title: Effects of Methicillin-Resistant Staphylococcus aureus/Multiresistant Gram-Negative Bacteria Colonization or Infection and Isolation Measures in End of Life on Family Caregivers: Results of a Qualitative Study.
abstract: Little is known about the experiences of family caregivers of hospitalized patients with confirmed methicillin-resistant Staphylococcus aureus/multiresistant gram-negative bacteria (MRSA/MRGN) diagnosis at the end of life. The study at hand is a subproject of an interdisciplinary cooperation project that aims at developing a patient-, family-, and team-centered approach in dealing with MRSA/MRGN-positive hospitalized patients in palliative and geriatric care.
  
  
  
  The present study aimed to assess the individual effects of the patient's MRSA/MRGN colonization or infection and isolation measures on family caregivers.
  
  
  
  Between April 2014 and September 2015, all known family caregivers associated with an MRSA/MRGN-positive patient from a palliative care unit, a hospital palliative care support team, and a geriatric ward were considered for study participation. A qualitative interview study with family caregivers and an additional focus group was conducted. Data were analyzed using the principles of Grounded Theory.
  
  
  
  Family caregivers (N = 62) raised suggestions regarding the provision of information and communication on the MRSA/MRGN diagnosis and hygiene measures from staff members and the consistency of hygiene procedures. Family caregivers requested not to be stigmatized or being disadvantaged due to the MRSA/MRGN diagnosis of the patient, and they wished to receive psychosocial and emotional support.
  
  
  
  Staff members and institutional stakeholders should be aware that family caregivers might be burdened and upset by positive MRSA/MRGN diagnosis and the required hygiene measures. The need for detailed and understandable information on MRSA/MRGN, adequate communication between staff members and family caregivers, and support for family caregivers should be of special attention in particular in end-of-life care.
authors.affiliation: 1 Department of Palliative Medicine, Comprehensive Cancer Center CCC Erlangen-EMN, Universitätsklinikum Erlangen , Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany .
authors.forename: Maria
authors.initials: M
authors.lastname: Heckel
authors.affiliation: 2 Institute for Biomedicine of Aging, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg , Erlangen, Germany .|3 Department of General Internal and Geriatric Medicine, Hospital of the Order of St. John of Lord , Regensburg, Germany .
authors.forename: Alexander
authors.initials: A
authors.lastname: Sturm
authors.affiliation: 1 Department of Palliative Medicine, Comprehensive Cancer Center CCC Erlangen-EMN, Universitätsklinikum Erlangen , Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany .
authors.forename: Franziska A
authors.initials: FA
authors.lastname: Herbst
authors.affiliation: 1 Department of Palliative Medicine, Comprehensive Cancer Center CCC Erlangen-EMN, Universitätsklinikum Erlangen , Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany .
authors.forename: Christoph
authors.initials: C
authors.lastname: Ostgathe
authors.affiliation: 1 Department of Palliative Medicine, Comprehensive Cancer Center CCC Erlangen-EMN, Universitätsklinikum Erlangen , Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany .
authors.forename: Stephanie
authors.initials: S
authors.lastname: Stiel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017028:Caregivers; D024881:Drug Resistance, Bacterial / Q000187:drug effects*; D005260:Female; D006090:Gram-Negative Bacteria / Q000187:drug effects* / Q000254:growth & development*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008712:Methicillin / Q000627:therapeutic use*; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects* / Q000254:growth & development*; D008875:Middle Aged; D010166:Palliative Care; D036301:Qualitative Research; D013203:Staphylococcal Infections / Q000188:drug therapy*; D013727:Terminal Care; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D008712:Methicillin
keywords: end of life; family caregivers; methicillin-resistant Staphylococcus aureus (MRSA); multiresistant gram-negative bacteria (MRGN); qualitative research