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ON002. Simple question, simple answer, complex implications: What does a distress thermometer tell us about disease activity and quality of life in IBD patients?

D. Keegan1, K. Byrne1, E. McDermott1, N. Rafter1, G. Cullen1, G. Doherty1, H. Mulcahy1, 1St Vincent's University Hospital, Centre for Colorectal Disease, Dublin, Ireland

Background

Numerous questionnaires have been developed to measure disease activity, quality of life and other biological and psychological aspects of inflammatory bowel diseases (IBD). Many of these are complex and time consuming to complete. However, there is no evidence that a lengthy series of questions within quality of life and other domains effectively captures all the subtle elements of physical and psychological distress experienced by IBD patients.

Aim: To determine if a simple single question using a distress thermometer can serve as a marker for other, more complex, physical and psychological disturbances in IBD patients.

Methods

The study included 441 consecutive patients attending a specialist IBD clinic. Patients completed a questionnaire that included demographic, clinical, validated disease activity and quality of life questionnaires. Patients were also asked to rate distress on an 11 point scale (0–10) using a previously validated “thermometer” initially developed for cancer patients.

Results

Linear regression analysis showed that distress experienced by IBD patients was closely associated with perceived well being in the week leading up to study (p < 0.001). However, distress was also independently and significantly associated with functional status (p = 0.01), symptom severity (p = 0.02), disease activity (p = 0.04) and female gender (p = 0.04) in our patient population.

Conclusion

A number of demographic, clinical and psychological variables are closely and independently linked to perceived distress in IBD patients. A simple distress thermometer may be an effective screening tool to identify patients who would benefit from more in-depth assessment of biological and psychosocial disability during clinic visits.