Saito Yuri A, Prather Charlene M, Van Dyke Carol T, Fett Sara, Zinsmeister Alan R, Locke G Richard
Clinical Enteric Neuroscience Translational and Epidemiological Research, Mayo Clinic and Foundation, Rochester, MN 55905, USA.
Clin Gastroenterol Hepatol. 2004 Jul;2(7):576-84. doi: 10.1016/s1542-3565(04)00241-1.
BACKGROUND & AIMS: The impact of education on irritable bowel syndrome (IBS) is not well known. This study evaluated the effect of a onetime group education program on patient-based outcomes in IBS.
All adults referred by Mayo Clinic physicians to the Gastroenterology Division with a diagnosis of IBS between May 1997 and March 1998 were asked to participate. Questionnaires were administered at baseline and 6 months. Symptom resolution, change in pain severity, quality of life, Health-Promoting Lifestyle Profile score, overall patient satisfaction, and health care utilization were compared among those patients who attended the multidisciplinary class and those who did not.
Of the 506 patients approached, 403 (80%) agreed to participate. The clinical diagnosis was confirmed in 344 patients (85%) on chart review; 211 patients (61%) subsequently completed a follow-up questionnaire. Overall, 29% of class attendees who met Rome criteria for IBS at baseline no longer met Rome criteria at follow-up, compared with 7% of nonattendees. By multivariate analysis, class attendance predicted higher odds of not meeting Rome criteria at follow-up in individuals meeting Rome criteria at baseline (odds ratio, 7.91; 95% confidence interval, 0.97-64.41) than in nonattendees, but the opposite effect was seen with class attendance in those not meeting Rome criteria at baseline. This interaction between baseline Rome status and class attendance was significant (P < 0.05). Class attendance was associated with improvement in Health-Promoting Lifestyle Profile scores (P < 0.05) but not with change in pain, quality of life, satisfaction, or health care utilization.
A onetime, multidisciplinary class for patients with IBS was associated with improvement in symptoms and health-promoting lifestyle behavior.
教育对肠易激综合征（IBS）的影响尚不明确。本研究评估了一次性团体教育项目对IBS患者相关结局的影响。
邀请1997年5月至1998年3月间被梅奥诊所医生转诊至胃肠病科且诊断为IBS的所有成年人参与。在基线期和6个月时进行问卷调查。比较参加多学科课程的患者与未参加者之间的症状缓解情况、疼痛严重程度变化、生活质量、健康促进生活方式量表得分、患者总体满意度以及医疗保健利用情况。
在506名被邀请的患者中，403名（80%）同意参与。经病历审查，344名患者（85%）的临床诊断得到确认；211名患者（61%）随后完成了随访问卷。总体而言，基线时符合IBS罗马标准的课程参与者中，29%在随访时不再符合罗马标准，而未参与者这一比例为7%。多因素分析显示，与未参与者相比，基线时符合罗马标准的个体参加课程后在随访时不符合罗马标准的几率更高（比值比，7.91；95%置信区间，0.97 - 64.41），但基线时不符合罗马标准的个体参加课程则出现相反效果。基线罗马状态与课程参与之间的这种相互作用具有统计学意义（P < 0.05）。参加课程与健康促进生活方式量表得分的改善相关（P < 0.05），但与疼痛、生活质量、满意度或医疗保健利用的变化无关。
为IBS患者举办的一次性多学科课程与症状改善及健康促进生活方式行为有关。
