Assessment and treatment of recurrent urinary tract infections in women: development of a questionnaire based on a quali
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RESEARCH ARTICLE
Assessment and treatment of recurrent urinary tract infections in women: development of a questionnaire based on a qualitative study of patient expectations in secondary care J. J. Pat2* , T. v. d. Aart2, M. G. Steffens1, L. P. W. Witte1 and M. H. Blanker2
Abstract Background: To develop a questionnaire to facilitate the inventorying of women’s expectations for the assessment and treatment of recurrent urinary tract infection (UTI) in secondary care. Methods: Semi-structured interviews were conducted among women with recurrent UTI referred to our urology department. The interviews were conducted by one interviewer, recorded, transcribed verbatim, and analyzed thematically by two researchers. We first developed 35 questions to identify potential themes, and we then tested them among women with and without recurrent UTI. Changes were made according to the feedback received. Results: Six interviews were conducted before saturation was reached. Thematic analysis identified three themes: patient pathway, personal knowledge, and social implications. All respondents had received multiple antibiotic courses but no prophylactic antibiotic therapy, and although all were aware of some preventive measures, they wanted more information about their disease. However, some women were afraid to access information for fear of what they might learn. Recurrent UTI also significantly affected the daily lives all respondents. Some women expressed fears over frequent antibiotic use, and others felt that there must be something wrong with their body to have so many UTIs. Women expected the urologist to provide an explanation and to start adequate therapy for their recurrent UTI. We created a 32-item questionnaire based on these themes Conclusion: This study not only developed a questionnaire for use when assessing patient expectations of recurrent UTI management in secondary care but also provided novel insights into the thoughts, opinions, and expectations of women who are referred. Keywords: Female, Urinary tract infections, Questionnaire, Interview Background Urinary tract infections (UTIs) are among the most common bacterial infections worldwide [1], with estimates indicating that over 30% of all women will experience *Correspondence: [email protected] 2 Department of General Practice, University of Groningen, University Medical Centre, Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands Full list of author information is available at the end of the article
at least one UTI in their lives. Studies have shown that 20–50% of these women will experience at least one recurrence, defined as at least two UTIs in 6 months or at least three UTIs in 12 months [2, 3]. Several guidelines are available for the assessment and treatment of recurrent UTI, but there is no agreement on the optimal diagnostic process [1, 4, 5]. The Dutch Association of Urology commissioned a specific guideline about bacterial UTI in which it advised using a voiding diary, urine sediment assessment, and uroflowmetry in
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