Inflammatory Bowel Disease Center, University Hospital, Federal University of Juiz de Fora, Juiz de Fora, Brazil.
School of Medicine, Federal University of Juiz de Fora, Juiz de Fora, Brazil.
J Crohns Colitis. 2021 Jan 13;15(1):55-63. doi: 10.1093/ecco-jcc/jjaa130.
Studies on inflammatory bowel disease [IBD] have shown that religiousness and spirituality [R/S] were associated with better mental health and quality of life [QOL]. However, longitudinal studies assessing the impact of R/S on long-term clinical outcomes of Crohn's disease [CD] are scarce. The aim of this study was to assess the influence of R/S on the course of CD after a 2-year follow-up and to determine whether these R/S beliefs were associated with mental health and QOL.
A longitudinal 2-year follow-up study was conducted at a referral centre for IBD, including patients with moderately to severely active CD. Clinical data, disease activity [Harvey-Bradshaw Index], QOL [Inflammatory Bowel Disease Questionnaire-IBDQ], depression and anxiety [Hospital Anxiety and Depression Scale-HADS], and R/S [Duke Religion Index-DUREL, Spirituality Self-Rating Scale-SSRS, and Spiritual/Religious Coping-SRCOPE scale] were assessed at baseline and at the end of the 2-year follow-up. Linear and logistic regression models were employed.
A total of 90 patients [88.2%] were followed up for 2 years. On logistic regression, baseline levels of spirituality (odds ratio [OR] = 1.309; 95% confidence interval [CI]= 1.104-1.552, p = 0.002) and intrinsic religiousness [OR = 1.682; 95% CI = 1.221-2.317, p = 0.001] were predictors of remission at 2 years. On linear regression, the different dimensions of R/S did not significantly predict IBDQ or anxiety and depression scores after 2 years.
R/S predicted remission of CD patients after a 2-year follow-up. However, these beliefs failed to predict mental health or QOL. Health professionals who treat CD should be aware of the religious and spiritual beliefs of their patients, given these beliefs may impact on the disease course.
炎症性肠病（IBD）的研究表明，宗教信仰和灵性与更好的心理健康和生活质量有关。然而，评估宗教信仰和灵性对克罗恩病（CD）长期临床结局影响的纵向研究很少。本研究旨在评估 2 年后宗教信仰和灵性对 CD 病程的影响，并确定这些宗教信仰是否与心理健康和生活质量相关。
这是一项在 IBD 转诊中心进行的为期 2 年的纵向随访研究，纳入了中重度活动期 CD 患者。在基线和 2 年随访结束时评估临床数据、疾病活动（Harvey-Bradshaw 指数）、生活质量（炎症性肠病问卷-IBDQ）、抑郁和焦虑（医院焦虑和抑郁量表-HADS）以及宗教信仰和灵性（Duke 宗教指数-DUREL、灵性自评量表-SSRS 和精神/宗教应对量表-SRCOPE）。采用线性和逻辑回归模型。
共有 90 例患者（88.2%）完成了 2 年随访。逻辑回归显示，基线时的灵性水平（比值比 [OR] = 1.309；95%置信区间 [CI] = 1.104-1.552，p = 0.002）和内在宗教信仰（OR = 1.682；95%CI = 1.221-2.317，p = 0.001）是 2 年后缓解的预测因素。线性回归显示，2 年后 R/S 的不同维度并不能显著预测 IBDQ 或焦虑和抑郁评分。
宗教信仰和灵性可预测 CD 患者在 2 年后的缓解情况。然而，这些信念并不能预测心理健康或生活质量。治疗 CD 的医务人员应了解患者的宗教和精神信仰，因为这些信仰可能会影响疾病进程。
