endocarditis, underlying cirrhosis or time to positivity of blood cultures less than 12 h. 2 –4,23,24…”

“…In addition, a recent study revealed that Staphylococcus aureus bacteremia leads to a significant impact on the quality of life among survivors. 22 Therefore, palliative care consultation may need to be considered more proactively for patients with Staphylococcus aureus bacteremia not only during admission but also in the outpatient setting. Given higher Patients who received palliative care consultation were less likely to undergo an echocardiogram.…”

Veterans’ Interpretation of Diabetes Distress in Diabetes Self-Management: Findings From Cognitive Interviews

“…Studies benefit from using applied and actionable qualitative data to influence data collection, measurement, and intervention development. [24][25][26][27] The purpose of these cognitive interviews was to ensure adequate coverage in quantitative measures and qualitative interview questions of domains and causes associated with DD in veterans with T2DM. The findings suggest that additional domains and event-based sampling not assessed in the DD Scale are salient to understanding DD among veterans.…”

“…Applied qualitative methods, such as cognitive interviewing, can produce actionable data that can add value to a study by enhancing and increasing the relevance of the knowledge generated. [24][25][26][27] Cognitive interviews help to assess and improve measurement tools and enhance understanding of the phenomenon being studied. 22,28 During a cognitive interview, after individuals are read each survey question, these individuals are probed regarding what they believe the question is asking and invited to describe information used to formulate a response.…”

Patients’ Experiences With Staphylococcus aureus and Gram-Negative Bacterial Bloodstream Infections: Results From Cognitive Interviews to Inform Assessment of Health-Related Quality of Life

“…Staphylococcus aureus and gram-negative bacterial bloodstream infections (SAB and GNB, respectively) are common and serious [ 1 , 2 ] infections that negatively impact survivors’ health-related quality of life (HRQoL), defined by and demonstrated across physical, functional, mental health/emotional, cognitive, and social domains [ 3 ]. Treatment of bloodstream infections often involves prolonged hospitalization, extended treatment and recovery times, and invasive procedures.…”