P134 Illness perceptions and outcomes in patients with inflammatory bowel disease: is coping a mediator?
S. van Erp*1, L. Brakenhoff1, M. Vollmann2, 3, D. van der Heijde4, R. Veenendaal1, H. Fidder5, D. Hommes1, 6, A. Kaptein7, A. van der Meulen- de Jong1, M. Scharloo7
1Leiden University Medical Centre, Gastroenterology and Hepatology, Leiden, Netherlands, 2University of Hagen, Health Psychology, Hagen, Germany, 3University of Utrecht, Clinical and Health Psychology, Utrecht, Netherlands, 4Leiden University Medical Centre, Rheumatology, Leiden, Netherlands, 5University Medical Centre Utrecht, Gastroenterology and Hepatology, Utrecht, Netherlands, 6UCLA Health System, Centre for Inflammatory Bowel Diseases, Los Angeles, California, United States, 7Leiden University Medical Centre, Medical Psychology, Leiden, Netherlands
Patients with inflammatory bowel disease (IBD) often experience severe impairment in different life domains. Psychological factors, such as illness perceptions and coping, may play a role in adjustment to IBD. The purpose of the present study was to examine the assumption of the Common Sense Model (CSM) that coping mediates the relationship between illness perceptions and adjustment in patients with IBD.
In a cross-sectional design, 211 patients (73% Crohn’s disease, 40% male, and mean age 42.9 ± 12.9 years) attending an outpatient clinic completed questionnaires assessing illness perceptions (IPQ-R), coping (CORS), mental and physical health (SF-36), and daily activity and work impairment (WPAI). Multiple mediation analyses that allow estimating the total and direct effects of all illness perception dimensions and the indirect effects through all coping strategies on the illness outcomes simultaneously were used.
The analyses yielded significant direct effects of the illness perception dimensions ‘timeline cyclical’, ‘timeline chronic’, ‘consequences’, ‘illness coherence’, and ‘emotional representations’ on study outcomes. Additionally, significant indirect effects were found for ‘consequences’, ‘personal control’, and ‘coherence’ on mental and physical health and activity impairment through the use of the coping strategy ‘decreasing activity’.
Figure 1. Results of the 4 mediation analyses.
The results provide evidence for the assumptions of the CSM and suggest the importance of addressing illness perceptions and the coping strategy ‘decreasing activity’ in quality health care for IBD.