Quality of life for patients with exacerbation in inflammatory bowel disease and how they cope with disease activity

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doi:10.1016/j.jpsychores.2007.10.007 Copyright © 2008 Elsevier Inc. All rights reserved.

Original article

Quality of life for patients with exacerbation in inflammatory bowel disease and how they cope with disease activity

Kjerstin Larssona, , , Lars Lööfb, Anders Rönnblomc and Karin Nordina aDepartment of Public Health and Caring Sciences, Uppsala University, Uppsala Science Park, Uppsala, SwedenbCenter for Clinical Research, Central Hospital Västerås, Västerås, SwedencDepartment of Medical Sciences, Uppsala University Hospital, Uppsala, Sweden Received 19 June 2007; revised 10 September 2007; accepted 4 October 2007. Available online 24 January 2008.

Abstract

Objective

Health-related quality of life (HRQoL) for patients with ulcerative colitis (UC) or Crohn's disease (CD) is influenced by symptoms and treatments. Periods with increased disease activity are specifically trying, but the knowledge of how patients manage this is sparse. The aim of this cross-sectional study was to examine (1) HRQoL for patients with UC or CD, (2) how patients cope with increased disease activity, and (3) if coping is associated with HRQoL. Methods

A postal questionnaire was sent to patients with UC and CD who attended the gastroenterology and surgery department at a Swedish university hospital. Coping, HRQoL, and emotional well-being were assessed by Jalowiec Coping Scale, Short Form-36 Health survey, Short Health Scale, and the Hospital Anxiety and Depression Scale. Results

Patients with increased disease activity reported impaired HRQoL and emotional distress. This was more prevalent among patients with CD, as compared to patients with UC. Optimistic, self-reliant and confrontive coping strategies were most frequently used to manage stressors, with no differences found between patients in exacerbation or remission or between patients with UC or CD. Conclusion

Impaired HRQoL and emotional distress is prevalent among patients with exacerbation in UC and CD. Thus, a complete evaluation of psychosocial status and management of psychosocial distress should be included in the clinical treatment of the patient. Patients use a variety of coping strategies in an effort to manage increased disease activity. However, these results did not support any associations between coping and HRQoL.

Keywords: Coping; Crohn's disease; Exacerbation; Inflammatory bowel disease; Ulcerative colitis

The investigation was supported by grants from the Medical and Pharmaceutical Faculty at Uppsala University.Corresponding author. Department of Public Health and Caring Sciences, Caring Sciences, Uppsala University, Uppsala Science Park, S-751 83 Uppsala, Sweden.

Journal of Psychosomatic Research Volume 64, Issue 2, February 2008, Pages 139-148