Interventions for fatigue in inflammatory bowel disease

Farrell, Dawn; Artom, Micol; Czuber‐Dochan, Wladyslawa; Jelsness-Jørgensen, Lars-Petter; Norton, Christine; Savage, Eileen

doi:10.1002/14651858.cd012005.pub2

Cited by 32 publications

(21 citation statements)

References 114 publications

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“…While the impact of the environment on the development of IBD is substantial, the role of specific factors is still poorly defined, one candidate being early life stress ( 3 – 5 ). Newer studies in IBD have suggested alterations in the brain-body communication, directly influencing the sensory and immune functions of the gastrointestinal tract ( 6 – 8 ). In line, gastrointestinal pathologies have been recently linked to altered interoceptive processes ( 9 ).…”

Section: Introductionmentioning

confidence: 99%

Multidimensional Assessment of Interoceptive Abilities, Emotion Processing and the Role of Early Life Stress in Inflammatory Bowel Diseases

et al. 2021

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Perception of internal bodily sensations includes three dissociable processes: interoceptive accuracy, interoceptive sensibility, and interoceptive awareness. Interoceptive abilities play a crucial role in emotion processing and impairments of these processes have been reported in several psychiatric disorders. Studies investigating interoceptive abilities and their role in emotional experience in individuals with somatic disorders such as inflammatory bowel diseases (IBD) are sparse. Recent findings suggested an association between adverse childhood experiences (ACE) and the development of gastrointestinal disorders. The aim of the current study was to investigate the associations between the different dimensions of interoception and emotional processing in IBD while taking ACE into account. We recruited IBD patients in clinical remission (n = 35) and 35 healthy control participants (HC) matched for age, education and IQ. Interoception was measured as a three-dimensional construct. Interoceptive accuracy was assessed with the heartbeat tracking task and interoceptive sensibility with a self-report measure (Multidimensional Assessment of Interoceptive Awareness questionnaire). Emotional processing was measured using an experimental task, where participants were asked to rate the subjectively perceived valence and arousal when presented with positive, neutral and negative visual stimuli. IBD patients significantly differed in two interoceptive sensibility domains, Emotional awareness and Not-distracting. Patients reported greater awareness of the connection between bodily sensations and emotional states, while showing a stronger tendency to use distraction from unpleasant sensations compared with HC. Higher emotional awareness was linked to higher perceived intensity and arousal of negative stimuli. The strength of this relation was dependent on the severity of ACE, with severer traumatization being associated with a stronger association between emotional awareness and perceived valence and arousal. Our findings suggest that it is the subjective component of interoception, especially the one assessing interoceptive abilities within the scope of emotional experience, which affects emotional processing in IBD. This is the first study providing evidence that IBD patients did not differ in their perception of visceral signals per se but only in the subjective ability to attribute certain physical sensations to physiological manifestations of emotions. Our findings support the hypothesis that ACE affect the association between interoception and emotional processing.

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Section: Introductionmentioning

confidence: 99%

Multidimensional Assessment of Interoceptive Abilities, Emotion Processing and the Role of Early Life Stress in Inflammatory Bowel Diseases

et al. 2021

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“…A review of the literature on nonpharmacological interventions for fatigue, pain, and urgency in IBD demonstrated a lack of theoretically grounded interventions with demonstrable efficacy for improving these outcomes. A Cochrane review included only 5 nonpharmacological interventions for IBD fatigue [ 44 ], including electroacupuncture, CBT, solution-focused therapy, and advice on physical activity. The studies were rated as low quality.…”

Section: Resultsmentioning

confidence: 99%

A Novel Digital Self-management Intervention for Symptoms of Fatigue, Pain, and Urgency in Inflammatory Bowel Disease: Describing the Process of Development

Sweeney¹,

Windgassen²,

Artom³

et al. 2022

JMIR Form Res

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Background Empirical studies and systematic reviews have demonstrated the role of biological, cognitive, behavioral, and emotional factors in fatigue, pain, and urgency in inflammatory bowel disease (IBD). Behavioral management that addresses the cognitive, behavioral, and emotional factors offered alongside medical treatment is seldom available to people with IBD. Digital interventions provide a potentially scalable and cost-effective way of providing behavioral support to patients. Objective This paper aimed to describe the process of developing a supported digital self-management intervention for fatigue, pain, and urgency in IBD using theory and evidence-based approaches and stakeholder input. Methods The Medical Research Council framework for complex health interventions and a person-based approach were used to guide intervention development, consulting with 87 patients with IBD and 60 nurses. These frameworks informed the selection and use of a theoretical model that subsequently guided cognitive behaviorally based intervention content. They also guided the design of tailored digital intervention pathways for individuals with IBD that matched the predominant symptoms. Results A transsymptomatic cognitive behavioral framework of symptom perpetuation was developed for the symptoms of fatigue, pain, and urgency in IBD. A logic model was used to define the intervention techniques. Patient feedback and qualitative interviews refined the website content and functionalities, including the use of visual aids, email reminders, and graphical tracking of symptoms. Nurse focus groups informed the volume and delivery model of the therapist facilitator support. Ratings of acceptability out of 10 following feasibility testing (31/87, 36%) demonstrated accessibility (scoring 9.43, SD 1.040), ease (scoring 8.07, SD 3.205), clarity, and the relevant tone of the intervention. The final intervention comprised 12 web-based sessions (8 core and 4 symptom-specific), with one 30-minute facilitator phone call following session 1 and subsequent on-site messaging. Conclusions The use of theory and integration of stakeholders’ views throughout informed the development of an evidence-based digital intervention for fatigue, pain, and urgency in IBD. This is the first web-based self-management intervention designed to address these multiple symptoms with the aim of improving the quality of life and reducing the symptom burden of IBD. The intervention is being tested in a large multicenter randomized controlled trial. Trial Registration ISRCTN Registry ISRCTN71618461; https://www.isrctn.com/ISRCTN71618461

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“…An important strength of the present research is the number of included patients, which was larger than that used in the validation of the instrument in other countries. Currently various pharmacological and non-pharmacological treatments are being evaluated for the management of fatigue in this type of patients 27 , who could directly benefit if this disorder is timely identified. Thus, having a scale for the evaluation of fatigue in patients with IBD validated in our population will allow gastroenterologists to reliably identify fatigue and its severity in patients with IBD, in order for available new techniques to be used for timely and comprehensive treatment.…”

Section: Discussionmentioning

confidence: 99%

Validity and reliability of the Inflammatory Bowel Disease Fatigue Scale in Mexican patients

Parra-Holguín¹,

Fresán‐Orellana²,

Yamamoto‐Furusho³

2023

GMM

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Introduction:Fatigue is an extra-intestinal manifestation of inflammatory bowel disease (IBD). Objective: To determine the construct validity, discriminant validity and reliability of an instrument for evaluating the Fatigue Scale for IBD in Mexican patients. Methods: Two hundred patients with an IBD confirmed diagnosis were included. Current demographic and clinical characteristics of the condition were evaluated. Each patient answered the IBD Fatigue Scale (IBD-F) and the Pittsburgh Sleep Quality Index (PSQI), which was used to determine IBD-F discriminant validity. A factor analysis of each IBD-F section was performed, independent sample Student's t-tests were used to contrast the PSQI, and reliability was evaluated using Cronbach's alpha. Results: The items in both IBD-F sections showed high factor loadings, which explained 68.3 and 38.4% of variance, respectively. Cronbach's alpha was > 0.80 in both, which discriminated patients with greater sleep disturbances. Conclusions: IBD-F is a valid and reliable scale for Mexican patients with IBD. Fatigue objective evaluation will allow timely interventions in order to reduce its impact on patients with IBD.

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Interventions for fatigue in inflammatory bowel disease

Cited by 32 publications

References 114 publications

Multidimensional Assessment of Interoceptive Abilities, Emotion Processing and the Role of Early Life Stress in Inflammatory Bowel Diseases

Multidimensional Assessment of Interoceptive Abilities, Emotion Processing and the Role of Early Life Stress in Inflammatory Bowel Diseases

A Novel Digital Self-management Intervention for Symptoms of Fatigue, Pain, and Urgency in Inflammatory Bowel Disease: Describing the Process of Development

Validity and reliability of the Inflammatory Bowel Disease Fatigue Scale in Mexican patients

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