将常识模型扩展到探讨内脏敏感性对炎症性肠病患者生活质量的影响。
Extending the Common Sense Model to Explore the Impact of Visceral Sensitivity on Quality of Life in Inflammatory Bowel Disease.
机构信息
Department of Psychological Sciences, Faculty of Health, Arts and Design, Swinburne University of Technology, Victoria, Australia.
Department of Gastroenterology, Alfred Health and Monash University, Victoria, Australia.
出版信息
Turk J Gastroenterol. 2022 Feb;33(2):103-110. doi: 10.5152/tjg.2021.201158.
BACKGROUND
Inflammatory bowel disease is associated with poor quality of life. The aim of the cross-sectional study was to extend the common sense model to explore the impact of inflammatory bowel disease activity on quality of life and the potential mediating roles of illness perceptions, visceral sensitivity, coping styles, acceptance, and psychological distress.
METHODS
A total of 141 inflammatory bowel disease patients (86 with Crohn's disease and 55 with ulcerative colitis; 74 males, 65 females, and 2 gender non-specific, mean age 40.43 years) from 2 metropolitan hospital inflammatory bowel disease outpatient clinics participated. Measures included disease activity (Crohn's Disease Activity Index, Simple Clinical Colitis Activity Index), illness perceptions (Brief Illness Perceptions Questionnaire), visceral sensitivity (Visceral Sensitivity Index), coping styles (Brief Coping Operations Preference Enquiry), acceptance (Acceptance and Action Questionnaire-II), psychological distress (Depression, Anxiety, and Stress Scale), and European Health Interview Survey-Quality of Life (EUROHIS-QoL).
RESULTS
A structural equation model of the extended common sense model was found to have a good fit (χ2(10) = 10.07, P = .43, root mean square error of approximation = 0.01, standardized root mean residual = 0.04, comparative index fit = 1.00, Tucker-Lewis index = 1.00, goodness-of-fit = 0.98). After controlling for irritable bowel syndrome diagnosis, the impact of disease activity on quality of life was statistically mediated by illness perceptions, maladaptive coping styles, and psychological distress. In addition, visceral sensitivity bordered on influencing the impact of disease activity and illness perceptions on quality of life through psychological distress.
CONCLUSIONS
This study demonstrates that together with illness perceptions and coping styles, visceral sensitivity plays an important role in an individual's adaption to living with inflammatory bowel disease.
背景
炎症性肠病与生活质量较差有关。本横断面研究旨在扩展常识模型，以探讨炎症性肠病活动对生活质量的影响，以及疾病认知、内脏敏感性、应对方式、接纳和心理困扰的潜在中介作用。
方法
本研究共纳入来自 2 家大都市医院炎症性肠病门诊的 141 名炎症性肠病患者（86 名克罗恩病患者和 55 名溃疡性结肠炎患者；74 名男性，65 名女性，2 名性别未指定，平均年龄 40.43 岁）。研究采用的评估工具包括疾病活动度（克罗恩病活动指数、简单临床结肠炎活动指数）、疾病认知（简要疾病认知问卷）、内脏敏感性（内脏敏感性指数）、应对方式（简要应对操作偏好问卷）、接纳（接纳与行动问卷-II）、心理困扰（抑郁、焦虑和压力量表）和欧洲健康访谈调查-生活质量（EUROHIS-QoL）。
结果
扩展的常识模型结构方程模型拟合度良好（χ2(10) = 10.07，P =.43，近似均方根误差 = 0.01，标准化均方根残差 = 0.04，比较指数拟合度 = 1.00，塔克-刘易斯指数 = 1.00，拟合优度 = 0.98）。在控制了肠易激综合征的诊断后，疾病活动度对生活质量的影响在统计学上由疾病认知、适应不良的应对方式和心理困扰所介导。此外，内脏敏感性通过心理困扰对疾病活动度和疾病认知对生活质量的影响起到了边缘性的影响作用。
结论
本研究表明，内脏敏感性与疾病认知和应对方式一起，在个体适应炎症性肠病方面起着重要作用。
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