Patient Health Communication Mediating Effects Between Gastrointestinal Symptoms and Gastrointestinal Worry in Pediatric Inflammatory Bowel Disease

被引：18

作者：

Varni, James W. ^{[1
,2
]}

Shulman, Robert J. ^{[3
]}

Self, Mariella M. ^{[4
,5
]}

Saeed, Shehzad A. ^{[6
,7
]}

Patel, Ashish S. ^{[9
]}

Nurko, Samuel ^{[10
]}

Neigut, Deborah A. ^{[11
]}

Saps, Miguel ^{[12
,13
]}

Zacur, George M. ^{[6
,8
]}

Dark, Chelsea V. ^{[14
,15
]}

Bendo, Cristiane B. ^{[16
]}

Pohl, John F. ^{[17
]}

机构：

[1] Texas A&M Univ, Coll Med, Dept Pediat, College Stn, TX 77843 USA

[2] Texas A&M Univ, Coll Architecture, Dept Landscape Architecture & Urban Planning, College Stn, TX 77843 USA

[3] Texas Childrens Hosp, Baylor Coll Med, Childrens Nutr Res Ctr, Dept Pediat, Houston, TX 77030 USA

[4] Texas Childrens Hosp, Baylor Coll Med, Dept Psychiat, Houston, TX 77030 USA

[5] Texas Childrens Hosp, Baylor Coll Med, Dept Pediat, Houston, TX 77030 USA

[6] Cincinnati Childrens Hosp Med Ctr, Div Gastroenterol Hepatol & Nutr, Cincinnati, OH 45229 USA

[7] Wright State Univ, Dayton Childrens Hosp, Div Pediat Gastroenterol, Dayton, OH 45435 USA

[8] Univ Michigan, CS Mott Childrens Hosp, Div Pediat Gastroenterol, Ann Arbor, MI 48109 USA

[9] Univ Texas Southwestern Med Sch, Childrens Med Ctr Dallas, Div Pediat Gastroenterol, Dallas, TX USA

[10] Harvard Med Sch, Boston Childrens Hosp, Ctr Motil & Funct Gastrointestinal Disorders, Boston, MA USA

[11] Childrens Hosp Colorado, Div Gastroenterol Hepatol & Nutr, Aurora, CO USA

[12] Northwestern Univ, Feinberg Sch Med, Lurie Childrens Hosp Chicago, Div Gastroenterol Hepatol & Nutr, Chicago, IL 60611 USA

[13] Ohio State Univ, Nationwide Childrens Hosp, Div Digest Dis Hepatol & Nutr, Columbus, OH 43210 USA

[14] Texas A&M Univ, Dept Psychol, College Stn, TX 77843 USA

[15] Childrens Med Ctr, Div Pediat Pulmonol, Dallas, TX 75235 USA

[16] Univ Fed Minas Gerais, Fac Dent, Dept Pediat Dent & Orthodont, Belo Horizonte, MG, Brazil

[17] Univ Utah, Primary Childrens Hosp, Dept Pediat Gastroenterol, Salt Lake City, UT USA

来源：

INFLAMMATORY BOWEL DISEASES | 2017年 / 23卷 / 05期

关键词：

inflammatory bowel disease; Crohn's disease; ulcerative colitis; gastrointestinal symptoms; worry; patient communication; PedsQL; QUALITY-OF-LIFE; FUNCTIONAL ABDOMINAL-PAIN; IBS-LIKE SYMPTOMS; ULCERATIVE-COLITIS; ACTIVITY INDEX; FOLLOW-UP; CHILDREN; ANXIETY; SCALES; UNCERTAINTY;

D O I：

10.1097/MIB.0000000000001077

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background: To investigate the effects of patient health communication regarding their inflammatory bowel disease (IBD) to their health care providers and significant others in their daily life as a mediator in the relationship between gastrointestinal symptoms and gastrointestinal worry in pediatric patients. Methods: The Pediatric Quality of Life Inventory Gastrointestinal Symptoms, GastrointestinalWorry, and Communication Scales, and Pediatric Quality of Life Inventory 4.0 Generic Core Scales were completed in a 9-site study by 252 pediatric patients with IBD. Gastrointestinal Symptoms Scales measuring stomach pain, constipation, or diarrhea and patient communication were tested for bivariate and multivariate linear associations with Gastrointestinal Worry Scales specific to patient worry about stomach pain or bowel movements. Mediational analyses were conducted to test the hypothesized mediating effects of patient health communication as an intervening variable in the relationship between gastrointestinal symptoms and gastrointestinal worry. Results: The predictive effects of gastrointestinal symptoms on gastrointestinal worry were mediated in part by patient health communication with health care providers/significant others in their daily life. In predictive models using multiple regression analyses, the full conceptual model of demographic variables, gastrointestinal symptoms (stomach pain, constipation, or diarrhea), and patient communication significantly accounted for 46, 43, and 54 percent of the variance in gastrointestinal worry (all P-s < 0.001), respectively, reflecting large effect sizes. Conclusions: Patient health communication explains in part the effects of gastrointestinal symptoms on gastrointestinal worry in pediatric patients with IBD. Supporting patient disease-specific communication to their health care providers and significant others may improve health-related quality of life for pediatric patients with IBD.

引用

页码：704 / 711

页数：8

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