Living with faecal incontinence: a qualitative investigation of patient experiences and preferred outcomes through semi-structured interviews

Purpose
Faecal incontinence (FI) is a prevalent and debilitating anorectal problem causing embarrassment, anxiety, and social isolation, diminishing quality of life. At present there is no optimal treatment option for FI. Consequently, treatments primarily focus on symptom reduction and improving quality of life. Understanding patient experiences and outcomes they seek from treatment is crucial for improving care. This study aims to explore how FI impacts patients’ lives and identify important treatment outcomes as part of the development of a Core Outcome Set (COS).

Methods
Patients with FI were recruited from outpatient clinics in the Netherlands. Semi-structured interviews were performed, audio recorded, transcribed per verbatim and coded. Thematic analysis was performed to identify (sub)themes and categories relevant to the patients.

Results
Twelve interviews were conducted before saturation was reached (75% female, 25% male, mean age 63, range 39–83 year). Four main themes emerged ‘Physical symptoms’, ‘Impact on daily life’, ‘Emotional impact’ and ‘Coping’. Patients expressed how FI severely limits daily activities and emotional wellbeing. Treatment priorities centred on resuming normal activities rather than solely on symptom reduction.

Conclusion
The impact of FI extends far beyond uncontrolled loss of faeces, affecting psychological, emotional, and social wellbeing. Patients prioritise outcomes focussed on reclaiming normalcy and independence rather than focusing on physical symptoms alone. Integrating these patient-centered outcomes in future studies could enhance treatment satisfaction and patient-perceived treatment success. Furthermore, the outcomes identified in this study can be included in a Delphi survey alongside other relevant outcomes, paving the way for the development of a COS.

Contributors

S. L. Assmann, D. Keszthelyi, S. O. Breukink & M. L. Kimman

Publication

Journal: Quality of Life Research
Volume:
Issue:
Pages: -
Year: 2024
DOI: 10.1007/s11136-024-03756-3

Further Study Information

Current Stage: Completed
Date:
Funding source(s): The authors did not receive funding for this study.


Health Area

Disease Category: Gastroenterology

Disease Name: Fecal Incontinence

Target Population

Age Range: 18 - 120

Sex: Either

Nature of Intervention: Any

Stakeholders Involved

- Consumers (patients)

Study Type

- Patient perspectives

Method(s)

- Interview

Patients with FI were recruited from outpatient clinics in the Netherlands. Semi-structured interviews were performed, audio recorded, transcribed per verbatim and coded. Thematic analysis was performed to identify (sub)themes and categories relevant to the patients.