Document Type : Original Article
Authors
- . Seyed Mostafa Mohsenizadeh
- . Zahra Sadat Manzari 1
- . Hassan Vossoughinia 2
- . Hossein Ebrahimipour 3
1 Department of Medical‑Surgical Nursing, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
2 Department of Gastroenterology and Hepatology, Ghaem Hospital, Mashhad University of Medicine Science, Mashhad, Iran
3 Department of Health Sciences, Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
Abstract
BACKGROUND: Patients with inflammatory bowel disease (IBD) experience wide range of physical
and psychological problems experience. The use of strategies to improve disease management by
patients is of has special importance in solving these problems. The aim of present study was to
discover the strategies and behaviors of patients to manage their disease.
MATERIALS AND METHODS: The present study was conducted with a qualitative research approach
and a qualitative content analysis method. The research participants included 20 patients with IBD
referred to gastrointestinal wards in 2020 in Mashhad. Data were collected through unstructured
interviews and purposeful sampling method and continued until data saturation. Data analysis was
performed continuously and simultaneously with data collection and comparatively.
RESULTS: Data analysis provided five themes of “Improving self‑efficacy and problem‑solving skills,”
“Coexistence with disease,” “Reviewing and modifying of interactions,” “Adjusting job and professional
conditions” and “Commitment to self‑care.” The combination of these concepts indicated that is the
main theme in disease management for these patients.
CONCLUSIONS: Reconstruction of individual, social, and professional life can improve self‑regulation
and problem‑solving skills in these patients and make them a sense of control on their lives and
disease.
Keywords
Barreiro‑de Acosta M, McCartney S, et al. A qualitative
research for defining meaningful attributes for the treatment of
inflammatory bowel disease from the patient perspective. Patient
2020;13:317‑25.
2. Casellas F, Guise CH, Robles V, Navarro E, Borruel N. Patient
preferences for infammatory bowel disease treatment objectives.
Dig Liver Dis 2017;49:152‑6.
3. Kamp KJ, Brittain K. Factors that infuence treatment and
nontreatment decision making among individuals with
infammatory bowel disease: An integrative review. Patient
2018;11:271‑84.
4. M’Koma AE. Inflammatory bowel disease: An expanding global
health problem. Clin Med Insights Gastroenterol 2013;6:33‑47.
5. Mohsenizadeh SM, Manzari ZS, Vosoghinia H, Ebrahimipour H.
Family caregivers’ burden in inflammatory bowel diseases: An
integrative review. J Educ Health Promot 2020;9:289.
6. Mikocka‑Walus AA, Andrews JM, Bernstein CN, Graff LA,
WalkerJR, Spinelli A, et al. Integrated models of care in managing
inflammatory bowel disease: A discussion. Inflamm Bowel Dis
2012;18:1582‑7.
7. Grady PA, Gough LL. Self‑management: A comprehensive
approach to management of chronic conditions. Am J Public
Health 2014;104:e25‑31.
8. Jalilian F, Motlagh FZ, Solhi M, Gharibnavaz H. Effectiveness of
self‑management promotion educational program among diabetic
patients based on health belief model. J Educ Health Promot
2014;3:14.
9. Miller WR, Lasiter S, Bartlett Ellis R, Buelow JM. Chronic disease
self‑management: A hybrid concept analysis. Nurs Outlook
2015;63:154‑61.
10. Tran L, Mulligan K. A systematic review of self‑management
interventions for children and adolescents with inflammatory
bowel disease. Inflamm Bowel Dis 2019;25:685‑98.
11. Plevinsky JM, Greenley RN, Fishman LN. Self‑management in
patients with inflammatory bowel disease: Strategies, outcomes,
and integration into clinical care. Clin Exp Gastroenterol
2016;9:259‑67.
12. Hsieh HF, Shannon SE. Three approaches to qualitative content
analysis. Qual Health Res 2005;15:1277‑88.
13. Lincoln YS. Emerging criteria for quality in qualitative and
interpretive research. Qual Inq 1995;1:275‑89.
14. Zare F, Ghafari M, Ramezankhani A, Kamran BL, Kavoosi A.
Identifying dimensions of empowerment in patients with
inflammatory bowel disease: A qualitative study. Health Educ
Res 2020;35:637‑47.
15. Sykes DN, Fletcher PC, Schneider MA. Balancing my disease:
Women’s perspectives of living with inflammatory bowel disease.
J Clin Nurs 2015;24:2133‑42.
16. Pittet V, Vaucher C, Froehlich F, Burnand B, Michetti P,
Maillard MH, et al. Patient self‑reported concerns in inflammatory
bowel diseases: A gender‑specific subjective quality‑of‑life
indicator. PLoS One 2017;12:e0171864.
17. Trivedi I, Darguzas E, Balbale SN, Bedell A, Reddy S,
Rosh JR, et al. Patient understanding of “Flare” and
“Remission” of inflammatory bowel disease. Gastroenterol Nurs
2019;42:375‑85.
18. Jelsness‑Jørgensen LP, Moum B, Bernklev T. Worries and
concerns among inflammatory bowel disease patients
followed prospectively over one year. Gastroenterol Res Pract
2011;2011:492034.
19. KeetonRL, Mikocka‑WalusA, Andrews JM. Concerns and worries
in people living with inflammatory bowel disease (IBD): A mixed
methods study. J Psychosom Res 2015;78:573‑8.
20. Larsson K, Lööf L, Nordin K. Stress, coping and support needs of
patients with ulcerative colitis or Crohn’s disease: A qualitative
descriptive study. J Clin Nurs 2017;26:648‑57.
21. CooperJM, CollierJ, James V, Hawkey CJ. Beliefs about personal
control and self‑management in 30‑40 year olds living with
inflammatory bowel disease: A qualitative study. Int J Nurs Stud
2010;47:1500‑9.
22. Bishop J, Lemberg DA, Day A. Managing inflammatory bowel
disease in adolescent patients. Adolesc Health Med Ther
2014;5:1‑3.
)