P160 Do positive psychological factors affect the perception of health-related quality of life in inflammatory bowel disease patients?
M. Lozano Lanagran*1, L. Camacho Martel2, R. Camargo Camero2, J. Lopez Megias3, G. Alcain Martinez2
1Hospital Quiron, Malaga, Spain, 2Hospital Virgen de la Victoria, Malaga, Spain, 3Universidad de Granada, Granada, Spain
To date, there are no studies focusing on positive psychological factors in inflammatory bowel disease (IBD).
The aim of the study was to determine the role of positive psychological factors (optimism, resilience, and emotional intelligence) and disease characteristics in IBD-related QOL.
We carried an observational, cross-sectional study in IBD outpatients from October 2014 to July 2015.
Data including demographics and psychological and disease characteristics were gathered using medical records and validated questionnaires (IBDQ-9 for QOL, Revised Life Orientation Test LOT-R for optimism, Wagnild and Young Resilience scale, and Trait Meta Mood Scale TMMS-24 for emotional intelligence).
Disease activity was determined by the index ‘actual severity’, which consists of the sum of the following: steroid treatment, Harvey index > 6, Walmsley index > 2, fistula, ostomy, anaemia, thrombocytosis, leucocytosis, C-reactive protein > 3.1, surgery, and emergency visit and hospitalisation in the past year.
Predictors of QOL were analysed with univariate and multivariate lineal regression analysis.
In total, 157 outpatients were included. Mean age was 40.4 (SD = 12.4) years; 96 (44%) were female; 95 (60%) had Cohn’s disease (CD), and 62 (40%) had ulcerative colitis (UC).
The mean scores were 43.9 (SD = 10.9) for QOL, 129.8 (SD = 19.6) for resilience, and 19.5 (SD = 3.9) for optimism. There were no significant differences between patients with CD and UC these scores, but the ‘actual severity’ was significantly higher in CD (mean 2.6 in CD, 1.2 in UC, t = 4.8, p < 0.001). In addition, there were differences in QOL between women and men (mean 41.1 and 44.3 respectively, t = 2.7, p = 0.006). The levels of the emotional intelligence dimensions (emotional attention, clarity, and repair) were adequate in almost all patients (86 patients [55%], 88 patients [52%], and 95 patients [60%], respectively).
Using the Spearman test, the following variables correlated with lower QOL: female gender, extraintestinal manifestations, steroid treatment, thrombocytosis, leucocytosis, anaemia, higher Walmsley and Harvey score, emergency visits in the past year, lower optimism, lower resilience, and higher emotional attention.
All of these variables were included in the multivariate analysis. Independent predictors of a lower QOL in CD were female gender (β = -0.28, p = 0.004), lower optimism score (β = 0.25, p = 0.02), higher emotional attention score (β = -0.23, p = 0.02), and higher actual severity (β = -0.27, p = 0.007). In contrast, the only predictor of lower QOL in UC was higher actual severity (β = -0.31, p = 0.01).
Low QOL was prevalent in IBD outpatients and was related to female gender and activity of the disease. Positive factors, such optimism and resilience, positively affect the health-related quality of life in IBD outpatients.