Factors affecting health related quality of life of patients with inflammatory bowel disease

Factors affecting health related quality of life of patients with inflammatory bowel disease

former variableswere measured by existing, evaluatedquestionnaires. QoC was assessed by the QUOTE-IBD (QoC through the Patients' Eyes), especially dev...

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former variableswere measured by existing, evaluatedquestionnaires. QoC was assessed by the QUOTE-IBD (QoC through the Patients' Eyes), especially developedfor the purpose of this study. QUOTE-IBDscores range from 0 to 10 (best). Questionnaireswere sent to 1051 European and Israeli IBD patients, diagnosed between 1991 and 1993. RESULTS:Response rate was 78% (n=823). Ten patients had indeterminate colitis and were excluded from subsequent analyses. Of the remainder, 518 patients (64%) had received health care by a specialist during the last year, 196 patients with Crohn s disease (119 females; median age 40.5 yrs, range 22-84 yrs) and 322 patients with ulcerativecolitis (151 females; median age 45 yrs, range 19-85 yrs). Dataof these patientswere analyzedby multiple regressionanalysis assuming a hierarchical (two-level) structure, and corrected for age, sex, diagnosis, smoking, marital status, type of hospital, way of administration of the questionnaire, social economic status, and geographicposition. Total mean _+ SD OUOTE-IBDscore in the study population was 9.0 + 12. The different dimensions of QoC scored as follows: competenceof physician (9.3 _+ 1.7), accessibility of physician (8.8 _+ 1.7), information (8.6 -'- 2.1), continuity of care (9.0 + 1.6), hospital accommodation(9.6 +_1.4), courtesy (9.3 _+ 1.4), patient autonomy (9.1 _+ 2.6), and patient s expenses(8.9 +_ 2.7). All variablesof the conceptualmodel, except coping, contributed significantly to 9oL, whereas of the separate dimensions of QoC, only information yielded significance (p = .008). CONCLUSION:The conceptualmodel appearedto be a realistic representationof the factors influencing QoL in IBD.We also found that providing optimal information could increase OoL in IBD. 2297 Mood Disorders (MD) Worsen Health Related Quality of Life (HRQOL) in Inflammatory Bowel Disease (IBD) Forough Farrokhyar,John K. Marshall, Ruth A. Cawdron, E Jan Irvine, McMaster Univ, Hamilton Canada Rationale: HRQOLin IBD may be affected by diseaseseverity and psychosocialfactors. Aim: To assess the prevalenceof Anxiety (Anx) and depression (Dep) and evaluatetheir impact on HRQOLstatus in IBD patients. Methods: ConsecutiveIBD patients attending an ambulatory clinic completed a questionnaireassessing diseaseactivity (DAI), HRQOL (Short IBDQ), Anx and Dep (Hospital Anxiety & Depression Survey). Mean HROOL scores were compared in patients with vs. without Anx or Dep. General linear modeling was used to explore the association between demographic factors and HROOL. Results: 219 IBD patients (40.2% males) with a mean age of 39.5 (range 18-86) participated.The prevalenceof Anx was 37.4% (CD 38.1%, UC 35.9%, with respectivelyHRQOLscores of 4.2 vs. 4.8, p = 0.03), Dep 16.4% (CD 15.9%, UC 16.9%, with HROOLscores of 3.0 vs. 4.3, p=O.O01) and both Anx and Dep 11.9% (CD 12.3%, UC 10.9%, with HROOLscores of 3.0 vs. 4.2, p=O.O02). Mean HRQOL scores (table) were significantly lower in patients with Anx or Dep vs. without. In CD or UC patients with Anx or Dep, mean HRQOL scores were not affected significantly by age, sex, annual income or DAI. Dep, DAI and Anx were the strongest predictors (P
N DAI

Inactive Active Age <40 yrs >40yrs Sex Male Female Income $<25,000 $>25,000

Crohn's disease (N:155) Anxiety Depression Yes No Yes No 59 96 25 130

UlceraUveColitis (N:64) Anxiety Depression Yes No Yes No 23 41 11 53

5.0 3.9 4.0 4.5 4.0 4.4

6.1" 4.8* 5.3* 5.4* 5.5* 5.3*

2.9 3.0 2.7 3.7 2.8 3.2

6.0* 4.8* 5.2* 5.3* 5.2* 5.3*

5.7 6.1 4.5 5.4* 4.7 5.5 5.4 5.9* 5.2 5.6* 4.6 5.9*

5.0 4.0 4.2 4.5 4.7 4.2

6.2* 5.3* 5.3* 62* 5.6 5.7*

3.9 4.6

5.2* 5.5*

2.7 3.3

5.1" 5.4*

4.6 5.5* 5.0 5.7*

4.2 4.4

5.3* 5.7*

medical vs. surgical, there was no associationwith psychologicalstatus (p>O.05). Conclusion: The utilisation of health care resources in patients with IBD is not related to their level of psychological morbidity, sense of personal control or adjustment to illness. The opinion that patients who frequently use the hospital facilities offered to them have a more dependent psychological status was not apparent in this study. The level of heatihcare utilisation may be related to the severity of their illness. 2299 Quality Of Life In Patients With Restorative ProctocolectomyFor Ulcerative Colitis Akira Sugita, Yokohama City Univ Medical Ctr, YokohamaJapan; Hideki Hashimoto, Teikyo Univ, Tokyo Japan; Yasushi Iwao, Keio Univ, Tokyo Japan; Schunichi Fukuhara, Kyoto Univ, Kyoto Japan BACKGROUND:Standardoperativeprocedurefor ulcerativecolitis is ileal pouch analanastomosis with rectal mucosal stripping(IPAA)and stapledileal pouch analanastomosiswith preservation of anal canal mucosa(SIPAA).It has beendifficult to evaluatequality of life in postoperative patients precisely.AIM: 1)Health-relatedquality of life in patientswith these surgical procedures were evaluatedby meansof MOS-SF36and diseasespecific questionnaire.2)Pra and postoperative QOL were compared by this technique in patients with SIPAA. PATIENTSAND METHOD: 1)This multicenter study included 244 patients with IPAAand 82 patients with SIPAAwithout ileostomy. Postoperativeperiodwas 5.2 yearsand 2.7 years in average,respectively(p
* One-wayANOVA,P7=Anxor Dep) 2298 The Relationship between UUlisation of Healthcare Resources and Psychological Factors in Patients with Inflammatory Bowel Disease. Katherine M. Sheehan, Derek G. Power, Beaumont Hosp, Dublin Ireland; Christopher Steele, Royal Coil of Surgeons in Ireland, Dublin Ireland; Michael F. Byrne, Beaumont Hosp, Dublin Ireland; Eva Doherty, Royal Coil of Surgeons in Ireland, Dublin Ireland; Frank E. Murray, BeaumontHosp, Dublin Ireland Background: Patients with inflammatory bowel disease (IBD) experienceincreased levels of anxiety and depression. There is a suggestion that those patients who attend hospital or clinics more frequently have a tendency for a more anxious, dependentpersonality.The aim of this study was to investigate the relationship between patient personality, psychological morbidity and adjustment to illness with the level of hospital healthcare utilisetion in patients with IBD. Methods: 42 patients were evaluated(27 Crohns, 15 Ulcerativecolitis). Median age was 34 years (range 16-71, 27 females). The mean duration of illness was 5.8 years. Anxiety and depressive symptoms were measured using the hospital anxiety and depression scale (HADS). Self-efficacywas scored using the GeneralizedSelf Efficacy Scale(GSES).Adjustment to illness was evaluated using the Acceptance of Illness Scale (AIS). Hospital healthcare utilisation was assessed by recording numbers of outpatient visits, number of admissions, endoscopic and surgical procedures. Results: The level of psychological morbidity was high in this cohort of IBD patients. 35% of patients demonstratedclinical features of anxiety while 12% of patients reported symptoms diagnostic of depression.Anxiety levels correlated with depressivesymptoms (p = 0.01). Depressionscores were higher in females (p = 0.03). There was no relationship between anxiety or depression, self-efficacy and adjustment to illness with number of outpatient visits, number of admissions, endoscopicand surgical procedures using multiple regression analyses.When analysedfor predominant mode of treatment, i.e.

2301 Assessment Of Quality Of Life In inflammatory Bowel Disease (IBD) With A Short Instrument Alessandro Martin, Manuela Dinca, Dept of Surg and GastroenterologicalScience, Padova Italy Introduction. The assessment of HRQOLis not only important as a measure of outcome but may also improve the management of IBD. Commonly employed instruments are usually long, take time to complete and are therefore not useful for the managementof the individual

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