The effect of self-management online modules plus nurse-led support on pain and quality of life among young adults with irritable bowel syndrome: A randomized controlled trial

• Authors: Jie Chen, University of Connecticut, Storrs; Yiming Zhang, University of Connecticut, Storrs; Zahra A. Barandouzi, Emory University; Joochul Lee, University of Connecticut, Storrs; Tingting Zhao, University of Connecticut, Storrs; Wanli Xu, University of Connecticut, Storrs; Ming-Hui Chen, University of Connecticut, Storrs; Bin Feng, University of Connecticut, Storrs; Angela Starkweather, University of Connecticut, Storrs; Xiaomei Cong, University of Connecticut, Storrs
• Journal Title: International Journal of Nursing Studies
• Volume: Volume 132
• Publisher: Elsevier | 2022-04-30, Pages 104278-None
• Type of Work: Article | Post-print: After Peer Review
• Publisher DOI: http://doi.org/10.1016/j.ijnurstu.2022.104278
• Subjects: Health Sciences, Nursing; Health Sciences, Public Health
• Keywords: Irritable bowel syndrome; Nursing support; Online education; Pain; Quality of life; Self-management; Symptom

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.