Experiences of urinary tract infection: A systematic review and meta‐ethnography

Abstract

Aim To understand the experience of urinary tract infection (UTI) by synthesizing primary qualitative research findings and developing a conceptual model that illustrates this experience. Method A systematic search of Medline, PsychInfo, Embase, and CINAHL from inception to August 2020 to find qualitative research exploring the experience of UTI. Qualitative evidence synthesis in the form of meta‐ethnography was undertaken. Findings are reported in keeping with eMERGe guidance. Results We included 16 qualitative studies in the synthesis of evidence, providing data from over 1038 participants aged 13–97 years. We developed nine themes: the impact of UTI on my whole body; impact on quality of life, activities, and the associated psychological toll; I know my body and my experience has taught me when I need to seek care; worry and the transition to medicalization; antibiotics are a valuable treatment approach; antibiotics are a last resort; being heard, seen, and cared for with dignity; self‐judgment; and the end of the road, a need for information and cure. These themes supported a conceptual model to illustrate the patient experience of UTI. Conclusions The conceptual model communicates the wide and varied symptoms of patients' UTI experiences and how they process this and make care decision based on past health experiences. For some, there appears to be a sense of hopelessness and frustration. This model may be used to highlight the need for improvements in diagnostic and treatment pathways. Future research to further understand the nuances of acute, recurrent, and persistent UTI is needed.

Re-examining advice to complete antibiotic courses: a qualitative study with clinicians and patients

“…( 23) These studies and our data suggest that reducing antibiotic use (e.g., through delayed prescriptions, nonantibiotic strategies, SAWB) appears more acceptable for women with less severe, uncomplicated UTIs; if there was evidence that these approaches are safe; and if the benefits of these approaches were explained. Our data agreed with the findings of the meta-ethnography, (17) including the impact of UTIs on the whole body, quality of life and activities, and a need for information and cure. This highlights the need for effective (including optimal antibiotic and non-antibiotic) treatments to resolve painful UTI symptoms and prevent long-term, life-changing complications.…”

Unravelling patient pathways in the context of antibacterial resistance in East Africa

“…UTIs are mild bacterial illnesses that are usually treated with ABs, [14] but which can be stigmatizing and reduce quality of life. [15] Globally, over 150 million individuals are diagnosed with UTIs each year, most of whom are women. [16] Empiric use of ABs globally to treat UTIs contributes to ABR of the uropathogens responsible (typically Escherichia coli and other Enterobacteriacae), and presents a growing challenge to effective treatment.…”

Qualitative Analysis of a Twitter-Disseminated Survey Reveals New Patient Perspectives on the Impact of Urinary Tract Infection

“…Outside of these studies, less emphasis was placed on symptom severity. Similarly, in terms of psychological distress, although Izett-Kay et al found that UTIs had a negative “impact on quality of life and [an] associated psychological toll”, they did not present the same depth of despair that some of our participants experienced (e.g., depression or suicidal ideation) [ 21 ].…”

“…Other themes, such as the pervasive impacts of UTIs on life, psychological tolls, and lack of support, empathy, and awareness of the UTI burden among clinicians, were detected in studies including patients with either recurrent or sporadic UTIs. For example, a recent systematic review that analyzed 16 qualitative studies found overlap among the following themes: the disruptive nature of UTIs on patients’ lives, their negative impact on quality of life and associated psychological toll, and a lack of acknowledgment and empathy from some clinicians, summarized as “ being heard, seen and cared for with dignity ” [ 21 ]. A recent study that interviewed 65 women with sporadic or recurrent UTIs from the US ( n = 40) or Germany ( n = 25) also uncovered several limitations that impacted quality of life and strong emotional responses to these limitations and treatment failures, including anxiety, frustration, helplessness, isolation, and embarrassment [ 16 ].…”