title: Patients' experience and perception of hospital-treated Clostridium difficile infections: a qualitative study.
abstract: BACKGROUND
  Clostridium difficile is the leading cause of antibiotic-associated diarrhea and an important source of nosocomial infection. Clinical manifestations can range from mild diarrhea to lethal pseudomembranous colitis. Little is known about the burden of C. difficile infections (CDI) in patients.
  
  
  OBJECTIVE
  This qualitative study explored the impact of hospital-treated CDI on patients' lives from the first occurrence of CDI symptoms, through their hospital stay, and after discharge.
  
  
  METHODS
  Semi-structured interviews with 12 US and 12 French patients who had experienced CDI were conducted using an interview guide that was developed on the basis of a thorough literature review. Transcripts from these interviews were analyzed to identify concepts related to the research question.
  
  
  RESULTS
  CDI affected numerous aspects of patients' lives. Patients reported that the continuous, watery, and uncontrollable diarrhea characteristic of CDI had the most impact on their daily lives. Diarrhea prevented them from participating in usual daily activities; this caused the collapse of their social lives. Patients felt humiliated and embarrassed. Patients' emotional distress worsened once hospitalized; they reported feelings of loneliness and worry when placed in isolation. From discharge to the time of the interview, patients reported both psychological and physical improvement. However, despite continuing improvement, most patients reported persistent worry and fear of recurrent episodes, and they were thus more careful about their diet and hygiene.
  
  
  CONCLUSIONS
  As one patient in this study explained, CDI is "the worst of everything that I've had." The emotional distress and extreme physical exhaustion associated with CDI result in a traumatic and frightening experience for patients. This trauma persists after recovery and includes lingering fears of a recurrent episode.
authors.affiliation: Mapi, 27, Rue de la Villette, 69003, Lyon, France, iguillemin@mapigroup.com.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Guillemin
authors.forename: Alexia
authors.initials: A
authors.lastname: Marrel
authors.forename: Jérémy
authors.initials: J
authors.lastname: Lambert
authors.forename: Axelle
authors.initials: A
authors.lastname: Beriot-Mathiot
authors.forename: Carole
authors.initials: C
authors.lastname: Doucet
authors.forename: Odysseas
authors.initials: O
authors.lastname: Kazoglou
authors.forename: Christine
authors.initials: C
authors.lastname: Luxemburger
authors.forename: Camille
authors.initials: C
authors.lastname: Reygrobellet
authors.forename: Benoit
authors.initials: B
authors.lastname: Arnould
mesh_terms: D000328:Adult; D016360:Clostridioides difficile; D003015:Clostridium Infections / Q000523:psychology*; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D010465:Perception; D036301:Qualitative Research