Is a Self-Management Process Effective in Young Adults With IBS?

young girl with stomach pain,
Researchers assessed whether a nurse-led self-management program would help young adults with irritable bowel syndrome.

Both self-guided and nurse-led online educational modules provided pain relief and improved quality of life (QOL) for young adults with irritable bowel syndrome (IBS), while the nurse-led modules also reduced anxiety, according to study findings published in the International Journal of Nursing Studies.

Researchers enrolled 80 young adults diagnosed with IBS from 2 public universities and 2 gastroenterology clinics and randomly assigned them to 2 groups: 41 to the self-guided online learning module group and 39 to the nurse-led online module group. All participants received 10 self-guided online learning modules, while those in the nurse-led group received an additional 3 one-on-one consultations with a nurse in addition to the modules.

The online modules were each approximately 15 minutes long, educating the patients about the brain-gut axis, IBS triggers, self-management strategies, such as progressive muscle relaxation, guided imagery, mindfulness, belly breathing, pain problem-solving, and strong encouragement to increase physical activity levels. The researchers could monitor if the patients clicked the link to view the video, but they had no way of knowing if they watched the video in its entirety.

Three 30-minute nurse consultations were conducted by phone following participant completion of the online videos and the last 2 data collections. Patients also kept an online diary of their IBS-related symptoms, food intake, stool patterns per the Bristol stool scale, and physical activities — all recorded through an automated link for the researchers’ review.

The researchers collected self-reported data at baseline, week 6, and week 12 regarding:

  • pain using the Brief Pain Inventory (BPI)
  • symptoms such as anxiety, depression, sleep disturbance, and fatigue using the National Institutes of Health Patient-Reported Outcomes Measurement Information System
  • QOL using a 34-item IBS specific QOL questionnaire
  • self-efficacy using the 6-item Self-Efficacy for Managing Chronic Disease (SEMCD)
  • and coping strategies using the Coping Strategies Questionnaire-Revised (CSQ-R)

Both groups reported significantly improved QOL and decreased pain intensity and interference after 12 weeks of intervention (P <.05). Patients in the nurse-led group also demonstrated decreased anxiety (P =.016) and significantly greater QOL improvements (P =.040) compared with the self-guided group.

Improved self-efficacy led to improvements in the nurse-led group, whereas the self-led group improved by reducing catastrophizing — an inefficient coping strategy, according to the researchers.

“This study showed that both the pain self-management online education and nurse-led intervention were effective for alleviating pain and improving [QOL] among young adults with [IBS] by targeting the self-management process,” the study authors concluded.

Study limitations included restriction of the study only to those with internet access, lack of generalizability due to lack of ethnic diversity in the study, and lack of ability to determine patient adherence to watching the online modules completely.

Reference

Chen J, Zhang Y, Barandouzi ZA, et al. The effect of self-management online modules plus nurse-led support on pain and quality of life among young adults with irritable bowel syndrome: a randomized controlled trial. Int J Nurs Stud. Published online April 30, 2022:104278. doi:10.1016/j.ijnurstu.2022.104278