Abstract

Doctor-patient relationship and quality of life in Irritable Bowel Syndrome: an exploratory study of the potential mediating role of illness perceptions and acceptance

Hulme K1,2, Chilcot J2, Smith MA1,3. Psychol Health Med. 2017 Dec 20:1-11. doi: 10.1080/13548506.2017.1417613. [Epub ahead of print]
 
     
Author information

1 a Psychology Department , Northumbria University , Newcastle , UK.

2 b Health Psychology Section, Psychology Department , Institute of Psychiatry, King's College London , London , UK.

3 c Faculty of Health and Medical Sciences , University of Western Australia , Perth , Australia.

Abstract

Irritable Bowel Syndrome (IBS) is a functional gastrointestinal disorder characterised by unpredictable bowelsymptoms. These can be difficult to manage, consequently impacting quality of life (QoL). In addition, a strained doctor-patient relationship is independently reported in the qualitative literature. Given the doctor is often the first port of call for people with IBS, a difficult relationship may influence subsequent IBS management. Research suggests illness perceptions are important in determining IBS outcomes in therapy; however, their association with doctor-patient relationship and QoL is yet to be investigated. This exploratory study aimed to investigate the association between these constructs in IBS, as well as potential mediation by illness perceptions. Online questionnaires measuring doctor-patient relationship, illness perceptions, acceptance and QoL, were completed by 167 participants who reported an IBS diagnosis (144 female, mean age = 44.22 years, SD = 15.91 years). Bootstrapped pathway analysis was used to model the relationship and mediation effects. There was a significant positive correlation between patient-doctor relationship and QoL, r = .258, n = 167, p = .001. There was a significant indirect effect between doctor-patient relationship and QoL through illness coherence and acceptance (bootstrapped estimate = .058, 95%CI Lower-Upper = .02, .095, p = .002). No other indirect effects were observed in combination with good fit indices for the other illness perceptions. Findings suggest a doctor-patient relationship which fosters mutual understanding and helps patients make sense of symptoms, increases their ability to manage their IBS in a psychologically flexible manner, subsequently helping them maintain their QoL.

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