Gattoni Marina Francesca, Previtali Enrica, Leone Salvatore, Amore Alessia, Volpato Eleonora
University of Florence, Florence, Italy.
IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy.
Therap Adv Gastroenterol. 2025 Feb 19;18:17562848251314796. doi: 10.1177/17562848251314796. eCollection 2025.
Crohn's disease (CD) is a chronic autoimmune inflammatory bowel disease. It is estimated that approximately 40% of individuals with CD are non-adherent to medical prescriptions. This lack of adherence to treatment plans has been linked to an increased risk of hospitalisation and surgical procedures, which can have a detrimental impact on the patient's quality of life (QoL). Furthermore, the CD can impose significant stress on individuals, affecting their mental health and sense of mastery. The term 'mastery' is used to describe an individual's awareness of their abilities and capacities that are essential for effectively managing life events and situations.
This study aimed to investigate the role of mastery in relation to medical adherence, distress, perceived social support, QoL, depressive and anxious symptoms and interoception in persons with a diagnosis of CD.
This is a cross-sectional study, involving 261 adults diagnosed with CD.
Participants completed an online questionnaire comprising validated clinical and psychological scales, which lasted approximately 20 min. Participants were permitted to provide their most recently available medical report.
Patients with CD reported discrete levels of mastery. Two factorial ANOVA highlighted statistically significative differences in mastery in relation to clinical conditions ((2, 253) = 11.22, < 0.001) and a significative interaction effect between gender and symptomatology ((2, 253) = 7.22, < 0.001). Multiple linear regression illustrated a statistically significant association between mastery, clinical conditions, QoL, stress and interoception (adjusted square = 0.558; (14, 211) = 21.32, < 0.001). Concerning the possible mediator role of mastery between psychological state and medical adherence, no statistically significant results emerged from the mediation model analysis.
This study highlighted an effective impairment of mastery in CD patients, especially among men experiencing mild disease activity. A positive association between mastery and enteroception was outlined. The higher prevalence of distress, anxiety and depressive symptoms connected to mastery was substantiated. Future research should deepen the relationship between mastery with medical adherence.
克罗恩病（CD）是一种慢性自身免疫性炎症性肠病。据估计，约40%的CD患者不遵医嘱。这种对治疗方案的不依从与住院和手术风险增加有关，这可能对患者的生活质量（QoL）产生不利影响。此外，CD会给个人带来巨大压力，影响他们的心理健康和掌控感。“掌控感”一词用于描述个人对其能力的认知，这些能力对于有效应对生活事件和情况至关重要。
本研究旨在调查掌控感在确诊为CD的患者的医疗依从性、痛苦、感知到的社会支持、生活质量、抑郁和焦虑症状以及内感受方面所起的作用。
这是一项横断面研究，涉及261名被诊断为CD的成年人。
参与者完成了一份包含经过验证的临床和心理量表的在线问卷，该问卷大约持续20分钟。参与者被允许提供他们最近的医疗报告。
CD患者报告了不同程度的掌控感。双因素方差分析突出显示，在掌控感方面，与临床状况相关存在统计学显著差异（(2, 253) = 11.22，< 0.001），并且性别与症状之间存在显著的交互作用（(2, 253) = 7.22，< 0.001）。多元线性回归表明，掌控感、临床状况、生活质量、压力和内感受之间存在统计学显著关联（调整后R方 = 0.558；(14, 211) = 21.32，< 0.001）。关于掌控感在心理状态和医疗依从性之间可能的中介作用，中介模型分析未得出统计学显著结果。
本研究强调了CD患者，尤其是疾病活动较轻的男性患者，在掌控感方面存在有效损害。概述了掌控感与内感受之间的正相关关系。证实了与掌控感相关的痛苦、焦虑和抑郁症状的较高患病率。未来的研究应深入探讨掌控感与医疗依从性之间的关系。
