Background
The main objective in the management of chronic diseases is to maintain and improve the quality of life. In this sense, the involvement of the patient in their self-care should be a priority for nursing, but we know that the results are not always the desired ones. Self-care education and training should focus on social and emotional aspects, identified as predictors of the deterioration of the quality of life. Studies have identified psychosocial profiles (Controlled, Reinforced, Weak, Fragile) of patients with inflammatory bowel diseases (IBD) based on their level of social support and emotional coping. These profiles could predict the effectiveness of these educational workshops. This study aims to compare the effectiveness of a self-management workshop in different patient profiles to identify what type of patient might benefit and which don’t.
Methods
Non-randomised clinical trial. 61 outpatients were included. Inclusion criteria: Have IBD, be over 18 years old and sign the informed consent. They were included in a self-management training programme to learn about the disease and coping. There were 4 sessions in a month. They completed a questionnaire before the workshop, at the end of the workshop, at 3 months and at 6 months. The variables were sociodemographic, clinical, quality of life, coping, perceived stress, social support and anxiety-depression.
Results
The characteristics of the sample are shown in Table 1. The four psychosocial profiles described in the literature were identified and the effectiveness of the workshop in each one was analysed. The intrasubject linear analysis showed a linear type increase in the quality of life of patients with Reinforced and Weakening profile, between baseline and third month (−3.81, p = 0.036, CI: (− 7.45; −0.17) and − 6.21, p = 0.004, CI: (− 11.08; −1.35) respectively). The observed power was 91.5% and 93.8% for each case. However, no significant differences were found in patients with Controlled profile and Fragiles. The results found were not associated with other variables of the study.
Conclusion
Identifying psychosocial profiles allows us to succeed with the type of education we offer to patients. We must customise the information and resources. In the case of patients with a great lack of family support, one would first have to intervene with the family and then offer emotional education and not vice versa.
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