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Desperately seeking a cure: Treatment seeking and appraisal in irritable bowel syndrome

Desperately seeking a cure: Treatment seeking and appraisal in irritable bowel syndrome
Desperately seeking a cure: Treatment seeking and appraisal in irritable bowel syndrome

Objectives: Irritable bowel syndrome (IBS) is common and adversely affects patients' quality of life. Multiple potential treatment options exist for patients (and clinicians) to choose from, with limited evidence to inform treatment selection. The aim was to explore how patients with IBS go about seeking and appraising different treatment modalities, with a view to elucidating the psychological processes involved and identifying opportunities to improve clinical practice. Design: Qualitative study nested within a randomized controlled trial of therapist-delivered and web-based cognitive behavioural therapy versus treatment-as-usual for IBS. Methods: A total of 52 people participated in semi-structured interviews about their prior experiences of treatments for IBS. Transcripts were analysed using inductive thematic analysis. Results: Key themes (desperation for a cure, disappointment at lack of cure, appraising the effects of diverse treatments, and hope for positive effects) clustered around an overarching theme of being trapped within a vicious cycle of hope and despair on treatment seeking. A desperation and willingness drove interviewees to try any treatment modality available that might potentially offer relief. Coming to accept there is no cure for IBS helped interviewees escape the vicious cycle. Treatments were appraised for their effects on symptoms and quality of life while also considering, but rarely prioritizing, other aspects including convenience of the regimen itself, whether it addressed the perceived root causes of IBS, perceived side-effects, and cost. Conclusion: Treatment seeking in IBS can be challenging for patients. Supportive discussions with health care professionals about illness perceptions, treatment beliefs, and goals could improve patients' experiences. Statement of contribution: What is already known on this subject? Irritable bowel syndrome (IBS) is a highly prevalent chronic relapsing functional gastrointestinal disorder. Studies show few treatment modalities provide complete symptom relief. IBS is associated with emotional and physical distress, and negatively impacts personal, social, and professional aspects of quality of life. What does this study add? Patients appraise IBS treatments for impact on quality of life and treatment characteristics. Developing acceptance and coping strategies helps escape treatment-seeking vicious cycles of hope and despair. Clinicians could better support patients by discussing their illness perceptions, treatment goals, and values.

Attitude to health, Irritable bowel syndrome, Qualitative methods, Treatment beliefs
1359-107X
Harvey, J. Matthew
624a5cc9-d8b4-485b-8028-bf9019ea10a8
Sibelli, Alice
64b9c97c-3cf9-4915-8af0-c40b7805a8f1
Chalder, Trudie
cb09653b-2c1e-4dfc-bb13-c6e8ca918602
Everitt, Hazel
80b9452f-9632-45a8-b017-ceeeee6971ef
Moss-Morris, Rona
a502f58a-d319-49a6-8aea-9dde4efc871e
Bishop, Felicity L.
1f5429c5-325f-4ac4-aae3-6ba85d079928
Harvey, J. Matthew
624a5cc9-d8b4-485b-8028-bf9019ea10a8
Sibelli, Alice
64b9c97c-3cf9-4915-8af0-c40b7805a8f1
Chalder, Trudie
cb09653b-2c1e-4dfc-bb13-c6e8ca918602
Everitt, Hazel
80b9452f-9632-45a8-b017-ceeeee6971ef
Moss-Morris, Rona
a502f58a-d319-49a6-8aea-9dde4efc871e
Bishop, Felicity L.
1f5429c5-325f-4ac4-aae3-6ba85d079928

Harvey, J. Matthew, Sibelli, Alice, Chalder, Trudie, Everitt, Hazel, Moss-Morris, Rona and Bishop, Felicity L. (2018) Desperately seeking a cure: Treatment seeking and appraisal in irritable bowel syndrome. British Journal of Health Psychology. (doi:10.1111/bjhp.12304).

Record type: Article

Abstract

Objectives: Irritable bowel syndrome (IBS) is common and adversely affects patients' quality of life. Multiple potential treatment options exist for patients (and clinicians) to choose from, with limited evidence to inform treatment selection. The aim was to explore how patients with IBS go about seeking and appraising different treatment modalities, with a view to elucidating the psychological processes involved and identifying opportunities to improve clinical practice. Design: Qualitative study nested within a randomized controlled trial of therapist-delivered and web-based cognitive behavioural therapy versus treatment-as-usual for IBS. Methods: A total of 52 people participated in semi-structured interviews about their prior experiences of treatments for IBS. Transcripts were analysed using inductive thematic analysis. Results: Key themes (desperation for a cure, disappointment at lack of cure, appraising the effects of diverse treatments, and hope for positive effects) clustered around an overarching theme of being trapped within a vicious cycle of hope and despair on treatment seeking. A desperation and willingness drove interviewees to try any treatment modality available that might potentially offer relief. Coming to accept there is no cure for IBS helped interviewees escape the vicious cycle. Treatments were appraised for their effects on symptoms and quality of life while also considering, but rarely prioritizing, other aspects including convenience of the regimen itself, whether it addressed the perceived root causes of IBS, perceived side-effects, and cost. Conclusion: Treatment seeking in IBS can be challenging for patients. Supportive discussions with health care professionals about illness perceptions, treatment beliefs, and goals could improve patients' experiences. Statement of contribution: What is already known on this subject? Irritable bowel syndrome (IBS) is a highly prevalent chronic relapsing functional gastrointestinal disorder. Studies show few treatment modalities provide complete symptom relief. IBS is associated with emotional and physical distress, and negatively impacts personal, social, and professional aspects of quality of life. What does this study add? Patients appraise IBS treatments for impact on quality of life and treatment characteristics. Developing acceptance and coping strategies helps escape treatment-seeking vicious cycles of hope and despair. Clinicians could better support patients by discussing their illness perceptions, treatment goals, and values.

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Desperately Seeking a Cure Final - Accepted Manuscript
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More information

Accepted/In Press date: 2 March 2018
e-pub ahead of print date: 5 March 2018
Keywords: Attitude to health, Irritable bowel syndrome, Qualitative methods, Treatment beliefs

Identifiers

Local EPrints ID: 419054
URI: http://eprints.soton.ac.uk/id/eprint/419054
ISSN: 1359-107X
PURE UUID: dd96373e-687f-47df-8e2a-10b1f87609ed
ORCID for Hazel Everitt: ORCID iD orcid.org/0000-0001-7362-8403
ORCID for Felicity L. Bishop: ORCID iD orcid.org/0000-0002-8737-6662

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Date deposited: 28 Mar 2018 16:30
Last modified: 08 Oct 2020 04:22

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