Symptom clusters in adults with inflammatory bowel disease.
Samantha Conley, Deborah D Proctor, Sangchoon Jeon and 2 others
PMID 28833284WHAT IT FOUND
Adults with IBD: 73.33% reported two or more symptoms.
Four clusters emerged: low burden, high burden, physical symptoms, and psychological symptoms; remission, Crohn’s disease, corticosteroids, female gender, and smoking history were linked to cluster membership.
Key findings
01Four symptom clusters were identified among adults with IBD: low symptom burden (25.59%), high symptom burden (38.10%), physical symptoms (22.09%), and psychological symptoms (14.22%).
0273.33% of participants reported two or more symptoms, and individual symptom prevalences were pain interference 54.06%, fatigue 63.14%, sleep disturbance 59.23%, depression 49.92%, and anxiety 62.65%.
03Current corticosteroid use and Crohn’s disease were associated with medium higher odds of the high symptom burden and physical symptoms groups; remission was associated with medium lower odds of the psychological symptoms group and large lower odds of the high symptom burden and physical symptoms groups.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a cross-sectional survey analysis, so it can show associations but not cause-and-effect. Symptoms were reduced to present or absent categories, so severity, frequency, and symptom distress cannot be inferred. The analysis used existing survey data, so disease location, non-IBD medications, diarrhea, and fecal incontinence were not available as variables. The sample was largely non-Hispanic white and female and was recruited through the internet, so results may not generalise to underrepresented groups. Participants with ostomies or j-pouches were excluded, and excluded participants were younger and had shorter disease duration than those analysed. No intervention was tested, so the paper cannot show that assessing or treating a symptom cluster improves outcomes.
Declared interests
The supplied text does not include an author conflict-of-interest declaration. The publication types list NIH extramural and non-U.S. government research support.
The easy way to misread this
Do not read the cluster associations as proof that corticosteroids, Crohn’s disease, female gender, or smoking cause symptom burden. This was a cross-sectional survey, not an intervention study.