Int J Nurs Stud. 2022 Aug;132:104278.doi: 10.1016/j.ijnurstu.2022.104278. Epub 2022 Apr 30.

Jie Chen ¹, Yiming Zhang ², Zahra Amirkhanzadeh Barandouzi ³, Joochul Lee ⁴, Tingting Zhao ⁵, Wanli Xu ⁶, Ming-Hui Chen ⁷, Bin Feng ⁸, Angela Starkweather ⁹, Xiaomei Cong ¹⁰

Author information

¹University of Connecticut, School of Nursing, 231 Glenbrook Road, Unit 4026, Storrs, CT 06269-4026, United States of America; Department of Pain and Translational Symptom Science, University of Maryland School of Nursing, 655 W. Lombard St., Baltimore, MD 21201, United States of America. Electronic address: jiechen@umaryland.edu.

²University of Connecticut, Department of Statistics, 215 Glenbrook Road, U-4120, Storrs, CT 06269-4120, United States of America. Electronic address: yiming.3.zhang@uconn.edu.

³University of Connecticut, School of Nursing, 231 Glenbrook Road, Unit 4026, Storrs, CT 06269-4026, United States of America; Emory University, School of Nursing, 1520 Clifton Rd, Atlanta, GA 30322, United States of America. Electronic address: zahra.barandouzi@emory.edu.

⁴University of Connecticut, Department of Statistics, 215 Glenbrook Road, U-4120, Storrs, CT 06269-4120, United States of America. Electronic address: joochul.lee@uconn.edu.

⁵University of Connecticut, School of Nursing, 231 Glenbrook Road, Unit 4026, Storrs, CT 06269-4026, United States of America. Electronic address: tingting.zhao@uconn.edu.

⁶University of Connecticut, School of Nursing, 231 Glenbrook Road, Unit 4026, Storrs, CT 06269-4026, United States of America. Electronic address: wanli.xu@uconn.edu.

⁷University of Connecticut, Department of Statistics, 215 Glenbrook Road, U-4120, Storrs, CT 06269-4120, United States of America. Electronic address: ming-hui.chen@uconn.edu.

⁸University of Connecticut, Department of Biomedical Engineering, 260 Glenbrook Road, U-3247, Storrs, CT 06269-3247, United States of America. Electronic address: fengb@uconn.edu.

⁹University of Connecticut, School of Nursing, 231 Glenbrook Road, Unit 4026, Storrs, CT 06269-4026, United States of America. Electronic address: angela.starkweather@uconn.edu.

¹⁰University of Connecticut, School of Nursing, 231 Glenbrook Road, Unit 4026, Storrs, CT 06269-4026, United States of America. Electronic address: xiaomei.cong@uconn.edu.

Abstract

Background: Irritable bowel syndrome is a chronic pain condition that needs life-long self-management. However, the effect of self-management among young adults with irritable bowel syndrome is limited.

Objectives: This study aimed to examine the effect of a nurse-led self-management program on pain, symptoms, and quality of life among young adults with irritable bowel syndrome.

Design: A randomized controlled trial.

Settings and participants: Eighty young adults with irritable bowel syndrome recruited from two campuses of a public university and two gastrointestinal clinics were randomly assigned into a self-management online education and learning modules alone group (Online Modules, n = 41) or a nurse-led one-to-one consultation plus self-management online education and learning modules group (Nurse-Led Online Modules, n = 39). Twenty-one healthy controls were also recruited from these two campuses.

Methods: Both the intervention groups received ten online modules after baseline data collection. Participants in the Nurse-Led Online Modules group received additional three nurse-led one-to-one consultations at baseline, 6- and 12-week follow-ups. Self-reported pain, symptoms, quality of life, self-efficacy for managing chronic disease, and coping were measured at baseline, and 6- and 12-week follow-ups among the participants with irritable bowel syndrome. The healthy controls completed data collection of pain and symptoms at baseline and the 12-week follow-up. The intervention effects across study time points and the comparisons between the two interventional groups were analyzed using linear mixed models. A longitudinal mediation analysis was also conducted to explore the mediation effects of self-management mechanisms of the interventions.

Results: Both the intervention groups showed significant interventional effects on decreasing pain intensity and pain interference and increasing quality of life at the 12-week follow-up (all p < 0.05). At the 12-week follow-up, the Nurse-Led Online Modules significantly reduced anxiety (p = 0.016) and had a significant greater improvement in quality of life than the Online Modules (p = 0.040). Increased self-efficacy mediated the intervention effect of the Nurse-Led Online Modules group on reducing pain interference and improving quality of life, while the effect of the Online Modules was mediated through decreasing inefficient coping strategy-catastrophizing.

Conclusions: This study showed that both the pain self-management online education and nurse-led intervention were effective for alleviating pain and improving quality of life among young adults with irritable bowel syndrome by targeting the self-management process. The nurse-led intervention had a better outcome than the online education alone in improving quality of life.

Registration number: NCT03332537.