Introduction Patients’ concerns have been negatively associated with adaptation and outcomes in inflammatory bowel diseases (IBD). Disease severity has been shown to be an important predictor for increased concerns and disability as well as for poor quality of life (QoL). However, recent studies reported significant concerns even when patients are in remission.
Our primary aim was to investigate the association among disease related concerns, disability and QoL in IBD in remission. Secondarily, we aimed to find possible associations between concerns and population characteristics.
Method The study lasted two years (2014–2016). 200 consecutive adult IBD patients from the outpatient clinic of a tertiary referral centre were screened for eligibility. Patients with psychiatric and other commorbidities were excluded. 67 patients were in remission and recruited. Patients‘ concerns were assessed with the rating form of IBD patients’ concerns (RFIPC). For disability and QoL, the 36-item version of WHODAS 2.0 and the inflammatory bowel disease questionnaire were used respectively. Factors significantly associated with RFIPC total and dimentional scores were entered in linear regression analysis.
Results 55.2% of the population had ulcerative colitis (UC) while the rest Crohn’s disease (CD). Mean disease duration was 7.73 years. The mean RFIPC score was 38.63 (sd: 10.3). No significant differences recorded per disease type (p>0.05). Worries about the unknown nature of the disease, feeling out of control, having access to quality medical care, the fear of side effects and the energy level prevailed in our population. Increased level of concerns was strongly associated with increased perceived disability (r=0.716–0.895, p=0.001) and low QoL (r=–0.6–0.7,p=0.001). Full-time employment was the only factor that was independently associated with increased level of concerns among IBD patients in remission in all 4 RFIPC domains. (b=0.509–0.573, p=0.018–0.001) In addition, celibacy (b=0.264, p=0.007) and male sex (b=0.244,p=0.001) were found to be independently related with higher scores in the domains of disease impact and complications respectively.
Conclusion In remission, the level of patients’ concerns is strongly associated with increased perceived disability and low QoL. Full time employment, celibacy and male gender were associated with increased level of concerns indicating specific targets for future interventions.
. Keeton RL, et al. Concerns and worries in people living with inflammatory bowel disease (IBD): A mixed methods study.J Psychosom Res. 2015Jun;78(6):573–8
. Soares JB, et al.The Inflammatory Bowel Disease-Disability Index: validation of the Portuguese version according to the COSMIN checklist.Eur J Gastroenterol Hepatol. 2016Oct;28(10):1151–60
Disclosure of Interest None Declared
- Inflammatory bowel disease
- Patients‘ concerns
- Quality of life