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Illness perceptions mediate the relationship between bowel symptom severity and health-related quality of life in IBS patients.

De Gucht V - Qual Life Res (2015)

Bottom Line: Irritable bowel syndrome (IBS) is a functional bowel disorder with a large negative impact on HRQOL.Mediation models were tested using the bootstrapping procedure developed by Hayes.Perceived consequences were a mediator of the relationship between bowel symptom severity, total HRQOL as well as its subscales, with the exception of Sexuality.

View Article: PubMed Central - PubMed

Affiliation: Health Psychology Unit, Faculty of Social Sciences, Institute of Psychology, Leiden University, Wassenaarseweg 52, PO BOX 9555, 2300 RB, Leiden, The Netherlands, degucht@fsw.leidenuniv.nl.

ABSTRACT

Purpose: Irritable bowel syndrome (IBS) is a functional bowel disorder with a large negative impact on HRQOL. The present study examines whether severity of bowel symptoms is directly related to HRQOL, and/or indirectly, mediated by the patients' illness perceptions.

Methods: Patients were recruited from an IBS support group (N = 123), and data were collected online. HRQOL was measured with the Quality of Life Measure for Persons with IBS and illness perceptions with the brief Illness Perception Questionnaire. Mediation models were tested using the bootstrapping procedure developed by Hayes.

Results: Irritable bowel syndrome symptom severity is directly related to total HRQOL and its subscales; after entering the mediator variables (i.e. the patients' illness perceptions) into the model, this direct association remained only significant for total HRQOL. The relationship between bowel symptom severity and total HRQOL was partially mediated by illness perceptions, and its relationship with each of the HRQOL subscales was fully mediated by the patients' illness perceptions. Perceived consequences were a mediator of the relationship between bowel symptom severity, total HRQOL as well as its subscales, with the exception of Sexuality.

Conclusions: Bowel symptom severity not only has a direct relationship with HRQOL, but also an indirect relationship via the patients' cognitive and emotional representations of their illness. In order to better understand this relationship, future research should not only include illness perceptions but also assess cognitive and behavioural coping responses. Clinicians wanting to improve patients' HRQOL should not only focus on the patients' symptoms, but also on their illness beliefs and coping responses.

No MeSH data available.


Related in: MedlinePlus

Direct and indirect effects of irritable bowel syndrome symptom severity (IBSS) on health-related quality of life (HRQOL; total and subscales) through the illness perceptions “consequences”, “emotional representation” and “identity”. Note. a1–3 effect of independent variable on mediators, b1–3 effect of mediators on dependent variables, c total effect of independent variable on dependent variable; c’ = direct effect of independent variable on dependent variable after the effect of the mediators was taken into account. Only statistically significant associations are depicted. * p < 0.05, ** p < 0.01, *** p < 0.001
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Fig2: Direct and indirect effects of irritable bowel syndrome symptom severity (IBSS) on health-related quality of life (HRQOL; total and subscales) through the illness perceptions “consequences”, “emotional representation” and “identity”. Note. a1–3 effect of independent variable on mediators, b1–3 effect of mediators on dependent variables, c total effect of independent variable on dependent variable; c’ = direct effect of independent variable on dependent variable after the effect of the mediators was taken into account. Only statistically significant associations are depicted. * p < 0.05, ** p < 0.01, *** p < 0.001

Mentions: Finally, the analysis of the indirect relationship between IBS symptom severity and HRQOL revealed that bowel symptom severity was indirectly related to total HRQOL as well as the subscales dysphoria and social reaction (a × b paths), mediated by the IPQ dimensions consequences and emotional representation. A significant indirect relationship was found between symptom severity and the subscales interference with activity and food avoidance, mediated only by the IPQ dimension consequences. The relationship between symptom severity and the subscale sexuality was only mediated by identity. The results of the mediation analyses are presented in Table 3 and Fig. 2.Fig. 2


Illness perceptions mediate the relationship between bowel symptom severity and health-related quality of life in IBS patients.

De Gucht V - Qual Life Res (2015)

Direct and indirect effects of irritable bowel syndrome symptom severity (IBSS) on health-related quality of life (HRQOL; total and subscales) through the illness perceptions “consequences”, “emotional representation” and “identity”. Note. a1–3 effect of independent variable on mediators, b1–3 effect of mediators on dependent variables, c total effect of independent variable on dependent variable; c’ = direct effect of independent variable on dependent variable after the effect of the mediators was taken into account. Only statistically significant associations are depicted. * p < 0.05, ** p < 0.01, *** p < 0.001
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4493794&req=5

Fig2: Direct and indirect effects of irritable bowel syndrome symptom severity (IBSS) on health-related quality of life (HRQOL; total and subscales) through the illness perceptions “consequences”, “emotional representation” and “identity”. Note. a1–3 effect of independent variable on mediators, b1–3 effect of mediators on dependent variables, c total effect of independent variable on dependent variable; c’ = direct effect of independent variable on dependent variable after the effect of the mediators was taken into account. Only statistically significant associations are depicted. * p < 0.05, ** p < 0.01, *** p < 0.001
Mentions: Finally, the analysis of the indirect relationship between IBS symptom severity and HRQOL revealed that bowel symptom severity was indirectly related to total HRQOL as well as the subscales dysphoria and social reaction (a × b paths), mediated by the IPQ dimensions consequences and emotional representation. A significant indirect relationship was found between symptom severity and the subscales interference with activity and food avoidance, mediated only by the IPQ dimension consequences. The relationship between symptom severity and the subscale sexuality was only mediated by identity. The results of the mediation analyses are presented in Table 3 and Fig. 2.Fig. 2

Bottom Line: Irritable bowel syndrome (IBS) is a functional bowel disorder with a large negative impact on HRQOL.Mediation models were tested using the bootstrapping procedure developed by Hayes.Perceived consequences were a mediator of the relationship between bowel symptom severity, total HRQOL as well as its subscales, with the exception of Sexuality.

View Article: PubMed Central - PubMed

Affiliation: Health Psychology Unit, Faculty of Social Sciences, Institute of Psychology, Leiden University, Wassenaarseweg 52, PO BOX 9555, 2300 RB, Leiden, The Netherlands, degucht@fsw.leidenuniv.nl.

ABSTRACT

Purpose: Irritable bowel syndrome (IBS) is a functional bowel disorder with a large negative impact on HRQOL. The present study examines whether severity of bowel symptoms is directly related to HRQOL, and/or indirectly, mediated by the patients' illness perceptions.

Methods: Patients were recruited from an IBS support group (N = 123), and data were collected online. HRQOL was measured with the Quality of Life Measure for Persons with IBS and illness perceptions with the brief Illness Perception Questionnaire. Mediation models were tested using the bootstrapping procedure developed by Hayes.

Results: Irritable bowel syndrome symptom severity is directly related to total HRQOL and its subscales; after entering the mediator variables (i.e. the patients' illness perceptions) into the model, this direct association remained only significant for total HRQOL. The relationship between bowel symptom severity and total HRQOL was partially mediated by illness perceptions, and its relationship with each of the HRQOL subscales was fully mediated by the patients' illness perceptions. Perceived consequences were a mediator of the relationship between bowel symptom severity, total HRQOL as well as its subscales, with the exception of Sexuality.

Conclusions: Bowel symptom severity not only has a direct relationship with HRQOL, but also an indirect relationship via the patients' cognitive and emotional representations of their illness. In order to better understand this relationship, future research should not only include illness perceptions but also assess cognitive and behavioural coping responses. Clinicians wanting to improve patients' HRQOL should not only focus on the patients' symptoms, but also on their illness beliefs and coping responses.

No MeSH data available.


Related in: MedlinePlus