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ANTIC 试验中清洁间歇自我导尿、尿路感染和抗生素使用的参与者体验——一项定性研究。

Participant experiences of clean intermittent self-catheterisation, urinary tract infections and antibiotic use on the ANTIC trial - A qualitative study.

机构信息

Nursing, Midwifery and Allied Health Professions, Research Unit, United Kingdom; Glasgow Caledonian University, Room A603 Govan Mbeki Building, Glasgow, G4 0BA, United Kingdom.

Newcastle University, The Medical School, Newcastle upon Tyne, NE2 4HH, United Kingdom.

出版信息

Int J Nurs Stud. 2018 May;81:1-7. doi: 10.1016/j.ijnurstu.2018.01.012. Epub 2018 Jan 31.

Abstract

BACKGROUND

Recurrent urinary tract infections are a commonly reported problem in people who use clean intermittent self-catheterisation. Yet there is a lack of knowledge regarding both the impact on people's lives, the use of prophylactic anti-biotics and perceptions of patients on their use.

AIMS

To explore the views and experiences of adults who use clean intermittent self-catheterisation for long-term bladder conditions, with a focus on urinary tract infection experience and prophylactic antibiotic use.

DESIGN

A qualitative descriptive study.

METHODS

Twenty-six semi-structured qualitative interviews were conducted with individuals recruited from the ANTIC Trial (Antibiotic treatment for intermittent bladder catheterisation: A randomised controlled trial of once daily prophylaxis). Participants were intermittent self-catheter users aged 18 years or older. Interviews took place between August 2015 and January 2016. Transcript data were analysed thematically.

FINDINGS

Three overarching topics were revealed with corresponding themes: the experiences of intermittent self-catheterisation and urinary tract infections (normalisation, perceived burden); attitudes towards antibiotics for urinary tract infection treatment (nonchalant attitudes, ambivalence towards antibiotic resistance); and experiences of low-dose prophylaxis antibiotics (habitual behaviour and supportive accountability).

CONCLUSION

The emotional and practical burden of catheter use and urinary tract infection was considerable. Beliefs pertaining to antibiotic use were based on utility, gravity of need and perceived efficacy. These opinions were often influenced by clinician recommendations.

摘要

背景

在使用清洁间歇性自我导尿的人群中,复发性尿路感染是一个常见的问题。然而,人们对其对生活的影响、预防性抗生素的使用以及患者对其使用的看法知之甚少。

目的

探讨长期患有膀胱疾病并使用清洁间歇性自我导尿的成年人的观点和体验,重点是尿路感染的经历和预防性抗生素的使用。

设计

定性描述性研究。

方法

从 ANTIC 试验(间歇膀胱导管插入术的抗生素治疗:每日一次预防的随机对照试验)中招募了 26 名个体进行了 26 次半结构式定性访谈。参与者为年龄在 18 岁或以上的间歇性自我导尿使用者。访谈于 2015 年 8 月至 2016 年 1 月进行。对转录数据进行了主题分析。

结果

揭示了三个总体主题,分别对应三个主题:间歇性自我导尿和尿路感染的经历(正常化,感知负担);对抗生素治疗尿路感染的态度(漠不关心的态度,对抗生素耐药性的矛盾态度);以及低剂量预防用抗生素的经验(习惯性行为和支持性问责制)。

结论

导管使用和尿路感染的情绪和实际负担相当大。关于抗生素使用的信念基于效用、需求的严重程度和感知疗效。这些观点往往受到临床医生建议的影响。

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