Abstract
Urinary stone disease is a common, often recurrent disease, that can have a negative impact on patients’ health-related quality of life (HRQoL), often effecting working, productive members of society. The literature lacks data from structured, qualitative research which could give unique insight into patients’ HRQoL. The objective is to understand the impact of urinary stone disease and treatments on patients’ HRQoL, from patients’ and their relatives’ perspective using qualitative and quantitative methodologies. Semi-structured interviews and a focus group were used to understand the HRQoL issues of patients with urinary stones disease, covering the American Urology Association index stone categories. Thematic analysis was performed (using qualitative data analysis software). Familial impact was assessed using the family-related outcome measure (FROM-16©). 62 patients with stone disease and interventions (mean age 51, range 19–92) participated. Data collection stopped when data saturation was achieved. Analysis revealed negative impact of stone disease and interventions on the patients’ HRQoL, affecting domains of pain, physical symptoms, outlook on life, work/career, change in lifestyle/diet, social life, difficulties of daily living, travel/holiday problems, relationships and family member impact (106 themes grouped under ten broad headings). Sub-group analyses revealed similar impact in either sex, ureteric and renal stone groups. Recurrent stones were associated with work/financial concerns and treatment preferences varied accordingly. Our qualitative study presents detailed insights into the multidimensional impact of urinary calculi and their treatments on various domains of the HRQoL, confirming previous findings and adding new observations. The findings are expected to help in the development of patient-centric measures and communication tools.
Highlights
The prevalence of urinary stone disease is high and is estimated to be 2–3% amongst the general population
Patients participated in semi-structured interviews lasting between 30 and 90 min with a urology clinical research fellow trained in qualitative research methods
Our study demonstrates that stone disease and interventions tend to have significant impact on different domains of health-related quality of life
Summary
The prevalence of urinary stone disease is high and is estimated to be 2–3% amongst the general population. The peak age of incidence is between 35. The recent evidence suggests that in western nations the incidence of renal stones has increased and women might be nearly as affected as men [3,4,5]. Risk of recurrence is estimated to be 50% within 5 years of the first stone episode. Given their age, patients with urinary stone disease are often working, productive members of society and if they require a leave of absence from employment, it could have economic ramifications on the individual, their family and on a wider, societal level [6]
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