Disease acceptance, but not perceived control, is uniquely associated with inflammatory bowel disease-related disability
Anouk Teugels, Ilse van den Eijnden, Bep Keersmaekers, Bram Verstockt, João Sabino, Séverine Vermeire, Livia Guadagnoli, Ilse Van Diest, Marc Ferrante- Gastroenterology
- General Medicine
Abstract
Background and Aims
Disability, an important aspect of disease burden in patients with inflammatory bowel disease (IBD), has been suggested as a valuable clinical endpoint. We aimed to investigate how disease acceptance and perceived control, two psychological predictors of subjective health, are associated with IBD-related disability.
Methods
In this cross-sectional study, adult IBD patients from the University Hospitals Leuven received a survey with questions about clinical and demographic characteristics, disease acceptance and perceived control (Subjective Health Experience model questionnaire), and IBD-related disability (IBD Disk). Multiple linear regressions assessed predictors of IBD-related disability in the total sample and in the subgroups of patients in clinical remission or with active disease.
Results
In the total sample (N = 1250, 54.2% female, median [IQR] age 51 [39-61] years, 61.3% Crohn’s disease, 34.9% active disease), adding the psychological predictors to the model resulted in an increased explained variance in IBD-related disability of 19% compared to a model with only demographic and clinical characteristics (R2adj 38% vs. 19%, p<.001). The increase in explained variance was higher for patients in clinical remission (ΔR2adj 20%, p<.001) compared to patients with active disease (ΔR2adj 10%, p<.001). Of these predictors, disease acceptance was most strongly associated with disability in the total sample (β=-0.44, p<.001), as well as in both subgroups (β=-0.47, p<.001 and β=-0.31, p<.001 respectively). Perceived control was not significantly associated with disability when accounting for all other predictors.
Conclusions
Disease acceptance is strongly associated with IBD-related disability, supporting further research into disease acceptance as a treatment target.