N006 Psychosocial profiles in IBD according to the impairment risk of quality of life

Abstract

Background: The improvement of patients' quality of life (QoL) is the main objective when addressing chronic diseases according to the WHO.1 Predictors of QoL impairment in IBD are multifactorial. 2 However, psychosocial weaknesses are more influential than the physical symptoms of flare-ups and are potentially modifiable.3,4 In line with the European Plan of Action about the promotion of health in chronic diseases,5 it would be beneficial if nurses could classify patients psychosocially to allocate health resources in a preventive and efficient way in the control of QoL, the clinical course and health expenditure.6,7 Our objective was to identify patients profiles with a higher impairment risk of QoL depending on the influence of coping mechanisms and family support. Methods: A cross-sectional correlation study was conducted on a cohort of 181 IBD outpatients, over 16 years. They were consecutively enrolled from digestive outpatient consults at San Juan de Dios Hospital, over 2 years. To measure QoL, clinical activity, family support, coping and other socio-demographic variables, it used IBDQ-36, CDAI, Truelove-witts, family APGAR, Perceived Stress Scale and a socio-demographic questionnaire. (Table presented) The clusters were obtained by K-mean method. Results: Four psychosocial clusters were identified, called CONTROLLED, SUPPORTED, WEAKENED and FRAGILE, in which emotional coping and family support worked as compensatory variables of the negative effect of clinical activity, softening the expected QoL impairment due to clinical symptoms. (Figure presented) Thus, the controlled patients would have low risk of QoL impairment, the supported patients would have mild risk, the weakened patients would have moderate risk and the fragile patients would have severe risk. There was no significant difference in terms of gender or type of IBD. However, to being older was related with the less risk cluster and therefore suggested optimal conditions for maintaining QoL. (Figure presented) Conclusions: Early detection of the psychosocial profile allows the nurse to allocate individual interventions from the diagnosis of IBD, by encouraging improvement of QoL, a stable clinical course and a decreased health cost.