Oxelmark Lena, Magnusson Anne, Löfberg Robert, Hillerås Pernilla
Department of Medicine, Karolinska University Hospital, Solna.
Inflamm Bowel Dis. 2007 Feb;13(2):182-90. doi: 10.1002/ibd.20061.
Inflammatory bowel diseases (IBD) such as ulcerative colitis (UC) and Crohn's disease (CD) have great impact on patients' health-related quality of life (HRQOL). The aim of this study was to develop an integrated medical and psychological/ psychosocial group-based intervention program for IBD patients and to evaluate if such a program could influence the patients' HRQOL and coping abilities.
IBD patients in remission or with low disease activity were randomized to intervention or control groups. The intervention comprised nine weekly sessions, alternating lectures, and group therapy sessions. The Inflammatory Bowel Disease Questionnaire (IBDQ) and the Sense of Coherence scale (SOC) were used to measure HRQOL and coping ability at 0, 6, and 12 months. The intervention was evaluated by a visual analog scale (VAS) and written comments by a content analysis.
In all, 24 patients were included in the intervention group and 20 in the control group. The mean IBDQ score showed no statistically significant differences before (173.9) or after the intervention at month 6 (175.7) or at month 12 (171.8), or when comparing intervention and controls at month 12. Similarly, there were no statistically significant differences in mean SOC before or after intervention or when comparing groups. The VAS and the content analysis showed that the intervention was well appreciated by the patients.
The group-based intervention program was feasible and highly appreciated. There were no statistically significant differences in average IBDQ or SOC over time or in comparison with controls, although a significant increase was seen in patients with short disease duration.
炎症性肠病(IBD),如溃疡性结肠炎(UC)和克罗恩病(CD),对患者的健康相关生活质量(HRQOL)有很大影响。本研究的目的是为IBD患者制定一个综合医学和心理/社会心理的基于小组的干预计划,并评估这样一个计划是否能影响患者的HRQOL和应对能力。
处于缓解期或疾病活动度较低的IBD患者被随机分为干预组或对照组。干预包括为期九周的课程,讲座和小组治疗课程交替进行。使用炎症性肠病问卷(IBDQ)和连贯感量表(SOC)在0、6和12个月时测量HRQOL和应对能力。通过视觉模拟量表(VAS)和内容分析的书面评论对干预进行评估。
干预组共纳入24例患者,对照组纳入20例患者。干预前(173.9)、干预后6个月(175.7)或12个月(171.8)时,IBDQ平均得分无统计学显著差异,12个月时干预组与对照组比较也无显著差异。同样,干预前后或组间比较时,SOC平均得分也无统计学显著差异。VAS和内容分析表明患者对干预评价很高。
基于小组的干预计划是可行的且受到高度评价。随着时间推移或与对照组比较,IBDQ或SOC的平均得分无统计学显著差异,尽管病程短的患者有显著增加。