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A qualitative study of disease adjustment: inflammatory bowel disease post-traumatic growth

Date

2018

Authors

Bascom, Elise, author
Chavez, Ernest, advisor
Fisher, Gwenith, committee member
Jennings, Louise, committee member
Prince, Mark, committee member

Journal Title

Journal ISSN

Volume Title

Abstract

The current study developed a model of post-traumatic growth to assess the multiphasic, transitional experience of patients diagnosed with inflammatory bowel disease (IBD) by a provider at the Centers for Gastroenterology in Northern Colorado. Specifically, this study examined individuals within the IBD population who have received a diagnosis of either Crohn's disease (CD) or ulcerative colitis (UC). Consensual Qualitative Research (CQR) was used to identify the primary domains and subthemes from six participant interviews. Four large domains were extracted from the data, which were used to construct a model of Inflammatory Bowel Disease Post-Traumatic Growth (IBDPTG). The four, major domains include identity loss/grief, the perception effect, identity reconstruction, and post-traumatic growth (PTG). The original model proposed for this study included all of the aforementioned domains, except for the perception effect. The trained research team involved in this study conducted three meetings to discuss and compare domain/thematic findings. We identified that participants' attitudes/beliefs about their diagnosis was a precursor to progressing to the identity reconstruction phase, and, therefore, needed its own, distinct domain. Subthemes were also identified in each of the four domains, which further captured the nuances and complexities of IBD disease management for our participants. Participants were also asked to complete two sets of the Beck Depression Inventory-II (BDI-II), two sets of the Beck Anxiety Inventory (BAI), one Symptom Checklist 90-R (SCLR-90-R), and the Post-traumatic Growth Inventory (PTGI). Participants were asked to retrospectively complete the first set of self-report questionnaires (BDI-II, BAI, SCL-90-R), as they reflected on their psychological state during their most severe disease experience. We then conducted a semi-structured interview with each participant that lasted approximately 60-75 minutes. After the interview portion of the study, we asked participants to complete the BDI-II and BAI based on their symptom presentation within the last two weeks. We compared the difference between levels of anxiety and depression during active and inactive disease flares. Scores on the BDI-II indicated that participants experienced high levels of depression during severe flares, but that their mood greatly improved with adjustment and mental stability. Scores on the BAI also indicated that the participants experienced higher levels of anxiety during periods of disease relapse, as opposed to periods where their disease was dormant. The SCL-90-R was used to supplement the qualitative data obtained during the interviews. The PTGI was given to the participants at the end of the study to examine whether our qualitative data captured any additional, potentially disease-related growth not yet addressed on the questionnaire. The three subthemes identified in the domain of PTG include: positive personal growth, positive social growth, and positive growth in disease perception.

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Subject

post-traumatic growth
chronic illness
inflammatory bowel disease

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