Maladaptive coping, low self-efficacy and disease activity are associated with poorer patient-reported outcomes in inflammatory bowel disease

Che Yung Chao, Carolyne Lemieux, Sophie Restellini, Waqqas Afif, Alain Bitton, P. Lakatos, Gary Wild, Talat Bessissow

Research output: Contribution to journalArticle

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Abstract

Background/Aims: Patient-reported outcomes (PRO) are key aspects in the management of inflammatory bowel disease (IBD). This study aims to evaluate factors associated with adverse PRO, including modifiable social constructs of maladaptive coping and self-efficacy as well as physician-patient concordance on PRO. Patients and Methods: This cross-sectional study was performed in patients with Crohn's disease (CD) or ulcerative colitis (UC) from September 2015 to March 2016. Validated questionnaires were used to assess quality of life (Short IBD Questionnaire), disability (IBD disability index), productivity (work productivity and activity impairment questionnaire), anxiety/depression (Hospital Anxiety and Depression Scale), coping strategies [Brief Coping Operations Preference Enquiry (Brief COPE)], and self-efficacy (General Self-Efficacy Scale). Independent physician assessment was used to compare concordance with patients. Results: In all, 207 (CD: 144 and UC: 63) patients, with median age of 39 years, were included, with 42.5% males. Significant proportion of patients reported moderate/severe impairment of disability (30.5%), quality of life (29.4%), productivity (52.4%), anxiety (32.9%) and depression (23.3%). Disease activity and maladaptive coping were independently associated with unfavourable PRO, whereas self-efficacy had a positive effect in multivariate analysis. Physicians could accurately identify the magnitude of PRO impairment in standard clinical settings (r = 0.59-0.65, P < 0.001). Conclusion: Disease activity and modifiable psychological constructs are associated with unfavorable PRO in patients with IBD. These factors could assist with identifying high-risk patients, many of whom may benefit from targeted interventions to improve health outcomes.

Original languageEnglish
Pages (from-to)159-166
Number of pages8
JournalSaudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association
Volume25
Issue number3
DOIs
Publication statusPublished - May 1 2019

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Self Efficacy
Inflammatory Bowel Diseases
Physicians
Ulcerative Colitis
Crohn Disease
Anxiety
Quality of Life
Depression
Patient Reported Outcome Measures
Multivariate Analysis
Cross-Sectional Studies
Psychology
Health
Surveys and Questionnaires

Keywords

  • Biopsychosocial
  • inflammatory bowel disease
  • patient-reported outcomes
  • physician–patient concordance

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Maladaptive coping, low self-efficacy and disease activity are associated with poorer patient-reported outcomes in inflammatory bowel disease. / Chao, Che Yung; Lemieux, Carolyne; Restellini, Sophie; Afif, Waqqas; Bitton, Alain; Lakatos, P.; Wild, Gary; Bessissow, Talat.

In: Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association, Vol. 25, No. 3, 01.05.2019, p. 159-166.

Research output: Contribution to journalArticle

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AU - Chao, Che Yung

AU - Lemieux, Carolyne

AU - Restellini, Sophie

AU - Afif, Waqqas

AU - Bitton, Alain

AU - Lakatos, P.

AU - Wild, Gary

AU - Bessissow, Talat

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AB - Background/Aims: Patient-reported outcomes (PRO) are key aspects in the management of inflammatory bowel disease (IBD). This study aims to evaluate factors associated with adverse PRO, including modifiable social constructs of maladaptive coping and self-efficacy as well as physician-patient concordance on PRO. Patients and Methods: This cross-sectional study was performed in patients with Crohn's disease (CD) or ulcerative colitis (UC) from September 2015 to March 2016. Validated questionnaires were used to assess quality of life (Short IBD Questionnaire), disability (IBD disability index), productivity (work productivity and activity impairment questionnaire), anxiety/depression (Hospital Anxiety and Depression Scale), coping strategies [Brief Coping Operations Preference Enquiry (Brief COPE)], and self-efficacy (General Self-Efficacy Scale). Independent physician assessment was used to compare concordance with patients. Results: In all, 207 (CD: 144 and UC: 63) patients, with median age of 39 years, were included, with 42.5% males. Significant proportion of patients reported moderate/severe impairment of disability (30.5%), quality of life (29.4%), productivity (52.4%), anxiety (32.9%) and depression (23.3%). Disease activity and maladaptive coping were independently associated with unfavourable PRO, whereas self-efficacy had a positive effect in multivariate analysis. Physicians could accurately identify the magnitude of PRO impairment in standard clinical settings (r = 0.59-0.65, P < 0.001). Conclusion: Disease activity and modifiable psychological constructs are associated with unfavorable PRO in patients with IBD. These factors could assist with identifying high-risk patients, many of whom may benefit from targeted interventions to improve health outcomes.

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