Open AccessBiopsychosocial determinants of health‐related quality of life after ileal pouch anal anastomosis for ulcerative colitis
Author(s) -
Häuser Winfried,
Dietz Nadine,
StederNeukamm Ulf,
Janke KarlHeinz,
Stallmach Andreas
Publication year - 2004
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 - 10.1097/00054725-200407000-00011
Subject(s) - medicine , ulcerative colitis , hospital anxiety and depression scale , pouchitis , quality of life (healthcare) , proctocolectomy , population , anxiety , psychosocial , gastroenterology , inflammatory bowel disease , irritable bowel syndrome , anastomosis , physical therapy , disease , surgery , psychiatry , nursing , environmental health
Background: In patients with ileal pouch anal anastomosis (IPAA) the influences of psychosocial variables and of extraintestinal manifestations of ulcerative colitis (UC) on health‐related quality of life (HRQOL) have not been studied so far. Methods: 61 patients with UC (age 52.7 ± 13.9 years; 47% female) completed the German version of the Inflammatory Bowel Disease Questionnaire (IBDQ‐D), the Short Form Health Survey (SF – 36), the German version of the Hospital Anxiety and Depression Scale (HADS‐D) and the Giessener Symptom List (GBB 24). Independent of their current clinical activity 37 patients underwent endoscopies. Pouchitis was defined by the Pouch Disease Activity Score (PDAI) ≥ 7. Where possible, IPAA‐patients were compared with the data for the German general population and with a clinical sample of patients with UC and no IPAA. Results: Patients with IPAA complained more about fatigue and arthralgia and a reduced physical and mental health (SF‐36) than the German general population ( P < 0.01). The IBDQ‐total score could be predicted (adjusted R 2 = 29.1, P < 0.01) by the number of operations due to IPAA‐related complications (β = −18.8) and HADS‐D‐Anxiety scores ≥ 11 (β= −29.1). The IBDQ‐subscale score “Bowel” could be predicted (adjusted R 2 = 13.7, P = 0.04) by PDAI ≥ 7 (β= −9.2) and the subscale score “Systemic” (adjusted R 2 = 13.3, P = 0.04) by the number of extraintestinal manifestations (β= −1.9). Conclusions: HRQOL of patients with UC and IPAA is determined not only by IPAA‐related factors but also by anxiety and extraintestinal manifestations with associated musculoskeletal pain.