Background In chronic diseases like inflammatory bowel disease (IBD), self-efficacy is one of important health outcomes. The IBD-Self-Efficacy Scale (IBD-SES) is an outcome measure used in research settings. In this study, we aimed to develop a Japanese version of IBD-SES and investigate the self-efficacy of IBD patients in Japan. Methods We conducted a questionnaire survey with IBD patients from two different sources: outpatients of a specialized IBD clinic and respondents recruited online. The original 29-item IBD-SES, with scores from 1 (not at all) to 10 (totally) in each item, and higher scores indicating greater self-management efficacy, was translated into Japanese with permission of the original author and was used for the surveys after confirming its linguistic equivalence with the original version. The reliability of the scale was assessed by calculating the Cronbach’s alpha coefficient for internal consistency, and the validity was assessed by disease activity (remission vs. active period) for known-group validity. Items of IBD-SES score comparison between the outpatient clinic group and online group were performed by t-test. Results A total of 919 valid responses were obtained, 482 patients (ulcerative colitis (UC): 184, Crohn’s disease (CD): 298) from the specialized IBD clinic and 437 (UC: 255, CD: 182) online. The mean score per item for each subscale [Stress & Emotion Management], [Outpatient care & medication management], [Symptom & disease management] and [Maintenance of remission] was 4.7, 7.3, 4.9, and 4.9, respectively. Internal consistency was confirmed on each subscale (Cronbach’s α: 0.85–0.94). Comparing remission and active periods, significant differences were observed in three subscales: [Stress & Emotion Management (p < 0.001)], [Symptom & disease management (p < 0.001)] and [Maintenance of remission (p < 0.001)], and the known group validity was mostly confirmed. Conclusion This study demonstrates the reliability and validity of the Japanese version of the IBD-SES and reveals the current status of self-efficacy of the self-management of IBD patients in Japan. Compared to previous studies using IBD-SES in the USA or Canada, scores observed with Japanese IBD patients are lower. It might reflect a cultural difference.

Background Self-efficacy is an important health outcome for patients with inflammatory bowel disease (IBD). We aimed to develop a Japanese version of the IBD-Self-Efficacy Scale (IBD-SES.J) and compare characteristics of self-efficacy of IBD patients with previously reported results from patients in the United States. Methods We conducted a questionnaire survey of patients with IBD from a specialized IBD clinic and respondents recruited online. Self-efficacy of patients in Japan and the United States were compared by Student t test and Cohen d coefficient to gauge effect size. Results A total of 919 valid responses were obtained: 482 patients from the specialized IBD clinic and 437 patients from the online survey. Significant differences (P < .01) were observed in the following 3 subscales: “managing stress and emotions,” “managing symptoms and disease,” and “maintaining remission” when comparing remission and active periods; and known-group validity was mostly confirmed. Cronbach’s alpha coefficients of each subscale ranged between 0.85 and 0.94. Intraclass correlation coefficients (95% confidence intervals [CIs]) to assess test-retest reliability of each item were between 0.56 (95% CI, 0.47-0.64) and 0.78 (95% CI, 0.73-0.82). Self-efficacy scores for most items in Japanese patients with IBD were lower compared with patients in the United States, with moderate effect size (Cohen d > 0.5), especially in the subscale “managing stress and emotions.” Conclusions The study demonstrates the reliability and validity of the IBD-SESJ. Self-efficacy scores for most items in Japanese patients were lower than those of patients in the United States. Further investigation is required to understand cross-cultural score differences.

The difficulty of life scale (DLS) instrument is used to measure specific life problems in patients with ulcerative colitis (UC). Importantly, health care providers should consider the characteristics of the country in which they support patients with UC. This cross-cultural comparison study investigated DLS among patients with UC in Japan and the United Kingdom (UK). Outpatients attending one hospital in London and one in Osaka were included. We collected patient information using the DLS questionnaire, which comprises 18 items in three domains. Mean differences between Japan and the UK were compared for the total score and each domain of the DLS. Variables with P < .05 in univariate analysis were entered into a multiple regression model. We included 142 patients from Japan and 100 patients from the UK in the analysis. Univariate results showed that UK patients had more difficulties than Japanese patients in all three domains. Multivariate results showed that only “decline of vitality or vigor” showed significantly lower difficulty scores in Japanese patients. Having four or more bowel movements per day, visible bleeding, and being a homemaker or unemployed were significantly associated with greater difficulty according to the DLS total score. The level of daily life difficulties assessed using the DLS was greater among patients in the UK than among Japanese patients. This comparative study between patients with UC in Japan and the UK demonstrated certain country-related features for domain 3, “decline of vitality or vigor,” of the DLS. The reasons why UK patients felt greater decline in vitality or vigor may be that these patients may have symptoms other than bowel symptoms; also, Japanese patients are more hesitant to express discomfort. The findings of this study might lead to a better understanding of culturally sensitive perceptions of daily life difficulties in UC.

Background The IBD-Self-Efficacy Scale (IBD-SES) is an outcome measurement scale used in various countries, with psychometric properties that predicted psychological distress and showed moderate correlation with QOL. Although the 29-item IBD-SES is useful, a shorter instrument would increase the likelihood of usage. In this study, we aimed to develop a substantially shorter, but still as valid version of IBD-SES. Methods A total of 919 patients, 482 from a specialized IBD clinic (UC: 184, CD: 298) and 437 online (UC: 255, CD: 182), were used for psychometric assessment. The original 29-item IBD-SES was reduced using three major analytic steps (assessed ceiling or floor effect, correlation between items, test-retest reliability). The shorter version was evaluated on construct validity by confirmatory factor analysis, criterion validity by Pearson’s correlation coefficients with original version, and internal consistency by Cronbach’s alpha coefficient. Results In the item reduction process, the following items were removed: 2 items due to a ceiling effect, 12 additional items due to high correlation, 2 more items due to a low intraclass correlation coefficient (ICC). The short version was confirmed to consist of the same 4 subscales as the original version, [Managing Stress and Emotions], [Managing Medical Care], [Managing Symptoms and Disease] and [Maintaining Remission] and was validated by confirmatory factor analysis. The fit indices were as follows: Normed χ2 = 7.18 (p &lt; 0.001), comparative fit index (CFI) = 0.94, goodness-of-fit index (GFI) = 0.93, adjusted goodness-of-fit index (AGFI) =0.89, parsimony goodness-of-fit index (PGFI) = 0.60, and the root mean square error of approximation (RMSEA) = 0.084. Correlation with the original IBD-SES in each subscale was high (0.97–0.98). Cronbach’s alpha for each subscale ranged from 0.68 to 0.86. Conclusion The study showed that the revised scale has improved psychometric properties and demonstrated the reliability and validity of the IBD-SES13. The revised scale could provide clinical usefulness with the possibility of higher response rates.

I nflammatory bowel disease (IBD) includes ulcerative colitis (UC) and Crohn disease (CD). IBD is mainly characterized by abdominal symptoms such as bloody stools, abdominal pain, fever, and fatigue. Patients experience these symptoms for a long Content of Telephone Consultations of Patients With Inflammatory Bowel Disease