Sample and setting
The criteria for inclusion in this study were: diagnosed with cancer by pathology; aged ≥ 18 years; survival time ≥ 3 months; an understanding of the disease progress; and able to read and write Chinese. Patients with any of the following were excluded: critical condition; cognitive impairment or psychiatric illness; or failure to complete the questionnaire, leading to missing data.
Of 120 patients with cancer admitted to the project from 1 September 1 2018 to 30 September 30 2018 at West China Hospital of Sichuan University, the final population comprised 101 (84.2%). Of 19 patients who failed to complete the interview or questionnaire, 15 were not interested in our study, and 4 were not able to read and write Chinese.
A questionnaire was designed to assess the patients’ attitudes and preferences regarding FMT. The questionnaire consisted of 15 questions which were based on previous studies [11–14]. Ten questions were used to collect demographic data and clinical indexes such as gender, age, education, health insurance, religion, tumor stage, and performance status (PS). Five questions gathered information regarding attitudes and preferences toward the FMT option, and the donor, route, expenditure, and potential adverse effects.
In the attitudes and preferences section of the questionnaire, patients answered the following open-ended questions:
■Are you willing to receive fecal microbiota transplantation?
If no, please choose the reasons:
□ worry about side effects □ worry about efficacy □ financial burden
□ the therapy disgusts me □ other, please specify ____
If yes, please answer the following questions:
■Who do you prefer to be the donor, and why?
□ relative □ friend □ stranger □ reason ____
■Which method of delivery do you prefer, and why?
□ oral □ nasoduodenal tube □ colonoscopy □ reason ____
■What is the highest expense you are willing to pay for this treatment, and why?
□ ≤10K □10-20K □ 20-30K □ ≥30K □ reason ____
■Which adverse event is most worrisome, and why?
□ flatulence □ infection □ diarrhea □ fatigue □ reason ____
Design and data collection
A cross-sectional survey was conducted of patients with cancer via convenience sampling in a cancer center of China. A semi-structured interview was developed to collect data. The Ethics Committee of the West China Hospital granted approval for the study. Before the formal investigation began, the patients’ primary care physicians were contacted to gain their support, and a clinical nurse was trained to interview the participants. A specified room was prepared for the interview.
The nurse used a printed questionnaire collect data from the participants. All the participants were given the same instructions for the study and were asked not to share their responses with other participants. The interviewer recorded each participant’s responses to the questions, without any attempt to influence their answers. The data were analyzed by an independent statistician who was not involved in the data collection or storage. All the data was confidential, and available only for reasons that were in accordance with the goal of the study.