Perceptions, experiences, and beliefs regarding urinary tract infections in patients with neurogenic bladder: A qualitative study

PLOS ONE, 2023 · DOI: https://doi.org/10.1371/journal.pone.0293743 · Published: November 1, 2023

Urology Immunology Research Methodology & Design

Simple Explanation

This study explores how patients with neurogenic bladder (NB), often caused by conditions like spinal cord injury or multiple sclerosis, perceive and experience urinary tract infections (UTIs). These infections are a common issue for individuals with NB. The research involved focus groups with veterans to understand their beliefs and experiences related to UTIs, aiming to improve patient-centered care by better understanding their perspectives. The study found that caregivers, the healthcare environment, and communication with healthcare providers significantly influence how patients perceive and manage their UTIs. Positive relationships and knowledgeable caregivers were key factors.

Study Duration

May 2021-May 2022

Participants

23 Veterans (SCI/D, 78%; MS, 18.5%)

Evidence Level

Qualitative Study

Key Findings

1
Caregivers play a crucial role in UTI management by enabling access to care, helping recognize symptoms, and aiding in understanding medical information.
2
The healthcare environment and provider characteristics significantly influence patient perceptions of UTI care quality; knowledgeable providers and positive communication improve patient experiences.
3
Barriers to accessing care, such as mobility limitations and distance to facilities, impact UTI perceptions and experiences; home-based care programs can facilitate access and improve outcomes.

Research Summary

This qualitative study explored the perceptions, experiences, and beliefs regarding urinary tract infections (UTIs) in patients with neurogenic bladder (NB). It involved virtual focus groups with 23 Veterans with NB due to spinal cord injury/disorder (SCI/D) or multiple sclerosis (MS). The study identified three major themes: the influence of caregivers, the influence of the healthcare environment and provider characteristics, and barriers and facilitators to care. These themes highlight the importance of caregiver involvement, effective patient-provider communication, and accessible healthcare settings in UTI management. The findings suggest that patient-centered interventions should focus on expanding caregiver involvement, enhancing patient-provider communication, and targeting provider types and care settings that lack familiarity with NB to improve UTI management in this population.

Practical Implications

Enhance Caregiver Involvement

Develop educational resources and training programs for caregivers to improve their ability to recognize UTI symptoms, support treatment adherence, and participate in shared decision-making.

Improve Patient-Provider Communication

Implement strategies to foster better communication between patients and healthcare providers, ensuring that providers actively listen to patients' concerns, provide clear explanations, and address individual needs and preferences.

Optimize Healthcare Access

Expand access to home-based care programs and telehealth services to overcome mobility and transportation barriers, enabling timely diagnosis and treatment of UTIs for patients with NB.

Study Limitations

1
The study was conducted in the VA and primarily included older male Veterans, limiting generalizability to non-Veteran populations and women.
2
Focus group discussions may not have allowed as in-depth exploration of concepts as semi-structured interviews.
3
Virtual focus groups limited participation to those who could access Microsoft Teams.

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