Skip to main content

Welkom bij THIM Hogeschool voor Fysiotherapie & Bohn Stafleu van Loghum

THIM Hogeschool voor Fysiotherapie heeft ervoor gezorgd dat je Mijn BSL eenvoudig en snel kunt raadplegen. Je kunt je links eenvoudig registreren. Met deze gegevens kun je thuis, of waar ook ter wereld toegang krijgen tot Mijn BSL. Heb je een vraag, neem dan contact op met helpdesk@thim.nl.

Registreer

Om ook buiten de locaties van THIM, thuis bijvoorbeeld, van Mijn BSL gebruik te kunnen maken, moet je jezelf eenmalig registreren. Dit kan alleen vanaf een computer op een van de locaties van THIM.

Eenmaal geregistreerd kun je thuis of waar ook ter wereld onbeperkt toegang krijgen tot Mijn BSL.

Login

Als u al geregistreerd bent, hoeft u alleen maar in te loggen om onbeperkt toegang te krijgen tot Mijn BSL.

Top

26-11-2024

Understanding diagnostic delays and health outcomes for inflammatory bowel disease: a mixed-methods study of patients’ perspectives

Auteurs: R. J. Purc-Stephenson, Keely Blake

Gepubliceerd in: Quality of Life Research

Log in om toegang te krijgen
share
DELEN

Deel dit onderdeel of sectie (kopieer de link)

  • Optie A:
    Klik op de rechtermuisknop op de link en selecteer de optie “linkadres kopiëren”
  • Optie B:
    Deel de link per e-mail

Abstract

Purpose

Inflammatory bowel disease (IBD) is a chronic condition affecting the digestive system with symptoms that are often episodic, unpredictable, socially stigmatizing, and impact quality of life. While a timely diagnosis reduces the risk of complications and improves health outcomes, diagnostic delays (DDs) are common. Our study used narratives and data from patient-reported outcome measures (PROMs) of individuals diagnosed with IBD to examine: (1) What factors helped or hindered achieving a timely diagnosis of IBD? and (2) how do DDs relate to PROMs?

Methods

We conducted a mixed-methods study of 296 individuals diagnosed with IBD in Canada. The survey included a set of validated measures that assessed depression, fatigue, satisfaction with life, disease severity, and several open-ended questions.

Results

Thematic analysis of open-ended responses revealed five themes that highlighted the ways a diagnosis was delayed or facilitated: symptom ambiguity, fear and denial, patient-provider communication breakdown, misdiagnosis and self-doubt, and self-advocacy. Quantitative findings revealed that a longer time to receive a diagnosis was significantly correlated with higher levels of depression (r = .26) and fatigue (r = .25), reduced satisfaction with life (r =  − .25), and greater disease severity (r =  − .22). We used the data to generate a framework called the Diagnostic Pathways Model to illustrate the diagnostic process of a chronic disease such as IBD.

Conclusion

DDs involve the interacting roles of patient, medical, and communication factors, and a DD can negatively impact a patient’s quality of life. Implications for physician–patient communication and public information are discussed.
Bijlagen
Alleen toegankelijk voor geautoriseerde gebruikers
Literatuur
3.
go back to reference Frolkis, A. D., Dykeman, J., Negrón, M. E., deBruyn, J., Jette, N., Fiest, K. M., Frolkis, T., Barkema, H. W., Rioux, K., Panaccione, R., Gosh, S., Wiebe, S., & Kaplan, G. (2013). Risk of surgery for inflammatory bowel diseases has decreased over time: A systematic review and meta-analysis of population-based studies. Gastroenterology, 145(5), 996–1006. https://doi.org/10.1053/j.gastro.2013.07.041CrossRefPubMed Frolkis, A. D., Dykeman, J., Negrón, M. E., deBruyn, J., Jette, N., Fiest, K. M., Frolkis, T., Barkema, H. W., Rioux, K., Panaccione, R., Gosh, S., Wiebe, S., & Kaplan, G. (2013). Risk of surgery for inflammatory bowel diseases has decreased over time: A systematic review and meta-analysis of population-based studies. Gastroenterology, 145(5), 996–1006. https://​doi.​org/​10.​1053/​j.​gastro.​2013.​07.​041CrossRefPubMed
6.
go back to reference Qualter, P., Rouncefield-Swales, A., Bray, L., Blake, L., Allen, S., Probert, C., Crook, K., & Carter, B. (2021). Depression, anxiety, and loneliness among adolescents and young adults with IBD in the UK: The role of disease severity, age of onset, and embarrassment of the condition. Quality of Life Research, 30, 497–506. https://doi.org/10.1007/s11136-020-02653-9CrossRefPubMed Qualter, P., Rouncefield-Swales, A., Bray, L., Blake, L., Allen, S., Probert, C., Crook, K., & Carter, B. (2021). Depression, anxiety, and loneliness among adolescents and young adults with IBD in the UK: The role of disease severity, age of onset, and embarrassment of the condition. Quality of Life Research, 30, 497–506. https://​doi.​org/​10.​1007/​s11136-020-02653-9CrossRefPubMed
9.
go back to reference Walker, G., Lin, S., Chanchlani, N., Thomas, A., Hendy, P., Heerasing, N., Moore, L., Green, H. D., Chee, D., Bewshea, C., Mays, J., Kennedy, N., Ahmad, T., & Goodhand, J. (2020). Quality improvement project identifies factors associated with delay in IBD diagnosis. Alimentary Pharmacology & Therapeutics, 52(3), 471–480. https://doi.org/10.1111/apt.15885CrossRef Walker, G., Lin, S., Chanchlani, N., Thomas, A., Hendy, P., Heerasing, N., Moore, L., Green, H. D., Chee, D., Bewshea, C., Mays, J., Kennedy, N., Ahmad, T., & Goodhand, J. (2020). Quality improvement project identifies factors associated with delay in IBD diagnosis. Alimentary Pharmacology & Therapeutics, 52(3), 471–480. https://​doi.​org/​10.​1111/​apt.​15885CrossRef
13.
go back to reference Gamwell, K., Baudino, M., Bakula, D., Sharkey, C., Roberts, C., Grunow, J., Jacobs, N., Gillaspy, S., Mullins, L., & Chaney, J. M. (2018). Perceived illness stigma, thwarted belongingness, and depressive symptoms in youth with inflammatory bowel disease (IBD). Inflammatory Bowel Diseases, 24(5), 960–965. https://doi.org/10.1093/ibd/izy011CrossRefPubMed Gamwell, K., Baudino, M., Bakula, D., Sharkey, C., Roberts, C., Grunow, J., Jacobs, N., Gillaspy, S., Mullins, L., & Chaney, J. M. (2018). Perceived illness stigma, thwarted belongingness, and depressive symptoms in youth with inflammatory bowel disease (IBD). Inflammatory Bowel Diseases, 24(5), 960–965. https://​doi.​org/​10.​1093/​ibd/​izy011CrossRefPubMed
30.
36.
go back to reference Hart, A. L., Lomer, M., Verjee, A., Kemp, K., Faiz, O., Daly, A., Solomon, J., & McLaughlin, J. (2017). What are the top 10 research questions in the treatment of inflammatory bowel disease? A priority setting partnership with the James Lind alliance. Journal of Crohn’s and Colitis, 11(2), 204–211. https://doi.org/10.1093/ecco-jcc/jjw144CrossRefPubMed Hart, A. L., Lomer, M., Verjee, A., Kemp, K., Faiz, O., Daly, A., Solomon, J., & McLaughlin, J. (2017). What are the top 10 research questions in the treatment of inflammatory bowel disease? A priority setting partnership with the James Lind alliance. Journal of Crohn’s and Colitis, 11(2), 204–211. https://​doi.​org/​10.​1093/​ecco-jcc/​jjw144CrossRefPubMed
37.
go back to reference Rowse, G., Hollobone, S., Afhim, S., & Oliver, P. (2019). DOP30 Factors associated with life satisfaction in people with Crohn’s disease and ulcerative colitis: Results from the national 2018 Crohn’s and Colitis UK Inflammatory Bowel Disease Quality of Life Survey. Journal of Crohn’s and Colitis, 13(Supplement 1), S042–S043. https://doi.org/10.1093/ecco-jcc/jjy222.064CrossRef Rowse, G., Hollobone, S., Afhim, S., & Oliver, P. (2019). DOP30 Factors associated with life satisfaction in people with Crohn’s disease and ulcerative colitis: Results from the national 2018 Crohn’s and Colitis UK Inflammatory Bowel Disease Quality of Life Survey. Journal of Crohn’s and Colitis, 13(Supplement 1), S042–S043. https://​doi.​org/​10.​1093/​ecco-jcc/​jjy222.​064CrossRef
39.
go back to reference Creswell, J. W. (2003). Research design: Qualitative, quantitative, and mixed methods approaches (2nd ed.). Sage Publications. Creswell, J. W. (2003). Research design: Qualitative, quantitative, and mixed methods approaches (2nd ed.). Sage Publications.
40.
go back to reference Salmons, J. (2014). Qualitative online interviews: Strategies, design, and skills. Sage Publications.CrossRef Salmons, J. (2014). Qualitative online interviews: Strategies, design, and skills. Sage Publications.CrossRef
41.
go back to reference Von Elm, E., Altman, D. G., Egger, M., Pocock, S. J., Gøtzsche, P. C., & Vandenbroucke, J. P. (2007). The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies. The Lancet, 370(9596), 1453–1457.CrossRef Von Elm, E., Altman, D. G., Egger, M., Pocock, S. J., Gøtzsche, P. C., & Vandenbroucke, J. P. (2007). The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies. The Lancet, 370(9596), 1453–1457.CrossRef
45.
go back to reference Irvine, E. J., Zhou, Q., & Thompson, A. K. (1996). The Short Inflammatory Bowel Disease Questionnaire: A quality of life instrument for community physicians managing inflammatory bowel disease. American Journal of Gastroenterology, 91(8), 1571–1578.PubMed Irvine, E. J., Zhou, Q., & Thompson, A. K. (1996). The Short Inflammatory Bowel Disease Questionnaire: A quality of life instrument for community physicians managing inflammatory bowel disease. American Journal of Gastroenterology, 91(8), 1571–1578.PubMed
47.
go back to reference Faul, F., Erdfelder, E., Lang, A. G., & Buchner, A. (2007). G* Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39(2), 175–191.CrossRefPubMed Faul, F., Erdfelder, E., Lang, A. G., & Buchner, A. (2007). G* Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39(2), 175–191.CrossRefPubMed
48.
go back to reference Colaizzi, R. (1978). Psychological research as the phenomenologist views it. In R. Vale & M. King (Eds.), Existential-phenomenological alternatives for psychology (pp. 48–71). Oxford University Press. Colaizzi, R. (1978). Psychological research as the phenomenologist views it. In R. Vale & M. King (Eds.), Existential-phenomenological alternatives for psychology (pp. 48–71). Oxford University Press.
50.
go back to reference McCormick, J. B., Hammer, R. R., Farrell, R. M., Geller, G., James, K. M., Loftus, E. V., Mercer, M. B., Tilburt, J. C., & Sharp, R. R. (2012). Experiences of patients with chronic gastrointestinal conditions: In their own words. Health and Quality of Life Outcomes, 10(1), 1–11. https://doi.org/10.1186/1477-7525-10-25CrossRef McCormick, J. B., Hammer, R. R., Farrell, R. M., Geller, G., James, K. M., Loftus, E. V., Mercer, M. B., Tilburt, J. C., & Sharp, R. R. (2012). Experiences of patients with chronic gastrointestinal conditions: In their own words. Health and Quality of Life Outcomes, 10(1), 1–11. https://​doi.​org/​10.​1186/​1477-7525-10-25CrossRef
55.
go back to reference Barello, S., Guida, E., Leone, S., Previtali, E., & Graffigna, G. (2021). Does patient engagement affect IBD patients’ health-related quality of life? Findings from a cross-sectional study among people with inflammatory bowel diseases. Health and Quality of Life Outcomes, 19, 1–9. https://doi.org/10.1186/s12955-021-01724-wCrossRef Barello, S., Guida, E., Leone, S., Previtali, E., & Graffigna, G. (2021). Does patient engagement affect IBD patients’ health-related quality of life? Findings from a cross-sectional study among people with inflammatory bowel diseases. Health and Quality of Life Outcomes, 19, 1–9. https://​doi.​org/​10.​1186/​s12955-021-01724-wCrossRef
59.
go back to reference Nguyen, G. C., Bouchard, S., & Diong, C. (2019). Promoting Access and Care through Centres of Excellence (PACE) Network. Access to specialists and emergency department visits in inflammatory bowel disease: A population-based study. Journal of Crohns & Colitis, 13, 330–336. https://doi.org/10.1093/ecco-jcc/jjy161CrossRef Nguyen, G. C., Bouchard, S., & Diong, C. (2019). Promoting Access and Care through Centres of Excellence (PACE) Network. Access to specialists and emergency department visits in inflammatory bowel disease: A population-based study. Journal of Crohns & Colitis, 13, 330–336. https://​doi.​org/​10.​1093/​ecco-jcc/​jjy161CrossRef
Metagegevens
Titel
Understanding diagnostic delays and health outcomes for inflammatory bowel disease: a mixed-methods study of patients’ perspectives
Auteurs
R. J. Purc-Stephenson
Keely Blake
Publicatiedatum
26-11-2024
Uitgeverij
Springer New York
Gepubliceerd in
Quality of Life Research
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-024-03852-4