Associations between disease activity, social support and health-related quality of life in patients with inflammatory bowel diseases: the mediating role of psychological symptoms

Abstract

Background: Previous studies have indicated that disease activity, psychological symptoms and social support were associated with health-related quality of life (HRQoL) in patients with inflammatory bowel diseases(IBD). However, it is unclear how disease activity, psychological symptoms and social support interact to affect HRQoL. The main purpose of this study was to examine the mediation effect of psychological symptoms in the relationship between disease activity, social support and HRQoL. Methods: This was a cross-sectional study, which collected data using convenience sampling, between December 2016 and March 2018, from the Third XiangyaHospital of Central South University in Changsha, China. An online self-administered questionnaire (including demographic and clinical information), Inflammatory Bowel Disease Questionnaire, Disease Activity Indices scale, Hospital Anxiety and Depression Scale and Social Support Rating Scale, were administered to each participant. Descriptive statistics and Pearson's correlations were used to summarize data, whereas PROCESS analysis was performed to examine the pre-specified mediation effect. Results: A total of 199 patients with IBD were included. Disease activity indices (DAI) and hospital anxiety and depression (HAD) were negatively correlated with HRQoL (β = − 3.37, − 2.54 respectively, P < 0.001), while social support was positively correlated with HRQoL (β = 1.38, P < 0.01). HAD partially mediated the negative relationship between DAI and HRQoL (β = − 0.83, P < 0.001) with the mediation effect ratio of 24.6%, and completely mediated the positive relationship between social support and HRQoL (β = 1.20, P < 0.001). Conclusions: Psychological symptoms acted as a mediator in the relationship between disease activity, social support and HRQoL. Interventions to improve HRQoL in patients with IBD should take into account the mediation effect of psychological symptoms.

Disability and quality of life before and during the COVID-19 outbreak: A cross-sectional study in inflammatory bowel disease patients

“…[38] These are affected by the capacity for coping efficacy, acceptance of illness, and perceived social support. [38][39][40] Other limitations include the small sample size of the study but given that it was implemented just before the onset of the pandemic, we could not recruit a larger number of participants. Also, the time when the questionnaire was administered might have not been long enough to provoke any emotions of stress.…”

The Reality of Patient-Reported Outcomes of Health-Related Quality of Life in an Italian Cohort of Patients with Inflammatory Bowel Disease: Results from a Cross-Sectional Study

“…The great value of patient-reported outcomes is that they include information regarding HRQoL, symptoms, satisfaction with care, adherence to medications, and perceived value of treatment, which have consequences for the patient's overall picture [42]. The perception of disease has been recognized as a predictive factor of dimensions such as HRQoL, self-management of the disease, and adherence to medical therapy [10]. Epidemiological evaluations also suggest disconnections between what is relevant for the gastroenterologist (e.g., frequency of evacuations, bleeding, cessation of smoking, adequate treatment) and what is important for the patient (e.g., chronic fatigue, dyspepsia, emotional state, stress, and work disability), underlining how the patient's perception of the disease is closely linked to their quality of life [43].…”

“…This means that mental and social well-being should be achieved beyond the absence of disease or physical infirmity and clinicians should take care of the patients' global health, including the assessment of the psychological, social, and emotional spheres during routine visits [9]. Several studies have shown that IBD patients are more likely to suffer from depression and anxiety [10]. Although the exact relationship remains unclear, bi-directional processes have been suggested, as the experience of the disease is stressful enough to trigger or intensify an underlying psychiatric condition; conversely, anxiety or depression may themselves worsen HRQoL [11].…”

Umiestnenie kontroly vo vzťahu ku zdraviu, adherencia k liečbe a sociálna opora pri rekonvalescencii pacientov po prekonaní cievnej mozgovej príhody

“…Sociálna opora sa ukazuje ako dôležitý faktor pri rekonvalescencii. Výsledky výskumov túto súvislosť preukazujú v oblasti respiračných ochorení (Chen et al, 2017;Lenferink, Palen & Effing, 2018), onkologických ochorení (Usta, 2012;Gordner et al, 1996) gastroenterologických ochorení (Fu et al, 2020) ale aj kardiovaskulárnych ochorení (Glass et al 1999;Tsouna-Hadjis et al, 2000;Bucholz, 2014;Blessing & Oluwagbemiga, 2017) Cieľom prehľadovej štúdie poskytnúť vhľad do vybraných premenných a ich súvislosti na základe realizovaných empirických zistení, akú úlohu zohráva umiestnenie kontroly, adherencia k liečbe a sociálna opora pri rekonvalescencii pacientov po prekonaní cievnej mozgovej príhody.…”