ABSTRACT
INTRODUCTION AND OBJECTIVE: Overactive bladder (OAB) is highly prevalent, affecting millions of Americans, and poses a significant symptom burden. The purpose of this study was to understand patient experiences with OAB and the impact of these experiences on OAB treatment. METHOD(S): People with symptoms of OAB were recruited from a tertiary care clinic and from an online health research portal to complete semi-structured interviews regarding their OAB experiences. The interviews were recorded, transcribed, coded, and inductively analyzed to identify emerging themes. RESULT(S): We performed 19 interviews and identified several key themes central to the patient experience, including symptom impact and severity, knowledge, stigma, self-efficacy, and regret. We considered these themes along the following stages of the patient's OAB journey. Symptom Development and Awareness: The routine of self-care is insidious and normalized, making realization of a lifestyle that is centered around voiding less obvious to patients, leading to a delay of care-seeking. Participants noted restrictions on all aspects of life. Adjectives used to describe symptom impact included "annoyance, depression, humiliation and desperation." Care-Seeking: Participants expressed coping behaviors during onset and gradual worsening of symptoms, however many recounted a "sentinel event" that heightened their severity perception and served as a cue to action. Routine primary care visit screenings and friend recommendations were additional cues to action. Reasons for careseeking delay included lack of OAB knowledge, stigma, and embarrassment. Experiences with Therapy: Participants recognized that treatment outcomes depended on their engagement. Some individuals regretted their lack of self-advocacy and self-efficacy. Participants highlighted internal barriers (forgetfulness, doubting treatment effectiveness) and external barriers (comorbidities, COVID- 19) to therapy adherence. Among those with high self-efficacy, fear of treatment failure, calendar tools, and social support networks facilitated treatment compliance (Figure 1). CONCLUSION(S): Living with OAB affects patients physically, mentally, and socially. Gaining a better understanding of OAB experiences can help physicians tailor their practice to meet patients' needs.
ABSTRACT
SARS-CoV-2 is assumed to spread through exhaled respiratory droplets and aerosols, but very little research has directly measured the virus in exhaled breath, and our understanding of the relationship between olfactory symptoms of COVID-19 and infectious shedding of the virus is limited. Whether there is any relationship between olfactory dysfunction and viral shedding in nasal exhalate is unknown. Here, we developed a device and a method for collecting and quantifying SARS-CoV-2 RNA in the exhaled breath condensate of COVID-19 patients. Our device is portable, inexpensive and simple enough to use that breath samples can be self-collected by patients in their homes. It has configurations for both oral and nasal breath collection, allowing for comparison of viral loads across the two breathing routes. This device can be used to determine whether there is a difference between oral and nasal shedding of the virus on breath, and to determine whether viral shedding on nasal or oral breath is related to chemosensory symptoms.