Department of Psychology, University of Sheffield, UK.
Department of Psychology, University of Windsor, Ontario, Canada.
Br J Health Psychol. 2017 Nov;22(4):920-939. doi: 10.1111/bjhp.12262. Epub 2017 Aug 14.
Despite the toll of inflammatory bowel disease (IBD) on adjustment, many patients are resilient to the challenges associated with living with IBD, and successfully cope with their illness and thrive. Yet there is little research on why some individuals with IBD enter a trajectory of growth, while others may struggle to adapt. The aim of this study was to investigate the adjustment-related factors that distinguished thriving, resilience, and loss in people with IBD across personal growth, life satisfaction, and relationship quality domains.
Prospective cohort design with two data collection points, 6 months apart.
From a sample of 420 people with active IBD who completed an online survey, 152 participants completed the follow-up survey and were included in the analyses. Participants completed measures of thriving, and cognitive, affective, social, and disease-related variables known to predict adjustment.
Time 1 ANCOVAs and pairwise comparisons controlling for demographics distinguished loss from resilience and thriving on the four outcomes - coping efficacy, illness acceptance, depressive symptoms, and perceived social support - for all three domains. Time 2 ANCOVAs and pairwise comparisons controlling for baseline outcomes revealed that the Time thriving categories predicted differences in Time 2 adjustment, mainly for the life satisfaction domain, with those experiencing loss reporting poorer adjustment than those experiencing resilience and thriving.
Findings highlight the distinctions among profiles of thriving, resilience, and loss in adjustment to IBD, and suggest that strategies that enhance coping and address depressive symptoms may optimize thriving in the context of IBD. Statement of contribution What is already known on this subject? Inflammatory bowel disease (IBD) is associated with depression, poor coping, and stressful symptoms. Previous research has focused mainly on poor adjustment to IBD rather than on positive growth. There is little research on why some patients with IBD thrive or are resilient, while others struggle to adapt. What does this study add? This study is the first to longitudinally examine the profiles of thriving, resilience, and loss in individuals with IBD. The thriving profiles differed in coping efficacy, illness acceptance, depressive symptoms, and social support outcomes at Time 1, and predicted adjustment at T2 mainly for the life satisfaction domain. Strategies that enhance coping and social support may optimize thriving in the context of IBD.
尽管炎症性肠病（IBD）对患者的适应能力造成了严重影响，但许多患者具有很强的适应能力，能够应对与 IBD 相关的挑战，并成功地应对疾病和生活。然而，对于为什么有些 IBD 患者会走上成长的轨迹，而有些患者可能难以适应，相关研究却很少。本研究旨在调查区分 IBD 患者在个人成长、生活满意度和人际关系质量领域中茁壮成长、具有韧性和丧失适应能力的调整相关因素。
前瞻性队列设计，两次数据收集时间相隔 6 个月。
从 420 名患有活动性 IBD 的患者中，通过在线调查获得了样本，其中 152 名参与者完成了随访调查，并被纳入分析。参与者完成了关于茁壮成长、认知、情感、社会和与疾病相关的变量的测量，这些变量已知可以预测调整。
时间 1 的协方差分析和配对比较控制了人口统计学因素，区分了丧失适应能力与具有韧性和茁壮成长在四个结果上的差异 - 应对效能、疾病接受度、抑郁症状和感知社会支持 - 在所有三个领域中都是如此。时间 2 的协方差分析和配对比较控制了基线结果，结果表明，时间 1 的茁壮成长类别预测了时间 2 的调整差异，主要是在生活满意度领域，经历丧失适应能力的人报告的调整较差，而经历具有韧性和茁壮成长的人则报告的调整较好。
研究结果突出了 IBD 适应能力中茁壮成长、具有韧性和丧失适应能力的不同特征，并表明增强应对能力和解决抑郁症状的策略可能会优化 IBD 患者的茁壮成长。
