A Qualitative Secondary Analysis of Patient Health-Related Quality of Life in Bloodstream Infections by Source: Intra-abdominal, Urinary Tract, and Acute Bacterial Skin and Skin Structure Infection.
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2025-08
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Abstract
Background
Despite the prevalence of intra-abdominal infections, urinary tract infections, and skin/skin structure infections, the relative impact of these syndromes on patient health-related quality of life (HRQoL) is unclear. This qualitative secondary analysis used data from an interview-based HRQoL qualitative study of bloodstream infections by source of infection to inform the potential development, adaptation, and use of HRQoL measures.Methods
Interview transcripts from eligible participants (aged ≥18 years) with intra-abdominal, urinary tract, and skin/skin structure infections as the source of bloodstream infection were selected from parent study data collected between May 2017 and September 2018. Interviews were conducted at 6 to 8 weeks postdischarge with participants enrolled at a single, tertiary academic medical center in the United States. We assessed patients' perspectives using episode profile and content analysis to identify key concepts that impacted HRQoL during the course of illness, treatment, and follow-up care.Results
We analyzed 31 interview transcripts and identified 6 key concepts with a short- or long-term impact on HRQoL: (1) preinfection characteristics, (2) self-management after discharge, (3) overall health context, (4) fear of recurrent infection, (5) social support and caregivers' availability, and (6) follow-up and recovery. The concepts' impact varied by syndrome.Conclusions
Patient-reported perspectives expanded our understanding of the experiences of patients with bloodstream infections by source of infection. Future studies will require measuring patient-reported HRQoL in a way that captures what is meaningful to patients with different types of infection.Type
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Ruffin, Felicia, Katherine N Sutton, Julie Miller, Hannah Lane, Julie Schexnayder, Megan Oakes, Abigail Rader, Hayden B Bosworth, et al. (2025). A Qualitative Secondary Analysis of Patient Health-Related Quality of Life in Bloodstream Infections by Source: Intra-abdominal, Urinary Tract, and Acute Bacterial Skin and Skin Structure Infection. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 81(Supplement_1). pp. S48–S54. 10.1093/cid/ciaf295 Retrieved from https://hdl.handle.net/10161/34211.
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Scholars@Duke
Felicia Ruffin
Hannah Grace Lane
I am an implementation scientist with expertise in mixed methods and community-engaged research. My research focuses on improve implementation of federal policies that increase access to nutritious foods and physical activity for children facing social and economic disadvantages.
My research centers around 3 primary focus areas:
(1) optimizing implementation of evidence-based healthy eating and physical activity policies and practices in child-serving settings (mostly schools);
(2) studying implementation flexibilities of federal child nutrition assistance policies during COVID-19
(3) engaging children and adolescents as active participants in implementation research, including developing and testing pragmatic, age-appropriate evaluation metrics;
The ultimate goal of my research is to develop and disseminate strategies that improve health-promoting policy implementation in under-resourced community settings and, ultimately, reduce pediatric health inequities.
My methods expertise is broadly applicable across child and adolescent health outcomes and community settings. This expertise includes: implementation and dissemination methods, stakeholder-driven research, youth participatory research methods, mixed methods evaluation, pragmatic measures development (including rapid qualitative data collection and analysis), organizational capacity-building, theory-based program development, policy implementation.
Areas of Expertise: Implementation Science, Health Behavior, and Health Management
Hayden Barry Bosworth
Dr. Bosworth is a health services researcher and Deputy Director of the Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT) at the Durham VA Medical Center. He is also Vice Chair of Education and Professor of Population Health Sciences. He is also a Professor of Medicine, Psychiatry, and Nursing at Duke University Medical Center and Adjunct Professor in Health Policy and Administration at the School of Public Health at the University of North Carolina at Chapel Hill. His research interests comprise three overarching areas of research: 1) clinical research that provides knowledge for improving patients’ treatment adherence and self-management in chronic care; 2) translation research to improve access to quality of care; and 3) eliminate health care disparities.
Dr. Bosworth is the recipient of an American Heart Association established investigator award, the 2013 VA Undersecretary Award for Outstanding Achievement in Health Services Research (The annual award is the highest honor for VA health services researchers), and a VA Senior Career Scientist Award. In terms of self-management, Dr. Bosworth has expertise developing interventions to improve health behaviors related to hypertension, coronary artery disease, and depression, and has been developing and implementing tailored patient interventions to reduce the burden of other chronic diseases. These trials focus on motivating individuals to initiate health behaviors and sustaining them long term and use members of the healthcare team, particularly pharmacists and nurses. He has been the Principal Investigator of over 30 trials resulting in over 400 peer reviewed publications and four books. This work has been or is being implemented in multiple arenas including Medicaid of North Carolina, private payers, The United Kingdom National Health System Direct, Kaiser Health care system, and the Veterans Affairs.
Areas of Expertise: Health Behavior, Health Services Research, Implementation Science, Health Measurement, and Health Policy
Vance Garrison Fowler
Determinants of Outcome in Patients with Staphylococcus aureus Bacteremia
Antibacterial Resistance
Pathogenesis of Bacterial Infections
Tropical medicine/International Health
Thomas Lawrence Holland
Heather Alyse King
Areas of expertise: Implementation Science, Health Services Research, and Health Measurement
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