A nurse-led peer support intervention to enhance decision-making for fecal microbiota transplantation in recurrent UTI: a pilot study

Abstract

Abstract To examine the preliminary effects and feasibility of peer support on decision-making regarding fecal microbiota transplantation (FMT) among patients with recurrent urinary tract infections (rUTIs). This was a prospective, two-arm pilot study conducted from September 2023 to April 2024 in the urology outpatient departments of two tertiary hospitals in China using convenience sampling. Patients were assigned to either a peer support group or a control group. The intervention consisted of weekly WeChat-based interactions between trained peer supporters and patients for four weeks. Decision-making was assessed using validated tools including the Decisional Conflict Scale, Preparation for Decision Making Scale, Decision Self-Efficacy Scale, Choice Predisposition Scale, and Decisional Satisfaction Scale, all derived from the Ottawa Decision Support Framework. Anxiety and depression were measured using the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS). A total of 24 patients were assigned to a peer support group ( n  = 12) and a control group ( n  = 12). Compared with the control group, the peer support group showed higher FMT-related knowledge, stronger choice predisposition toward FMT, higher decision-making self-efficacy, and lower decisional conflict after the intervention. No significant between-group differences were observed in preparation for decision making, decisional satisfaction, anxiety, or depression. In this small exploratory pilot study, nurse-led peer support showed preliminary potential to improve selected decision-related outcomes among women with rUTIs considering FMT. Rather than confirming efficacy, this study supports the feasibility of a structured nurse-led peer support protocol and provides a basis for future larger-scale research. Given the small sample size, convenience sampling, and single cultural context, these findings should be interpreted cautiously and require confirmation in larger studies. Future studies should also assess whether these preliminary improvements are sustained and translate into actual treatment decisions and long-term decisional satisfaction.