Huisman Danielle, Fernhout Felice, Moxham Faye, Norton Christine, Bannister Kirsty, Moss-Morris Rona
Health Psychology Section, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK.
Br J Pain. 2024 Aug;18(4):325-336. doi: 10.1177/20494637241230807. Epub 2024 Jan 29.
Patients with inflammatory bowel disease (IBD) are often faced with distressing and confusing abdominal pain during remission. Some people respond adversely to healthcare professionals' (HCPs) suggestions that this pain and related symptoms are due to secondary irritable bowel syndrome (IBS). Exploring how HCPs view, manage, and explain pain during quiescent disease may provide insights into how communication can be improved to increase understanding and mitigate negative responses.
In-depth semi-structured interviews were conducted with 12 IBD-nurses ( = 4) and gastroenterologists ( = 8) working in the United Kingdom or the Netherlands. Reflexive thematic analysis was used to analyse interviews.
Findings suggest that HCPs pay relatively little attention to pain when there is no underlying pathology and prefer to concentrate on objectifiable causes of symptoms and treating disease activity (). Explanations of abdominal pain and IBS-like symptoms during remission were not standardised (). Processes of shared decision-making were outlined and shared sensemaking was reported as a strategy to enhance acceptance of IBS explanations ().
Future work should focus on establishing how pain during remission may be best defined, when to diagnose IBS in the context of IBD, and how to explain both to patients. The formulation of standardised explanations is recommended as they might help HCPs to adopt practices of shared sensemaking and shared decision-making. Explanations should be adaptable to specific symptom presentations and different health literacy levels.
炎症性肠病（IBD）患者在缓解期常面临令人痛苦且困惑的腹痛。一些人对医疗保健专业人员（HCPs）关于这种疼痛及相关症状是由继发性肠易激综合征（IBS）引起的建议反应不佳。探究HCPs在疾病静止期如何看待、处理和解释疼痛，可能有助于深入了解如何改善沟通以增进理解并减轻负面反应。
对在英国或荷兰工作的12名IBD护士（n = 4）和胃肠病学家（n = 8）进行了深入的半结构化访谈。采用反思性主题分析来分析访谈内容。
研究结果表明，当不存在潜在病理情况时，HCPs对疼痛的关注相对较少，更倾向于专注于症状的可客观化原因及治疗疾病活动（此处原文括号内容缺失具体信息）。缓解期腹痛和IBS样症状的解释未标准化（此处原文括号内容缺失具体信息）。概述了共同决策过程，并报告了共同意义建构作为增强对IBS解释接受度的一种策略（此处原文括号内容缺失具体信息）。
未来的工作应聚焦于确定缓解期疼痛的最佳定义方式、在IBD背景下何时诊断IBS以及如何向患者解释这两者。建议制定标准化解释，因为它们可能有助于HCPs采用共同意义建构和共同决策做法。解释应适应特定的症状表现和不同的健康素养水平。
