Open AccessPreliminary evidence supporting a framework of psychological adjustment to inflammatory bowel disease
Author(s) -
Kiebles Jennifer L.,
Doerfler Bethany,
Keefer Laurie
Publication year - 2010
Publication title -
inflammatory bowel diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.932
H-Index - 146
eISSN - 1536-4844
pISSN - 1078-0998
DOI - 10.1002/ibd.21215
Subject(s) - medicine , inflammatory bowel disease , disease , coping (psychology) , quality of life (healthcare) , ulcerative colitis , psychological adaptation , cognition , clinical psychology , severity of illness , gastroenterology , physical therapy , psychiatry , nursing
Background: Adjustment to chronic disease is a multidimensional construct described as successful adaptation to disease‐specific demands, preservation of psychological well‐being, functional status, and quality of life. Inflammatory bowel disease (IBD) can be particularly challenging due to the unpredictable, relapsing and remitting course of the disease. Methods: All participants were patients being treated in an outpatient gastroenterology clinic at a university medical center. Participants completed a survey of questionnaires assessing illness perceptions, stress, emotional functioning, disease acceptance, coping, disease impact, and disease‐specific and health‐related quality of life. Adjustment was measured as a composite of perceived disability, psychological functioning, and disease‐specific and health‐related quality of life. Results: Participants were 38 adults with a diagnosis of either Crohn's disease (45%) or ulcerative colitis (55%). We observed that our defined adjustment variables were strongly correlated with disease characteristics ( r = 0.33–0.80, all P < 0.05), an emotional representation of illness ( r = 0.44–0.58, P < 0.01), disease acceptance ( r = 0.34–0.74, P < 0.05), coping ( r = 0.33–0.60, P < 0.05), and frequency of gastroenterologist visits ( r = 0.39–0.70, P < 0.05). Better adjustment was associated with greater bowel and systemic health, increased activities engagement and symptom tolerance, less pain, less perceived stress, and fewer gastroenterologist visits. All adjustment variables were highly correlated ( r = 0.40–0.84, P < 0.05) and demonstrated a cohesive composite. Conclusions: The framework presented and results of this study underscore the importance of considering complementary pathways of disease management including cognitive, emotional, and behavioral factors beyond the traditional medical and psychological (depression and anxiety) components. (Inflamm Bowel Dis 2010)