[Assessing complex health problems of patients with IBD--first step to patient activation]

Z Gastroenterol. 2013 Mar;51(3):257-70. doi: 10.1055/s-0032-1325354. Epub 2013 Mar 13.
[Article in German]

Abstract

Background: Health care for inflammatory bowel diseases (IBD), to be comprehensive, takes a broad range of patients' somatic and psychosocial problems into account. Patients should be actively involved in health-care planning and organisation.

Methods: 431 adult patients with Crohn's disease (50 %) or ulcerative colitis participated in a postal questionnaire survey; 6 months apart it twice assessed the patients' individual problem profiles. The results of the assessment were back-reported to each patient combined with targeted (though standardised) recommendations for future care. This publication is the first of a series. It presents the basic study design, describes the prevalence of 16 psychosocial problem domains and analyses their association with socio-demographic and disease variables.

Results: Participants had a mean age of 46 years; 61 % were female; 57 % in remission (GIBDI ≤ 3). The most prevalent problems reported addressed sexual impairments (27 %), high stress (26 %) and depression (21 %). 27 % of the respondents did not report any psychosocial problem. One in five (21 %) described highly complex problem profiles (≥ 5 "active" problems) combined with a mean of 28 disability days within the past 3 months. Complex psychosocial profiles were associated with active disease, Crohn's disease and low educational level.

Conclusions: IBD patients show a highly variable spectrum of psychosocial problems. Their number is closely associated with disease activity and a social status variable (school education). The gradient could complicate efforts to increase patient participation in care and to enhance self-management.

Publication types

  • English Abstract

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Comorbidity
  • Depression / epidemiology
  • Depression / psychology*
  • Educational Status
  • Female
  • Germany / epidemiology
  • Humans
  • Inflammatory Bowel Diseases / epidemiology
  • Inflammatory Bowel Diseases / psychology*
  • Male
  • Middle Aged
  • Prevalence
  • Psychology
  • Risk Assessment
  • Sexual Dysfunctions, Psychological / epidemiology
  • Sexual Dysfunctions, Psychological / psychology*
  • Stress, Psychological / epidemiology
  • Stress, Psychological / psychology*
  • Surveys and Questionnaires
  • Young Adult