Abstract
Background and Objectives: Nursing management in Inflammatory Bowel Disease (IBD) is focused on global patient care. Starting from basic knowledge of diagnostic and therapeutic management, nurses can assess the impact of IBD on patients’ quality of life not only at the physical level, but also at the psychological, social, and emotional levels. The aim of this study was to evaluate the impact of gastrointestinal symptoms on psychosocial changes in IBD patients in remission through nursing-led Patient-Reported Outcomes. Materials and Methods: We performed a cross-sectional study of 109 IBD patients in clinical and endoscopic remission. Specialist nurses invited patients to complete questionnaires on gastrointestinal symptoms and quality of life through the Patient-Reported Outcomes Measurement Information System (PROMIS). Results: We found that the gastrointestinal symptoms that the patients reported had a significant impact on the analyzed aspects of health. More specifically, belly pain, diarrhea, and bloating were associated with depressive symptoms (p < 0.001), anxiety (p < 0.001), fatigue (p < 0.001), and sleep disturbances (p < 0.001). Moreover, these symptoms also significantly affected patients’ social dimension in terms of satisfaction with participation in social roles (p < 0.001, p < 0.05, and p < 0.001 for belly pain, diarrhea, and bloating, respectively) and physical functions (p < 0.001). The results were virtually the same in a multivariable analysis adjusted by age, gender, body mass index (BMI), and disease duration. Conclusions: Even during remission, gastrointestinal symptoms are the main factors that influence quality of life in IBD patients. This exploratory study highlights the need to adopt validated questionnaires in clinical practice, and demonstrates that PROMIS is a valid, objective, and standardized instrument that can help nursing staff to better define the consequences of the disease in a patient’s daily life.
Highlights
The 2nd Nursing–European Crohn Colitis Organization (N-ECCO) consensus on nursing management in patients with Inflammatory Bowel Disease (IBD) focuses on the role of nurses in global patient care, from basic knowledge of diagnostic and therapeutic management to the assessment of the disease’s impact on patients’ quality of life at the physical, psychological, social, and emotional levels [1]
The primary aim of this study is to evaluate the impact of gastrointestinal symptoms on psychosocial changes in IBD patients in clinical and endoscopic remission
109 patients with IBD (n = 78 (71%) Ulcerative Colitis (UC); n = 32 (29%) Crohn’s Disease (CD)) and a median age of 50 (42–59) years in clinical and endoscopic remission were included in the study
Summary
The 2nd Nursing–European Crohn Colitis Organization (N-ECCO) consensus on nursing management in patients with Inflammatory Bowel Disease (IBD) focuses on the role of nurses in global patient care, from basic knowledge of diagnostic and therapeutic management to the assessment of the disease’s impact on patients’ quality of life at the physical, psychological, social, and emotional levels [1]. The most widespread and distressing symptoms that occur in people with IBD are pain, fatigue, sleep disorders, depression, and anxiety. These symptoms are more common during periods when the disease is active. The aim of this study was to evaluate the impact of gastrointestinal symptoms on psychosocial changes in IBD patients in remission through nursing-led Patient-Reported Outcomes. Results: We found that the gastrointestinal symptoms that the patients reported had a significant impact on the analyzed aspects of health
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