Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
, 25 (3), 159-166

Maladaptive Coping, Low Self-Efficacy and Disease Activity Are Associated With Poorer Patient-Reported Outcomes in Inflammatory Bowel Disease


Maladaptive Coping, Low Self-Efficacy and Disease Activity Are Associated With Poorer Patient-Reported Outcomes in Inflammatory Bowel Disease

Che-Yung Chao et al. Saudi J Gastroenterol.


Background/aims: Patient-reported outcomes (PRO) are key aspects in the management of inflammatory bowel disease (IBD). This study aims to evaluate factors associated with adverse PRO, including modifiable social constructs of maladaptive coping and self-efficacy as well as physician-patient concordance on PRO.

Patients and methods: This cross-sectional study was performed in patients with Crohn's disease (CD) or ulcerative colitis (UC) from September 2015 to March 2016. Validated questionnaires were used to assess quality of life (Short IBD Questionnaire), disability (IBD disability index), productivity (work productivity and activity impairment questionnaire), anxiety/depression (Hospital Anxiety and Depression Scale), coping strategies [Brief Coping Operations Preference Enquiry (Brief COPE)], and self-efficacy (General Self-Efficacy Scale). Independent physician assessment was used to compare concordance with patients.

Results: In all, 207 (CD: 144 and UC: 63) patients, with median age of 39 years, were included, with 42.5% males. Significant proportion of patients reported moderate/severe impairment of disability (30.5%), quality of life (29.4%), productivity (52.4%), anxiety (32.9%) and depression (23.3%). Disease activity and maladaptive coping were independently associated with unfavourable PRO, whereas self-efficacy had a positive effect in multivariate analysis. Physicians could accurately identify the magnitude of PRO impairment in standard clinical settings (r = 0.59-0.65, P < 0.001).

Conclusion: Disease activity and modifiable psychological constructs are associated with unfavorable PRO in patients with IBD. These factors could assist with identifying high-risk patients, many of whom may benefit from targeted interventions to improve health outcomes.

Keywords: Biopsychosocial; inflammatory bowel disease; patient-reported outcomes; physician–patient concordance.

Conflict of interest statement


Comment in

Similar articles

See all similar articles

Cited by 1 PubMed Central articles


    1. Love JR, Irvine EJ, Fedorak RN. Quality of life in inflammatory bowel disease. J Clin Gastroenterol. 1992;14:15–19. - PubMed
    1. Leong RW, Huang T, Ko Y, Jeon A, Chang J, Kohler F, et al. Prospective validation study of the International Classification of Functioning, Disability and Health score in Crohn's disease and ulcerative colitis. J Crohns Colitis. 2014;8:1237–45. - PubMed
    1. Reilly MC, Gerlier L, Brabant Y, Brown M. Validity, reliability, and responsiveness of the work productivity and activity impairment questionnaire in Crohn's disease. Clin Ther. 2008;30:393–404. - PubMed
    1. Zhang CK, Hewett J, Hemming J, Grant T, Zhao H, Abraham C, et al. The influence of depression on quality of life in patients with inflammatory bowel disease. Inflamm Bowel Dis. 2013;19:1732–9. - PMC - PubMed
    1. Feagan BG, Reinisch W, Rutgeerts P, Sandborn WJ, Yan S, Eisenberg D, et al. The effects of infliximab therapy on health-related quality of life in ulcerative colitis patients. Am J Gastroenterol. 2007;102:794–802. - PubMed