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P553. Coping strategies for worsening conditions and their perceived effectiveness in patients with inflammatory bowel disease

M. Tanaka1, A. Kawakami1, Y. Iwao2, T. Fukushima3, M. Nishigaki1, M. Suzuki1, H. Sanada1, N. Yamamoto-Mitani1, 1The University of Tokyo, School of Health Sciences and Nursing, Tokyo, Japan, 2Keio University School of Medicine, Center for Preventive Medicine, Tokyo, Japan, 3Matsushima Clinic, Yokohama, Japan

Background

Although self-management is important for patients with inflammatory bowel disease (IBD), there is little research focusing on their coping strategies, especially in worsening conditions. This study aimed to investigate coping strategies of IBD patients for worsening conditions and their perceived effectiveness.

Methods

Questionnaires were mailed to 1,641 members of the Crohn's and Colitis Foundation of Japan. A questionnaire containing 11 types of coping strategies for worsening conditions was developed based on interviews to patients with IBD. We investigated how many used each strategy in a four-point Likert-scale, and recoded it into “uses the strategy” or not. Perceived effectiveness of each coping strategy for worsening conditions was asked, by effective or not, to those who answered that he/she used that strategy. The responses were described by disease group.

Results

A total of 426 (response rate 26%) questionnaires were returned. Data from 260 UC patients (age mean±SD = 47.2±17.1) and 140 CD patients (41.3±12.5) were used. The strategies used by more than half of both patients were “change contents of meals” (UC: 85.8%, CD: 93.6%), “get more sleep” (UC: 77.3%, CD: 82.1%), “see a doctor immediately without waiting for the next appointment” (UC: 73.1%, CD: 67.1%), and “take a day off” (UC: 57.7%, CD: 65.7%). In addition, “skip some meals” (81.4%), and “take/add elemental diet” (63.6%) were characteristically used by CD patients. “Use extra topical corticosteroids” were used by 21.5% of UC patients. Among subjects who used a strategy, strategies with high percentages of perceived effectiveness were “use extra topical corticosteroids” (53.6%) for UC, while “skip some meals” (61.4%) and “take/add elemental diet” (59.6%) were used by CD patients. As many as 35.4% of patients with UC and 20.7% of CD answered “there is no effective coping strategy”.

Conclusion

The additional use of topical medication and elemental diet were regarded as the most effective self-treatment. However, the number of patients who used these treatments was relatively small from those who merely modified their lifestyle. The effectiveness of the additional use of topical medication for UC patients and elemental diet for CD patients should be emphasized in patient education for self-management.

Financial Disclosure: This work was supported by a Grant-in-Aid for Young Scientists (B) (22792175), Tokyo, Japan.