Patients’ perspectives on providing a stool sample to their GP: a qualitative study

Abstract

BackgroundStool specimen collection is challenging and informal feedback has indicated that participants find the process difficult. Increasing stool specimen returns would improve the investigation of outbreaks of diarrhoeal and food-borne disease.AimTo explore the barriers to stool sample collection and specimen return to ascertain which factors may help to improve the process.Design and settingQualitative patient interview study in Gloucester, UK.MethodA two-stage purposive sampling process was used to identify patients who had either previous experience or no experience of collecting a stool sample. The interview schedule, based on the theory of planned behaviour, was used to facilitate interviews with 26 patients. Interview transcripts were analysed using a modified framework analysis.ResultsBarriers to collection included embarrassment, fear of results, concerns around hygiene and contamination, discretion and privacy, and lack of information. Personal gain was identified as the main incentive to collecting and returning a stool sample. The need for an information leaflet on stool collection was emphasised by most patients.ConclusionsGPs could make a number of small changes that could make a big difference for patients and potentially increase stool sample return. If they, rather than receptionists, distributed collection kits it may be easier for patients to ask any questions they had regarding collection. In addition, the provision of a stool-collection information leaflet could increase patients’ confidence regarding collecting the sample, and providing drop-off boxes for specimens could help prevent patients’ embarrassment regarding handing their stool over to a receptionist.

What is the qualitative evidence concerning the risks, diagnosis, management and consequences of gastrointestinal infections in the community in the United Kingdom? A systematic review and meta-ethnography

“…Most studies (n = 16) included data related to the risks of illness, with one study also incorporating data related to its management and consequences [43]. Two studies included data relating to the diagnosis of illness [44,47] and one study contained data relating to both diagnosis and management [44] (Table 4). Fourteen studies included data related to foodborne GI illness alone, while four studies included data which could relate to both foodborne GI illness and non-foodborne GI infections [43,44,47,50] (Table 4).…”

“…The majority of studies (n = 11) did not detail the ethnicity of their participants. Of the remaining studies, four included participants with a diverse range of ethnicities [38,39,46,47] and three stated that the majority of their participants were of White British descent [40,48,49].…”

What does soil-transmitted helminth elimination look like? Results from a targeted molecular detection survey in Japan

“…Settings in which residents do not perceive themselves as at a risk of STH infection, such as in the localities surveyed in this study, could experience lower stool test participation during future STH surveillance activities. Additionally, negative perceptions surrounding the provision of stool tests, reluctance of handling stools, as well as embarrassment, all reportedly reduce stool-sampling participation [74]. Therefore, it is important to design the target sample size appropriately by estimating a non-response rate.…”

Inflammatory bowel disease detection and monitoring by measuring biomarkers in non‐invasively collected colorectal mucus

“…Among fecal biomarkers, stool calprotectin (SC) quantification is the best studied and most widely used test for IBD . Unfortunately, the necessity of collecting stool often makes stool testing unpopular with patients . Moreover, it is well known that diagnostically informative cells and biomolecules detectable in stool originate from the mucus of the protective barrier overlaying colonic mucosa .…”

“…[9][10][11][12][13][14] Unfortunately, the necessity of collecting stool often makes stool testing unpopular with patients. [15][16][17] Moreover, it is well known that diagnostically informative cells and biomolecules detectable in stool originate from the mucus of the protective barrier overlaying colonic mucosa. [18][19][20] Excreted fragments of this mucus are not uniformly distributed throughout stool, and sampling bias may be significant, especially when samples are prepared by patients.…”