van Erp Sanne J H, van der Have Mike, Fidder Herma H, van der Heijde Désirée, Wolterbeek Ron, Hommes Daniel W, Kaptein Ad A, van der Meulen-de Jong Andrea E
Department of Gastroenterology and Hepatology.
Department of Gastroenterology and Hepatology, UMCU, Utrecht, The Netherlands.
Eur J Gastroenterol Hepatol. 2018 Apr;30(4):465-470. doi: 10.1097/MEG.0000000000001066.
Arthropathies are a common extraintestinal manifestation (EIM) in inflammatory bowel disease (IBD). This study evaluated the differences in illness perceptions, coping strategies, and illness outcomes between patients with IBD with and without arthropathies at baseline and examined changes at 12 months in these variables in patients with arthropathies.
In total, 204 patients with (n=123) and without (n=81) arthropathies completed questionnaires at baseline and after 1 year, assessing illness perceptions, coping strategies, quality of life, and work and activity impairment. A linear regression analysis assessed the effect of arthropathies on these factors compared with patients without arthropathies. A mixed model analysis evaluated changes in illness perceptions, coping strategies, and outcomes in patients with arthropathies over time.
Patients with arthropathies had more persistent thoughts on symptomatology and the variability of symptoms, held more negative views on the effects of illness, had heightened emotions that affected daily functioning, and had a poorer understanding of IBD than patients without arthropathies. Patients with arthropathies could more efficiently divert attention, felt more useful to others, and perceived a reduced physical and mental health and an increased activity impairment compared with patients without arthropathies. At follow-up, patients with arthropathies were more sceptical about the effectiveness of medical treatment but were better able to adapt their activities to their complaints compared with baseline.
Patients with arthropathies in IBD adopt different illness perceptions and coping strategies and have different outcomes compared with patients without arthropathies, which is important to know when designing behavioral and physical interventions to improve functioning.
关节病是炎症性肠病（IBD）常见的肠外表现（EIM）。本研究评估了基线时患有关节病和未患关节病的IBD患者在疾病认知、应对策略和疾病结局方面的差异，并研究了患有关节病的患者在12个月时这些变量的变化。
共有204例患有关节病（n = 123）和未患关节病（n = 81）的患者在基线和1年后完成了问卷调查，评估疾病认知、应对策略、生活质量以及工作和活动障碍。线性回归分析评估了与未患关节病的患者相比，关节病对这些因素的影响。混合模型分析评估了患有关节病的患者随时间推移在疾病认知、应对策略和结局方面的变化。
与未患关节病的患者相比，患有关节病的患者对症状学和症状变异性有更持续的想法，对疾病影响持更负面的看法，情绪高涨影响日常功能，对IBD的理解较差。与未患关节病的患者相比，患有关节病的患者能够更有效地转移注意力，觉得对他人更有用，并且感觉身心健康下降，活动障碍增加。在随访时，患有关节病的患者对药物治疗的有效性更持怀疑态度，但与基线相比，他们能够更好地根据自身不适调整活动。
与未患关节病的患者相比，IBD患有关节病的患者采用不同的疾病认知和应对策略，且有不同的结局，这在设计行为和物理干预以改善功能时很重要。
