Skip to main content
Top
Published in: Journal of Gastroenterology 11/2009

01-11-2009 | Original Article—Alimentary Tract

Coping strategy when patients with quiescent Crohn’s disease recognize that their conditions are worsening

Authors: Makoto Tanaka, Yasushi Iwao, Susumu Okamoto, Haruhiko Ogata, Toshifumi Hibi, Keiko Kazuma

Published in: Journal of Gastroenterology | Issue 11/2009

Login to get access

Abstract

Background

Although self-management is important for Crohn’s disease (CD), there is no research focusing on self-management, especially in worsening conditions. The purpose of this study was to investigate how quiescent CD patients cope with their conditions worsening.

Methods

A questionnaire containing six types of coping strategy for worsening conditions was created based on a semi-structured interview. Seventy-six quiescent CD patients participated in this study. We also analyzed the related factors of each coping strategy for worsening conditions.

Results

The total percentage of subjects who adopt the strategy of “change contents of meals” ‘always’ or ‘often’ was approximately 70%. On the other hand, the strategy of “see a doctor immediately” was approximately 20% in total of ‘always’ or ‘often’. When ‘sometimes’ was added, “take extra medicine” was approximately 42%. The subjects with experience of hospitalization within 3 years (Z = −2.352, P = 0.019), presence of supplemental elemental diet (Z = −5.182, P < 0.001), or 1 year or less interval since last relapse (Z = −3.352, P = 0.001) showed a significant tendency to adopt the coping strategy of “take (add to) elemental diet.”

Conclusion

The major coping strategy was “change contents of meals,” and the minor coping strategy was “see a doctor immediately.” The subjects with unstable disease state adopted the coping strategy of “take (add to) elemental diet.” The coping strategies for worsening conditions vary according to patients’ backgrounds. The coping type should be taken into account when treating CD patients.
Literature
1.
go back to reference Mitchell A, Guyatt G, Singer J, Irvine EJ, Goodacre R, Tompkins C, et al. Quality of life in patients with inflammatory bowel disease. J Clin Gastroenterol. 1988;10:306–10.CrossRefPubMed Mitchell A, Guyatt G, Singer J, Irvine EJ, Goodacre R, Tompkins C, et al. Quality of life in patients with inflammatory bowel disease. J Clin Gastroenterol. 1988;10:306–10.CrossRefPubMed
2.
go back to reference Drossman DA, Patrick DL, Mitchell CM, Zagami EA, Appelbaum MI. Health-related quality of life in inflammatory bowel disease. Functional status and patient worries and concerns. Dig Dis Sci. 1989;34:1379–86.CrossRefPubMed Drossman DA, Patrick DL, Mitchell CM, Zagami EA, Appelbaum MI. Health-related quality of life in inflammatory bowel disease. Functional status and patient worries and concerns. Dig Dis Sci. 1989;34:1379–86.CrossRefPubMed
3.
4.
go back to reference Levenstein S, Li Z, Almer S, Barbosa A, Marquis P, Moser G, et al. Cross-cultural variation in disease-related concerns among patients with inflammatory bowel disease. Am J Gastroenterol. 2001;96:1822–30.CrossRefPubMed Levenstein S, Li Z, Almer S, Barbosa A, Marquis P, Moser G, et al. Cross-cultural variation in disease-related concerns among patients with inflammatory bowel disease. Am J Gastroenterol. 2001;96:1822–30.CrossRefPubMed
5.
go back to reference Mussell M, Bocker U, Nagel N, Singer MV. Predictors of disease-related concerns and other aspects of health-related quality of life in outpatients with inflammatory bowel disease. Eur J Gastroenterol Hepatol. 2004;16:1273–80.CrossRefPubMed Mussell M, Bocker U, Nagel N, Singer MV. Predictors of disease-related concerns and other aspects of health-related quality of life in outpatients with inflammatory bowel disease. Eur J Gastroenterol Hepatol. 2004;16:1273–80.CrossRefPubMed
6.
go back to reference Irvine EJ. Review article: patients’ fears and unmet needs in inflammatory bowel disease. Aliment Pharmacol Ther. 2004;20(Suppl 4):54–9.CrossRefPubMed Irvine EJ. Review article: patients’ fears and unmet needs in inflammatory bowel disease. Aliment Pharmacol Ther. 2004;20(Suppl 4):54–9.CrossRefPubMed
7.
go back to reference Kennedy AP, Rogers AE. Improving patient involvement in chronic disease management: the views of patients, GPs and specialists on a guidebook for ulcerative colitis. Patient Educ Couns. 2002;47:257–63.CrossRefPubMed Kennedy AP, Rogers AE. Improving patient involvement in chronic disease management: the views of patients, GPs and specialists on a guidebook for ulcerative colitis. Patient Educ Couns. 2002;47:257–63.CrossRefPubMed
8.
go back to reference Hashimoto H, Iwao Y, Hibi T, Ueno F, Miyahara T, Sugita A, et al. A model of quality of life in the patients with Crohn’s disease (in Japanese with English abstract). Nippon Shokakibyo Gakkai Zasshi (JJSG). 1999;96:1258–65. Hashimoto H, Iwao Y, Hibi T, Ueno F, Miyahara T, Sugita A, et al. A model of quality of life in the patients with Crohn’s disease (in Japanese with English abstract). Nippon Shokakibyo Gakkai Zasshi (JJSG). 1999;96:1258–65.
9.
go back to reference Best WR, Becktel JM, Singleton JW, Kern F Jr. Development of a Crohn’s disease activity index. National Cooperative Crohn’s Disease Study. Gastroenterology. 1976;70:439–44.PubMed Best WR, Becktel JM, Singleton JW, Kern F Jr. Development of a Crohn’s disease activity index. National Cooperative Crohn’s Disease Study. Gastroenterology. 1976;70:439–44.PubMed
10.
go back to reference Shoda R, Matsueda K, Yamato S, Umeda N. Epidemiologic analysis of Crohn disease in Japan: increased dietary intake of n-6 polyunsaturated fatty acids and animal protein relates to the increased incidence of Crohn disease in Japan. Am J Clin Nutr. 1996;63:741–5.PubMed Shoda R, Matsueda K, Yamato S, Umeda N. Epidemiologic analysis of Crohn disease in Japan: increased dietary intake of n-6 polyunsaturated fatty acids and animal protein relates to the increased incidence of Crohn disease in Japan. Am J Clin Nutr. 1996;63:741–5.PubMed
11.
go back to reference Zachos M, Tondeur M, Griffiths AM. Enteral nutritional therapy for induction of remission in Crohn’s disease. Cochrane Database Syst Rev. 2009;1. Zachos M, Tondeur M, Griffiths AM. Enteral nutritional therapy for induction of remission in Crohn’s disease. Cochrane Database Syst Rev. 2009;1.
12.
go back to reference Griffiths AM, Ohlsson A, Sherman PM, Sutherland LR. Meta-analysis of enteral nutrition as a primary treatment of active Crohn’s disease. Gastroenterology. 1995;108:1056–67.CrossRefPubMed Griffiths AM, Ohlsson A, Sherman PM, Sutherland LR. Meta-analysis of enteral nutrition as a primary treatment of active Crohn’s disease. Gastroenterology. 1995;108:1056–67.CrossRefPubMed
13.
go back to reference Tanaka M, Iwao Y, Sasaki S, Okamoto S, Ogata H, Hibi T, et al. Moderate dietary temperance effectively prevents relapse of Crohn Disease: a prospective study of patients in remission. Gastroenterol Nurs. 2007;30:202–10.CrossRefPubMed Tanaka M, Iwao Y, Sasaki S, Okamoto S, Ogata H, Hibi T, et al. Moderate dietary temperance effectively prevents relapse of Crohn Disease: a prospective study of patients in remission. Gastroenterol Nurs. 2007;30:202–10.CrossRefPubMed
14.
go back to reference Bernal I, Domenech E, Garcia-Planella E, Marin L, Manosa M, Navarro M, et al. Medication-taking behavior in a cohort of patients with inflammatory bowel disease. Dig Dis Sci. 2006;51:2165–9.CrossRefPubMed Bernal I, Domenech E, Garcia-Planella E, Marin L, Manosa M, Navarro M, et al. Medication-taking behavior in a cohort of patients with inflammatory bowel disease. Dig Dis Sci. 2006;51:2165–9.CrossRefPubMed
15.
go back to reference Robinson A, Thompson DG, Wilkin D, Roberts C, Northwest Gastrointestinal Research. Guided self-management and patient-directed follow-up of ulcerative colitis: a randomised trial. Lancet. 2001;358:976–81.CrossRefPubMed Robinson A, Thompson DG, Wilkin D, Roberts C, Northwest Gastrointestinal Research. Guided self-management and patient-directed follow-up of ulcerative colitis: a randomised trial. Lancet. 2001;358:976–81.CrossRefPubMed
16.
go back to reference Travis SPL, Stange EF, Lemann M, Oresland T, Chowers Y, Forbes A, et al. European evidence based consensus on the diagnosis and management of Crohn’s disease: current management. Gut. 2006;55(Suppl 1):i16–35.CrossRefPubMed Travis SPL, Stange EF, Lemann M, Oresland T, Chowers Y, Forbes A, et al. European evidence based consensus on the diagnosis and management of Crohn’s disease: current management. Gut. 2006;55(Suppl 1):i16–35.CrossRefPubMed
Metadata
Title
Coping strategy when patients with quiescent Crohn’s disease recognize that their conditions are worsening
Authors
Makoto Tanaka
Yasushi Iwao
Susumu Okamoto
Haruhiko Ogata
Toshifumi Hibi
Keiko Kazuma
Publication date
01-11-2009
Publisher
Springer Japan
Published in
Journal of Gastroenterology / Issue 11/2009
Print ISSN: 0944-1174
Electronic ISSN: 1435-5922
DOI
https://doi.org/10.1007/s00535-009-0104-0

Other articles of this Issue 11/2009

Journal of Gastroenterology 11/2009 Go to the issue

Original Article—Liver, Pancreas, and Biliary Tract

Decreased production of immunoglobulin M and A in autoimmune pancreatitis

Original Article—Alimentary Tract

Sonic hedgehog relates to colorectal carcinogenesis

Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.