N12 The Experience of Post-traumatic Growth Process in Newly Diagnosed Chinese Patients with Crohn’s Disease: A Longitudinal Qualitative Study

Abstract

Abstract Background The impact of Crohn’s disease (CD) is not purely negative, it may become an opportunity for patients to undergo positive psychological adjustments and achieve personal growth. To date there has been limited in-depth research to understand the patients’ experiences of post-traumatic growth (PTG) process following an CD diagnosis using a qualitative study with a longitudinal perspective. Methods A longitudinal qualitative design was adopted. Sixteen newly diagnosed Chinese patients with CD were recruited through purposive sampling. Semi-structured interviews were conducted on three occasions: 3, 6 and 12 months post-diagnosis. Data were collected between November 2021 and December 2022. Data analysis of each time point was based on conventional content analysis. Afterwards, all data were combined for a comprehensive re-analysis to capture change. Results Four themes and fifteen sub-themes were formed through analysis (table 1). The process of PTG was shown in Figure 1. Within the first year post-diagnosis, patients with CD experienced considerable physical discomforts and psychological distress. Their personal development was also limited. With increased disease knowledge, and driven by a strong sense of responsibility and external support, the patients’ disease acceptance transformed from "difficult to accept" to "have to accept" to "should accept" then to "be able to accept". Living with CD, they actively engaged in monitoring disease condition, cooperating with treatment, exploring patterns of flare-ups, relieving stress and focusing on problem solving to eliminate negative emotions, and regaining hope and positively planning for future. Over time, the impact of CD on the patients’ lives became smaller, they integrated their disease as a part of themselves, and achieved personal growth. This growth was manifested by "developing closer relationships with others", "increasing personal strength", "changing in life philosophy" and "emerging new possibilities". Overall, as disease duration increased, the disease related sufferings diminished, and CD patients’ disease acceptance improved. In addition, as time goes by, the patients’ ability to self-manage disease enhanced, and their experience of personal growth increased. Conclusion The process of PTG in patients with CD within the first year of diagnosis primarily consists of four stages: "enduring hardships", "accepting illness", "living with illness", and "achieving personal growth". This growth was not linear, but rather cyclical. Nurses could provide targeted guidance to patients based on the trajectory identified in this study, helping them unearth inner resources and create conditions for PTG.