Activation and perceived expectancies: correlations with health outcomes among veterans with inflammatory bowel disease

J Gen Intern Med. 2009 Jul;24(7):809-15. doi: 10.1007/s11606-009-1002-0. Epub 2009 May 15.


Objective: Inflammatory bowel disease imposes psychosocial stress on the patient. Patients' adaptive capacities may predict quality of life. We examined two adaptive capacity measures and their association with quality of life.

Design: Cross-sectional mail survey of patients with inflammatory bowel disease. The Patient Activation Measure (PAM) assesses knowledge, skill, and confidence in self-health management. The Perceived Expectancies Index (PEI) measures perceived competence and dispositional optimism.

Setting/patients: Four hundred and seventy-seven veterans at VA-Tennessee Valley Healthcare System.

Main outcome measure: Primary outcome was health-related quality of life (measured by the Short Inflammatory Bowel Disease Questionnaire). Bivariate analysis assessed unadjusted correlations. Sequential multivariate linear regression tested theoretical model relationships by calculating the variation in each dependent variable accounted for by independent variables (R-squared statistic).

Results: Two hundred and sixty surveys were returned with usable data (54.5%). Median age was 63 years (range 19-91); 90.8% were men and 86.9% self-identified as white. Fifty percent reported having ulcerative colitis, 36.5% Crohn's disease, and 12.3% uncertain type. Unadjusted bivariate analysis revealed positive correlations between the PAM and PEI and the Short Inflammatory Bowel Disease Questionnaire (correlation coefficient = 0.35 and 0.60, respectively; p < 0.0001). Multivariate model including the PAM accounted for 26% of the variation in Short Inflammatory Bowel Disease Questionnaire scores, while the model including the PEI accounted for 50% (p < 0.0001).

Conclusions: There are positive, highly significant correlations between adaptive capacities and health-related quality of life in patients with inflammatory bowel disease.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adaptation, Psychological*
  • Adult
  • Aged
  • Aged, 80 and over
  • Cross-Sectional Studies
  • Female
  • Health Surveys
  • Humans
  • Inflammatory Bowel Diseases*
  • Kentucky
  • Linear Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Outcome Assessment, Health Care*
  • Psychometrics
  • Quality of Life*
  • Social Perception*
  • Statistics as Topic
  • Statistics, Nonparametric
  • Stress, Psychological*
  • Surveys and Questionnaires
  • Tennessee
  • United States
  • Veterans*