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粪便微生物群移植治疗溃疡性结肠炎:患者认知与体验的定性评估

Fecal Microbiota Transplantation for the Treatment of Ulcerative Colitis: A Qualitative Assessment of Patient Perceptions and Experiences.

作者信息

Chauhan Usha, Popov Jelena, Farbod Yasamin, Kalantar Mona, Wolfe Melanie, Moayyedi Paul, Marshall John K, Halder Smita, Kaasalainen Sharon

机构信息

Hamilton Health Sciences, Adult Digestive Diseases, Hamilton, Ontario, Canada.

Department of Pediatrics, McMaster University Medical Centre, Hamilton, Ontario,Canada.

出版信息

J Can Assoc Gastroenterol. 2021 Mar 26;4(6):e120-e129. doi: 10.1093/jcag/gwab007. eCollection 2021 Dec.

Abstract

BACKGROUND

Fecal microbiota transplantation (FMT) is a promising experimental therapy for ulcerative colitis (UC), yet patient acceptance remains poorly understood.

AIMS

The aim of this study was to explore perceptions and experiences of adult patients who received FMT for UC.

METHODS

This study used a qualitative descriptive design with thematic content analysis. Patients who were approached for enrollment in a clinical trial (NCT02606032) were invited to participate in face-to-face semistructured interviews. Two groups were interviewed: those who chose to pursue FMT and those who declined FMT. Non-FMT patients were interviewed once; FMT patients were interviewed twice at pre- and post-treatment.

RESULTS

Nine FMT patients (78% female, average age 46.7 years old) and eight non-FMT patients (50% female, average age 39.5 years old) were enrolled. Pretreatment themes included FMT as a natural therapy, external barriers to pursuing FMT, concerns with FMT and factors influencing the decision to pursue FMT. While both groups generally perceived FMT as a natural therapy, pre-FMT patients showed greater acceptance of alternative medicine. Both groups demonstrated poor understanding and similar initial concerns with product cleanliness. Pre-FMT patients were motivated to pursue FMT by feelings of last resort. Post-FMT themes included therapeutic impact of FMT and psychosocial impact of FMT. Post-FMT patients reported overall satisfaction and a unanimous preference for FMT over conventional medications.

CONCLUSION

This is the first study to assess adult patient perceptions and real-life experiences with FMT for the treatment of UC. By improving patient education, we may achieve greater acceptance of FMT.

摘要

背景

粪便微生物群移植(FMT)是一种治疗溃疡性结肠炎(UC)的很有前景的实验性疗法,但患者的接受度仍知之甚少。

目的

本研究旨在探讨接受FMT治疗UC的成年患者的看法和经历。

方法

本研究采用定性描述性设计和主题内容分析。邀请参与一项临床试验(NCT02606032)招募的患者参加面对面的半结构化访谈。访谈了两组患者:选择接受FMT的患者和拒绝接受FMT的患者。未接受FMT的患者接受了一次访谈;接受FMT的患者在治疗前和治疗后接受了两次访谈。

结果

招募了9名接受FMT的患者(78%为女性,平均年龄46.7岁)和8名未接受FMT的患者(50%为女性,平均年龄39.5岁)。治疗前的主题包括FMT作为一种自然疗法、接受FMT的外部障碍、对FMT的担忧以及影响接受FMT决定的因素。虽然两组患者普遍认为FMT是一种自然疗法,但接受FMT前的患者对替代医学的接受度更高。两组患者对产品清洁度的理解都很差,最初的担忧也相似。接受FMT前的患者因别无选择的感觉而有动力接受FMT。治疗后的主题包括FMT的治疗效果和FMT的心理社会影响。接受FMT后的患者报告总体满意度较高,并且一致倾向于FMT而非传统药物。

结论

这是第一项评估成年患者对FMT治疗UC的看法和实际生活经历的研究。通过改善患者教育,我们可能会提高对FMT的接受度。

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