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Desperately seeking a cure: Treatment seeking and appraisal in irritable bowel syndrome
Author(s) -
Harvey J. Matthew,
Sibelli Alice,
Chalder Trudie,
Everitt Hazel,
MossMorris Rona,
Bishop Felicity L.
Publication year - 2018
Publication title -
british journal of health psychology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.05
H-Index - 88
eISSN - 2044-8287
pISSN - 1359-107X
DOI - 10.1111/bjhp.12304
Subject(s) - irritable bowel syndrome , disappointment , thematic analysis , quality of life (healthcare) , medicine , randomized controlled trial , psychotherapist , psychology , qualitative research , psychiatry , surgery , sociology , social science
Objectives Irritable bowel syndrome ( IBS ) is common and adversely affects patients' quality of life. Multiple potential treatment options exist for patients (and clinicians) to choose from, with limited evidence to inform treatment selection. The aim was to explore how patients with IBS go about seeking and appraising different treatment modalities, with a view to elucidating the psychological processes involved and identifying opportunities to improve clinical practice. Design Qualitative study nested within a randomized controlled trial of therapist‐delivered and web‐based cognitive behavioural therapy versus treatment‐as‐usual for IBS . Methods A total of 52 people participated in semi‐structured interviews about their prior experiences of treatments for IBS . Transcripts were analysed using inductive thematic analysis. Results Key themes (desperation for a cure, disappointment at lack of cure, appraising the effects of diverse treatments, and hope for positive effects) clustered around an overarching theme of being trapped within a vicious cycle of hope and despair on treatment seeking. A desperation and willingness drove interviewees to try any treatment modality available that might potentially offer relief. Coming to accept there is no cure for IBS helped interviewees escape the vicious cycle. Treatments were appraised for their effects on symptoms and quality of life while also considering, but rarely prioritizing, other aspects including convenience of the regimen itself, whether it addressed the perceived root causes of IBS , perceived side‐effects, and cost. Conclusion Treatment seeking in IBS can be challenging for patients. Supportive discussions with health care professionals about illness perceptions, treatment beliefs, and goals could improve patients' experiences.Statement of contribution What is already known on this subject?Irritable bowel syndrome ( IBS ) is a highly prevalent chronic relapsing functional gastrointestinal disorder. Studies show few treatment modalities provide complete symptom relief. IBS is associated with emotional and physical distress, and negatively impacts personal, social, and professional aspects of quality of life.What does this study add?Patients appraise IBS treatments for impact on quality of life and treatment characteristics. Developing acceptance and coping strategies helps escape treatment‐seeking vicious cycles of hope and despair. Clinicians could better support patients by discussing their illness perceptions, treatment goals, and values.