[The impact of stress and coping strategies on health-related quality of life in ulcerative colitis].

OBJECTIVE

To further understand factors that influence health-related quality of life (HRQOL) in patients with ulcerative colitis (UC), especially the role of perceived stress and coping modes in Chinese patients with UC.

METHODS

This study was a cross-sectional study. Patients with UC were recruited from July 2013 to September 2014 in Peking Union Medical College Hospital. HRQOL was measured using the inflammatory bowel disease questionnaire (IBDQ). Perceived stress was measured by Perceived Stress Scale (PSS). Coping strategy was evaluated using Medical Coping Modes Questionnaire (MCMQ). Demographic data, course of the disease, clinical disease activity, and disease phenotype according to Montreal classification were also collected. Univariate analyses were conducted to determine which variables were associated with HRQOL, and those were statistically significant were entered into a multivariate regression model.

RESULTS

We recruited 214 patients (response rate 92.2%), whose median age was 37.5 (29.0, 49.3) years old and median course of UC was 4 (2, 9) years. Through univariate analyses, better HRQOL was significantly associated with regular medical visits, lower number of previous relapses and hospitalizations, no steroid use, Montreal E1, lower Mayo scores, clinical remission, less perceived stress and less acceptance strategy use. However, multivariate analyses revealed that perceived stress (OR=1.112, 95% CI 1.058-1.169), acceptance (OR=0.310, 95% CI 0.141-0.685), number of hospitalizations (OR=2.924, 95% CI 1.328-6.437) and clinical activity (OR=5.058, 95% CI 2.312-11.066) were most strongly related to HRQOL.

CONCLUSIONS

HRQOL of UC patients are not only associated with clinical activity of the disease, but also associated with coping strategy and perceived stress. Further research needs to focus on whether or not relieving stress and guiding patients to cope with ulcerative colitis would improve HRQOL.