title: Patients' perspectives on providing a stool sample to their GP: a qualitative study.
abstract: BACKGROUND
  Stool 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.
  
  
  OBJECTIVE
  To explore the barriers to stool sample collection and specimen return to ascertain which factors may help to improve the process.
  
  
  METHODS
  Qualitative patient interview study in Gloucester, UK.
  
  
  METHODS
  A 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.
  
  
  RESULTS
  Barriers 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.
  
  
  CONCLUSIONS
  GPs 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.
authors.affiliation: Public Health England Primary Care Unit, Gloucester.
authors.forename: Donna M
authors.initials: DM
authors.lastname: Lecky
authors.affiliation: Public Health England Primary Care Unit, Gloucester.
authors.forename: Meredith K D
authors.initials: MK
authors.lastname: Hawking
authors.affiliation: Public Health England Primary Care Unit, Gloucester.
authors.forename: Cliodna A M
authors.initials: CA
authors.lastname: McNulty
mesh_terms: D001294:Attitude to Health; D005243:Feces; D005260:Female; D005767:Gastrointestinal Diseases / Q000175:diagnosis; D058005:General Practitioners; D006801:Humans; D006920:Hygiene; D007407:Interviews as Topic; D008297:Male; D010353:Patient Education as Topic; D018907:Privacy; D036301:Qualitative Research; D011933:Reagent Kits, Diagnostic; D013048:Specimen Handling
chemical_list: D011933:Reagent Kits, Diagnostic
keywords: information leaflet; opinion; patient interview; primary care; qualitative; stool collection