Self-Efficacy, Patient Activation, and the Burden of Inflammatory Bowel Disease on Patients’ Daily Lives

• Published in: Digestive diseases and sciences 2024-11, Vol.69 (11), p.4089-4097
• Main Authors: Sheehan, Jessica L., Greene-Higgs, LaVana, Resnicow, Kenneth, Patel, Minal R., Barnes, Edward L., Waljee, Akbar K., Higgins, Peter D. R., Cohen-Mekelburg, Shirley
• Format: Article
• Language: English
• Subjects: Activities of Daily Living; Adult; Aged; Biochemistry; Colitis, Ulcerative - psychology; Colitis, Ulcerative - therapy; Cost of Illness; Crohn Disease - psychology; Crohn Disease - therapy; Female; Gastroenterology; Hepatology; Humans; Inflammatory Bowel Diseases - psychology; Inflammatory Bowel Diseases - therapy; Male; Medicine; Medicine & Public Health; Middle Aged; Oncology; Original Article; Patient Participation - psychology; Patient Reported Outcome Measures; Self Efficacy; Self-Management - psychology; Surveys and Questionnaires; Transplant Surgery
• ISSN: 0163-2116; 1573-2568; 1573-2568
• DOI: 10.1007/s10620-024-08712-2

Background The effective management of inflammatory bowel disease (IBD) requires complex self-management behaviors. Both patient activation (the degree to which patients are willing and able to engage in care) and self-efficacy (one’s confidence in performing certain behaviors) are thought to play an important role in chronic disease self-management, but patient activation is a broad concept that can be more difficult to precisely target than self-efficacy. We aimed to describe the relationship between patient activation, self-efficacy, and the burden of IBD on patients’ daily lives. Methods Patients with IBD were recruited from a single center to complete a survey including the Patient Activation Measure (PAM-13®), the IBD Self-Efficacy Scale (IBD-SES), and an IBD-specific patient-reported outcome measure. Using multivariable linear regression, we examined the relationship between IBD burden, self-efficacy, and patient activation, adjusting a priori for age, gender, IBD type, IBD medications, active corticosteroid use, anxiety, and depression. We performed a post-hoc mediation analysis to examine self-efficacy as a potential mediator in the relationship between patient activation and the burden of IBD on patient’s daily lives. Results A total of 132 patients with IBD completed the survey (59% Crohn’s disease, 41% ulcerative colitis, 52% female). Higher levels of patient activation and higher levels of self-efficacy were each associated with lower IBD burden (patient activation: ß = − 1.9, p