The impact of telemonitoring on the psychological well-being of patients with inflammatory bowel disease: a prospective randomized controlled study

Background Inflammatory Bowel Diseases (IBD) are chronic conditions with high rates of comorbid anxiety, depression and visceral hypersensitivity (VH). For patients with IBD, psychological distress often originates from disease-related fears and inconsistent healthcare access. Telemonitoring (TM) offers a promising approach to this issue, demonstrating proven efficacy in the management of chronic diseases. This study aimed to evaluate the impact of TM on the psychological well-being of IBD patients, directly comparing it to standard outpatient care. Methods We conducted a randomized controlled prospective study. Eligible patients with confirmed IBD were randomized in a 1:1 ratio to either a standard care group or an intervention group utilizing web-platform. This web-platform included three components: a repository of validated educational materials on IBD, an interactive module for daily symptom tracking, and a direct asynchronous chat for communication with a gastroenterologist. Outcomes were assessed at the baseline and after 6 months of monitoring via validated scales for visceral sensitivity (VSI), anxiety and depression (HADS). Results The final analysis included 68 patients: 32 in the TM group (18 female; 18 with Ulcerative Colitis (UC); mean age 31.6 ± 10.05 years) and 36 in the in-person group (12 female; 17 with UC; median age 35.5 [26; 41.25] years). At baseline, 57.4% of the participants were in clinical remission. Despite this, there was a high prevalence of psychological distress: 47% of patients demonstrated signs of anxiety and depression, 92.4% had VH. At baseline, there was no difference between studied groups (p > 0.05). After 6 months follow-up period, the TM group showed lower HADS and VSI scores compared to the standard care group (anxiety: 5.5 vs. 8, p = 0.025; depression: 4 vs. 6, p = 0.04; visceral sensitivity: 21.5 vs. 30, p = 0.013, respectively). Groups did not differ in disease activity scores in the end of follow-up period. Conclusion TM significantly improves psychological well-being in patients with IBD, specifically by reducing anxiety, depressive symptoms, and VH. TM can be effectively used for managing patients with IBD, especially exhibiting signs of psychological comorbidity. At its current stage of development, telemonitoring should not be considered a replacement for in-person care. However, integrating it as a supplemental component into existing standard of care protocols can address the psychological issues of patients with IBD. Conflict of interest: Dr. Akhmedzyanova, Dina: No conflict of interest Shumskaya, Yuliya: No conflict of interest Mnatsakanyan, Marina: No conflict of interest Vladzymyrskyy, Anton: No conflict of interest Reshetnikov, Roman: No conflict of interest

To evaluate the relationship between social isolation, loneliness and psychological well-being in patients with inflammatory bowel disease (IBD). Additionally, we examined the mediating effect of disease activity on the relationships between social isolation, loneliness and psychological well-being. Cross-sectional descriptive study. A total of 218 participants were recruited from outpatient clinic at a university hospital in Turkey and from the community membership of the patient support group. Participants provided their socio-demographic and disease-related information and completed (online and paper based) the Turkish Lubben Social Network Scale-6, the Turkish UCLA Loneliness Scale Short Form and the Turkish Psychological Well-being Scale. The data were analysed using univariate linear regression analysis. This study adhered to the STROBE checklist for reporting. The majority of the participants (72%) were socially isolated, and over half (54.1%) reported moderate to high levels of loneliness. Participants also had low psychological well-being. Linear regression analysis revealed that high loneliness level and social isolation were negative predictors of psychological well-being. The results revealed that the effect of social isolation and loneliness on psychological well-being was mediated by disease activity. In line with the findings, it can be recommended to enhance social support and networks, along with regular psychological evaluation, should be integrated into the holistic care approach for IBD patients. The findings of this study hold significant implications for the management and support of patients with IBD, particularly within clinical settings in Turkey. Patients were invited to complete questionnaires. The investigators explained the study's content and purpose, and addressed any concerns during the data collection process.

Little is known about the impact of ostomy formation in inflammatory bowel disease patients on course of disease, psychological well-being, quality of life and working capacity. We analyzed patients over a follow-up of up to 16 years in the Swiss inflammatory bowel disease cohort study (SIBDCS) with prospective data collection. We compared Ulcerative colitis and Crohn's disease patients with and without ostomy as well as permanent and closed stoma formation before and after surgery, investigating disease activity, psychological wellbeing and working capacity in a case-control design. Of 3825 SIBDCS patients, 176 with ostomy were included in the study and matched with 176 patients without ostomy using propensity score, equaling 352 patients for the analysis. As expected, we observed a lower mean and maximal disease activity in patients after stoma surgery compared with control patients without stoma. Overall, psychological wellbeing in patients with stomas vs. controls as well as patients with permanent vs. closed stoma was similar in terms of disease-specific quality of life (total score of the Inflammatory Bowel Disease Quality of Life questionnaire), psychological distress (total score of the Hospital Anxiety and Depression Scale), and stress at work (effort-reward-imbalance ratio), with the exception of a higher Posttraumatic Diagnostic Scale total score in patient with vs. without stoma. Compared to IBD patients without stoma, the adverse impact on working capacity in overall stoma IBD patients appeared to be modest. However we observe a significantly higher reduction in working capacity in permanent vs. closed stoma in CD but not UC patients. As to be expected, IBD patients may benefit from closed and permanent stoma application. Stoma surgery appears to only modestly impact working capacity. Importantly, stoma surgery was not associated with adverse psychological outcomes, with comparable psychological well-being regardless of presence and type of stoma.

BackgroundLittle is known about the impact of ostomy formation in inflammatory bowel disease patients on course of disease, psychological well-being, quality of life and working capacity.MethodsWe analyzed patients over a follow-up of up to 16 years in the Swiss inflammatory bowel disease cohort study (SIBDCS) with prospective data collection. We compared Ulcerative colitis and Crohn’s disease patients with and without ostomy as well as permanent and closed stoma formation before and after surgery, investigating disease activity, psychological wellbeing and working capacity in a case-control design.ResultsOf 3825 SIBDCS patients, 176 with ostomy were included in the study and matched with 176 patients without ostomy using propensity score, equaling 352 patients for the analysis. As expected, we observed a lower mean and maximal disease activity in patients after stoma surgery compared with control patients without stoma. Overall, psychological wellbeing in patients with stomas vs. controls as well as patients with permanent vs. closed stoma was similar in terms of disease-specific quality of life (total score of the Inflammatory Bowel Disease Quality of Life questionnaire), psychological distress (total score of the Hospital Anxiety and Depression Scale), and stress at work (effort-reward-imbalance ratio), with the exception of a higher Posttraumatic Diagnostic Scale total score in patient with vs. without stoma. Compared to IBD patients without stoma, the adverse impact on working capacity in overall stoma IBD patients appeared to be modest. However we observe a significantly higher reduction in working capacity in permanent vs. closed stoma in CD but not UC patients.ConclusionAs to be expected, IBD patients may benefit from closed and permanent stoma application. Stoma surgery appears to only modestly impact working capacity. Importantly, stoma surgery was not associated with adverse psychological outcomes, with comparable psychological well-being regardless of presence and type of stoma.

Significance. Inflammatory bowel diseases are chronic, relapsing conditions requiring continuous management by a multidisciplinary team. In 2021, the Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE II) consensus emphasized that therapeutic endpoints in inflammatory bowel diseases should encompass not only disease remission but also improvements in patient-reported outcomes, specifically quality of life and psychological well-being. Previous investigations in Russia have consistently demonstrated a compromised quality of life and psychological distress in individuals with inflammatory bowel diseases. This underscores the need to explore the relationship between these factors and to identify potential targets for therapeutic interventions. Purpose. To evaluate the interplay between psychosocial characteristics, disease activity, and their associations in inflammatory bowel disease patients to identify potential targets for interventions, including telemedicine. Material and methods. A cross-sectional, observational study was conducted among patients with inflammatory bowel diseases. The following questionnaires were used to assess the parameters: the Harvey-Bradshaw Index, the Simple Clinical Colitis Activity Index, the World Health Organization Quality of Life questionnaire, the Short Inflammatory Bowel Disease Questionnaire, the Hospital Anxiety and Depression Scale, the Visceral Sensitivity Index, and the Toronto Alexithymia Scale. Results. The study sample comprised 102 participants (52 with ulcerative colitis and 50 with Crohn’s disease), with a median age of 34 years. Half of the cohort was in clinical remission. The analysis revealed that 43.8% of the inflammatory bowel disease patients had suboptimal quality of life, 92.8% had high scores on the visceral sensitivity index, and 49.7% showed signs of anxiety and depression. Furthermore, 34% of the patients in remission showed signs of anxiety and depression. The visceral sensitivity index showed a significant moderate correlation with depression and anxiety (Spearman’s ρ 0.58 and 0.63, respectively, p-value < 0.05). Anxiety and depression scores also showed a moderate positive correlation with each other (Spearman’s ρ 0.64, p-value < 0.05). A significant, moderate negative correlation was observed between health-related quality of life and the visceral sensitivity index (Spearman’s ρ -0.67, p-value < 0.05), depression scores (Spearman’s ρ -0.53, p-value < 0.05), and anxiety scores (Spearman’s ρ -0.61, p-value < 0.05). Moreover, the quality of life was associated not so much with the disease activity, but rather with the presence of anxiety, depression, and increased visceral sensitivity. Conclusion. Patients with inflammatory bowel diseases need to have their psycho-emotional wellbeing and visceral hypersensitivity addressed. This can be a starting point for various interventions, including the use of telemedicine technology. Keywords: Inflammatory bowel disease; Ulcerative colitis; Crohn’s disease; anxiety and depression; clinical activity; telemonitoring.

Objective: The present study aimed to investigate the efficacy of emotion-focused psychotherapy on perceived stress and psychological well-being in patients with corona anxiety during the pandemic. Methods and Materials: This research was conducted using a quasi-experimental design with a pre-test, post-test, and a control group, along with a three-month follow-up period. The study population consisted of individuals suffering from corona anxiety who had contacted counseling centers in Isfahan for telephone counseling during the summer of 2021. Out of the study population, 33 individuals were selected through purposive sampling and randomly assigned to either the experimental or control group. Participants in the experimental group received emotion-focused psychotherapy over two months. The instruments used in this research included the Perceived Stress Scale (Cohen et al., 1983) (PSS), the Psychological Well-Being Questionnaire (Ryff, 1988) (PWBQ), and the Corona Disease Anxiety Scale (Alipour et al., 2019) (CDAS). The data were analyzed using mixed ANOVA with SPSS version 23. Findings: The results indicated that emotion-focused psychotherapy had a significant effect on perceived stress (P<0.0001; Eta=0.59; F=44.99) and psychological well-being (P<0.0001; Eta=0.68; F=66.28) in patients with corona anxiety. Conclusion: Based on the findings of the current study, emotion-focused psychotherapy, utilizing techniques of emotional awareness, emotional experience, regulation, transformation, and change, can be an effective method for reducing perceived stress and improving psychological well-being in patients with corona anxiety.

Background Chronic diseases like inflammatory bowel diseases (IBD) can pose challenges to the self-concept of a patient. Illness identity (IID) describes a patient′s way to integrate a chronic illness into the self-concept distinguishing the dimensions rejection, engulfment, acceptance and enrichment. Associations between IID and psychological and physiological functioning have been shown in other chronic diseases, but haven’t been investigated in IBD. In this study, we focus on associations between IID and (i) psychosomatic well-being and (ii) response to biological therapy in patients with IBD. Methods Eighty-four patients with active IBD answered questionnaires assessing IID, anxiety, depression, childhood trauma, quality of life (QOL), fatigue and visceral sensitivity (VS.) before the beginning of treatment with biologicals. Response to therapy (n = 73) and changes in the reported outcomes (n = 46) were assessed 3–6 months later. Associations between IID types and QOL, anxiety, depression, childhood trauma, fatigue and VS were examined using Pearson′s correlation. Response to therapy was defined as i) reduction of Harvey Bradshaw-Index (HBI) of >/ = 3 points/Partial Mayo-Score (PMS) of 0–1 points (if HBI >5/PMS >1 at baseline) OR ii) decline of faecal calprotectin or CRP of at least 50% OR iii) confirmation of a significant decline of inflammation in endoscopy/ sonography/MRI. Logistic regression was conducted to examine associations between IID and response to therapy. Results IID-rejection was positively associated with anxiety (r = 0.23, p < 0.05), depression (r = 0.28, p < 0.01) and VS. (r = 0.43, p < 0.01). IID-engulfment was associated with lower QOL (r = -0.61, p < 0.01) and more fatigue (r = 0.45, p < 0.01), anxiety (r = 0.66, p < 0.01), depression (r = 0.63, p < 0.01) and VS. (r = 0.74 p < 0.01). In contrast, IID-acceptance was associated with higher QOL (r = 0.34, p < 0.01) and lower levels of fatigue (r = -0.34, p < 0.01), anxiety (r = -0.45, p < 0.01), depression (r = -0.33, p < 0.01), childhood trauma (r = -0.31, p < 0.01) and VS. (r = -0.52, p < 0.01). IID-enrichment was negatively associated with depression (r = -0.3, p < 0.01). Logistic regression indicated no association between IID and response to therapy. Conclusion This study is the first to examine the concept of IID in IBD patients. It supports previous findings regarding its association to QOL and psychological well-being in patients with chronic disorders. Contrary to our expectation, IID was not shown to influence treatment response in this cohort, which might be owed to the modest sample size. However, given the strong association between IID and QOL, future studies should investigate the potential of IID as a targetable characteristic in personalised holistic therapy.

A mindfulness-based stress reduction program combined with music therapy is one of the interventions designed to help patients cope with stress and depression. The aim of this study was to examine the effects of an online mindfulness-based stress reduction program combined with music therapy on stress, depression, and psychological well-being in adult patients with cancer. This study was a single-blinded, prospective, randomized-controlled experimental design. One hundred twenty cancer patients were recruited (60 each in the intervention and control groups). Patients in the intervention group received a 10-day mindfulness-based stress reduction program combined with music therapy. Stress was measured with the State Trait Anxiety Inventory-State, psychological well-being was measured with the Psychological Well-being Scale, and depression was measured with the Beck Depression Inventory at baseline and the end of the study. The intervention group showed significantly lower stress and depression scores than the control group in the total scores at 10 days ( P < .05). The intervention group had significantly higher scores in the psychological well-being ( P < .001) than the control group at 10 days. Intragroup comparison of the stress and depression scores showed that posttest score of the intervention group was significantly lower than its pretest score ( P < .05). Mindfulness-based stress reduction program combined with music therapy reduced the levels of stress and depressive symptoms and improved psychological well-being in cancer patients. A nurse-led mindfulness-based stress reduction program combined with music therapy is an innovative and effective psychological intervention that may be integrated with regular patient care for adults receiving treatment of cancer.

BackgroundBoth motor and non-motor symptoms could contribute to significant deterioration of psychological well-being in patients with Parkinson's disease (PD). However, its assessment has been only indirectly evaluated using tools based on health-related quality of life (HRQoL), such as the PDQ-39 scale.ObjectivesTo evaluate psychological well-being in PD using a specific tool of assessment, the Psychological Well-being Scale (PWS), and its clinical correlates.MethodsThis article reports data of patients’ perception of health state, as measured by means of the PWS, from an epidemiological, cross-sectional study conducted in Italian PD patients (FORTE Study). We tested possible relationship between well-being and clinical characteristics including fatigue, depression, sleep disruption and HRQoL.Results272 patients completed the PWS questionnaire. Significant and clinically-relevant correlations were found between PWS total score and Parkinson’s Fatigue Scale, Beck Depression Inventory, UPDRS Section I, PD Sleep Scale and PDQ-39 for HRQoL scores. Only clinically negligible correlations were found between PWS and motor scores.ConclusionsNon-motor symptoms have a significant impact on psychological well-being in PD patients.

Background: This study aimed to investigate the effectiveness of Acceptance and Commitment Therapy (ACT) on psychological capital and psychological well-being of patients with thalassemia. Methods: This study was a quasi-experimental trial with a pretest-posttest design along with a control group. The statistical population included all patients with thalassemia referred to the office of the Thalassemia Association located in Mohammad Kermanshahi Hospital in Kermanshah. Thirty patients were selected as the sample by targeted sampling method and then randomly assigned to experimental and control groups equally (each n=15). The instruments included Ryff psychological well-being questionnaire and Luthan’s Psychological Capital Questionnaire. After performing the pretest, the experimental group underwent an ACT intervention, while the control group received no treatment. Data were analyzed using SPSS software version 21 according to analysis of covariance (ANCOVA). Results: There was a significant difference between the mean of psychological well-being and psychological capital variables in both experimental and control groups (P=0.014 & P=0.005, respectively). By eliminating the effect of pre-test psychological capital scores as a covariate variable, the main effect of the independent variable on post-test psychological capital scores was significant (F=53.601, P=0.001, Partial η2=0.665). By eliminating the effect of pre-test psychological capital scores as a covariate variable, the main effect of the independent variable on post-test psychological well-being scores was significant (F=181.34, P=0.001, Partial η2=0.87). Conclusion: ACT was effective on the psychological capital and the psychological well-being of thalassemia patients. Moreover, ACT can be used to improve the psychological capital and psychological well-being of patients with thalassemia.

Objectives: To determine whether thyroxine treatment is effective in patients with symptoms of hypothyroidism but with thyroid function tests within the reference range, and to investigate the effect of thyroxine...

Morbid obesity is rising around the world. It can cause unpleasant appearance and body image. Most of the studies have aimed to evaluate the psychopathology of overweight and obesity and paying attention to mental well-being in morbid obese individuals is rare. Therefore, this study aimed to assess the relationship between body image and psychological well-being in morbid obese patients. This cross-sectional study, using simple random sampling method, was done on 124 morbid obese patients who referred to obesity clinic in Shiraz from 2016 to 2017. The data were collected by body image index and psychological well-being questionnaire. Results were analyzed using descriptive statistics, Pearson correlation coefficient test, ANOVA, and Regression analysis. The results showed a significant relationship between body image and psychological well-being (r=0.43) (P<0.001), and between the total score of the body image and all the subscales of psychological well-being except autonomy and purpose in life (P<0.05). There was also a significant relationship between the total score of psychological well-being and all the subscales of body image (P<0.05). However, there was no significant difference between the mean scores of the body image and those of psychological well-being in different categories of body mass index (BMI) (P>0.05). Final results indicated that body image defects caused by obesity could lie in negative psychological well-being in all aspects. This study can promote health clinicians' knowledge in supporting of mental status of obese individuals. It is suggested that preventing and supporting intervention should be performed as effective methods for encountering and coping with psychological effects of obesity.

BackgroundRheumatoid arthritis (RA) is a chronic inflammatory disease that causes joint pain, swelling and stiffness with eventual structural damage leading to physical dysfunction. Consequently, people with RA tend to experience...

Inflammatory bowel disease is associated with poor quality of life. The aim of the cross-sectional study was to extend the common sense model to explore the impact of inflammatory bowel disease activity on quality of life and the potential mediating roles of illness perceptions, visceral sensitivity, coping styles, acceptance, and psychological distress. A total of 141 inflammatory bowel disease patients (86 with Crohn's disease and 55 with ulcerative colitis; 74 males, 65 females, and 2 gender non-specific, mean age 40.43 years) from 2 metropolitan hospital inflammatory bowel disease outpatient clinics participated. Measures included disease activity (Crohn's Disease Activity Index, Simple Clinical Colitis Activity Index), illness perceptions (Brief Illness Perceptions Questionnaire), visceral sensitivity (Visceral Sensitivity Index), coping styles (Brief Coping Operations Preference Enquiry), acceptance (Acceptance and Action Questionnaire-II), psychological distress (Depression, Anxiety, and Stress Scale), and European Health Interview Survey-Quality of Life (EUROHIS-QoL). A structural equation model of the extended common sense model was found to have a good fit (χ2(10) = 10.07, P = .43, root mean square error of approximation = 0.01, standardized root mean residual = 0.04, comparative index fit = 1.00, Tucker-Lewis index = 1.00, goodness-of-fit = 0.98). After controlling for irritable bowel syndrome diagnosis, the impact of disease activity on quality of life was statistically mediated by illness perceptions, maladaptive coping styles, and psychological distress. In addition, visceral sensitivity bordered on influencing the impact of disease activity and illness perceptions on quality of life through psychological distress. This study demonstrates that together with illness perceptions and coping styles, visceral sensitivity plays an important role in an individual's adaption to living with inflammatory bowel disease.

The aim of this study is to examine the relationship between self-stigma of seeking psychological help and psychological well-being and criminal involvement history in patients diagnosed with bipolar disorder (BD). This cross-sectional study was conducted at Elaziğ Fethi Sekin City Hospital with patients diagnosed with BD type 1 (BD-I) who agreed to participate in the study. Group 1 includes patients with and group 2 includes patients without a history of involvement in crime. Along with sociodemographic and clinical data, Self-Stigma of Seeking Psychological Help Scale (SSPHS), Psychological Well-Being Scale (PWBS), Young Mania Rating Scale (YMRS), and Beck Depression Inventory (BDI) were administered to all patients. While PWBS (p=0.021) score was lower in group 1 than in group 2, SSPHS (p=0.005) and BDI (p=0.015) scores were higher. There were 41 crimes belonging to 37 patients. Of these crimes (n=41), 12 were wounding, 8 were intentional killing, 7 were threatening, 5 were damaging public property, 3 were theft, 3 were insulting, 2 were sexual harassment, and 1 was intentional killing of a child. In total (n=71), a significant correlation was found between the total number of psychiatric hospitalizations and SSPHS (r=0.503; p&lt;0.001) and PWBS (r=-0.520; p&lt;0.001) scores; also a significant correlation between SSPHS and PWBS (r=-0.443; p&lt;0.001). This study reveals that a history of criminal involvement is associated with increased self-stigma in seeking psychological help and decreased psychological well-being in BD-I. The low rate of medication use by patients during criminal behavior may emphasize the importance of compliance with medical treatment.