Quality of Life in Group-Based Intervention Program in Inflammatory Bowel Disease

  • L. Oxelmark
Reference work entry


 Crohn’s disease (CD) and  ulcerative colitis (UC) are chronic inflammatory bowel diseases (IBD). The etiology of the diseases seems to be multifactorial whereas environmental and genetic factors play a substantial role, triggering an abnormal immune response. IBD are characterized by remitting diseases with acute exacerbations “flares” and periods of remission. During active disease IBD are often associated with debilitating symptoms such as diarrhea and abdominal pain. IBD mainly affects young people and the diseases have great impact on patients’  health related quality of life (HRQOL). Twenty to thirty percent of the patients are more or less refractory to standard medication and side effects from medical and surgical treatment is not uncommon. Living with a chronic disease is a stressful situation. Short-term stress has been shown not to trigger exacerbation in UC but long-term stress increases the risk of exacerbation over a period of months to years. The IBD-patient need to cope with the long-term effects of the disease, the uncertainty of the effects of medical treatment, sometimes lack of efficacy, makes support and education an important part of therapy. In this chapter several aspects on group based intervention programs for this patient group are discussed and a particular model is presented. Studies have shown considerably satisfaction among IBD patients participating in group based educations, although no major improvement in HRQOL has been revealed.


Inflammatory Bowel Disease Ulcerative Colitis Inflammatory Bowel Disease Patient Inflammatory Bowel Disease Questionnaire Group Therapy Session 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

List of Abbreviations:


Crohn’s disease


centre of epidemiological studies-depression scale




hospital anxiety and depression scale


health index


health related quality of life


inflammatory bowel disease


inflammatory bowel disease questionnaire


rating form of IBD patients concerns


short form 36


symptom check list 90 revised


sense of coherence


ulcerative colitis


visual analogue scale


ways of coping questionnaire


  1. Andersson P, Olaison G, Bendtsen P, Myrelid P, Sjödahl R. (2003). Colorect Dis. 5: 56–62.CrossRefGoogle Scholar
  2. Antonovsky A. (1987). Unraveling the mysteries of Health. Jossey-Bass. San Fransisco.Google Scholar
  3. Antonovsky A. (1993). Soc Sci Med. 36: 725–733.PubMedCrossRefGoogle Scholar
  4. Bernklev T, Jahnsen J, Schulz T, Sauar J, Lygren I, Henriksen M, et al. (2005). Eur J Gastroenterol Hepatol. 17: 1037–1045.PubMedCrossRefGoogle Scholar
  5. Borgaonkar MR, Townson G, Donnelly M, Irvine EJ. (2002). Inflamm Bowel Dis. 8: 264–269.PubMedCrossRefGoogle Scholar
  6. Casellas F, Lopez-Vivancos J, Badia X, Vilaseca J, Malagelada JR. (2001). Eur J Gastroenterol Hepatol. 13: 567–572.PubMedCrossRefGoogle Scholar
  7. Delbar V, Benor DE. (2001). J Psychosoc Oncol. 19: 57–75.CrossRefGoogle Scholar
  8. Diaz Sibaja MA, Comeche Moreno MI, Mas Hesse B. (2007). Rev Esp Enfer Dig. 99: 593–598.Google Scholar
  9. Drossman D. (1986). Stress Med. 2: 119–128.CrossRefGoogle Scholar
  10. Drossman D, Leserman J, Li Z, Mitchell C, Zagami E, Patrick D. (1991). Psychosom Med. 56: 701–712.Google Scholar
  11. Drossman D, Patrick D, Mitchell C, Zagami E, Appelbaum M. (1989). Dig Dis Sci. 34: 1379–1386.PubMedCrossRefGoogle Scholar
  12. Eaden JA, Abrams K, Mayberry JF. (1999). Am J Gastroenterol. 94: 3560–3566.PubMedCrossRefGoogle Scholar
  13. Farrokhyar F, Swarbrick ET, Irvine EJ. (2001). Scand J Gastroenterol Suppl. 36: 2–15.CrossRefGoogle Scholar
  14. Folkman S, Lazarus RS. (1995). Mind Garden, Redwood City.Google Scholar
  15. Forbes A. (2003). Clinical Presentation and Diagnosis of Crohn’s Disease. In: Satsangi J, Sutherland L Inflammatory Bowel Diseases. Churchill Livingstone, London, pp. 183–198.Google Scholar
  16. Forcione D, Friedman L. (2003). Extraintestinal Manifestations of Inflammatory Bowel Disease. In: Lichtenstein G (ed.) The Clinician’s Guide to Inflammatory Bowel Disease Slack, Thorofare, pp. 77–112.Google Scholar
  17. Forsberg C, Björvell H. (1993). Qual Life Res. 2: 349–356.PubMedCrossRefGoogle Scholar
  18. Franke G. (1995). Die Symptom-Checkliste von Derogatis. (German) Göttingen: Belts Test.Google Scholar
  19. Hautzinger M, Bailer M. (1993). Allegemeine Depressionsskala (ADS). (German) Weinheim: Beltz Test.Google Scholar
  20. Hjortswang H, Järnerot G, Curman B, Sandberg-Gertzén H, Tysk C, Blomberg S, et al. (2001). Scand J Gastroenterol. 1: 77–85.Google Scholar
  21. Hjortswang H, Järnerot G, Curman B, Sandberg-Gertzén H, Tysk C, Blomberg B, et al. (2003). Eur J Gastroenterol Hepatol. 15: 1011–1020.PubMedCrossRefGoogle Scholar
  22. Irvine EJ. (1999). J Ped Gastroenterol Nutr. 28: S23–S27.CrossRefGoogle Scholar
  23. Irvine EJ. (2004). Aliment Pharmacol Therap, Suppl. 4: 54–59.CrossRefGoogle Scholar
  24. Jäghult S, Larson J, Wredling R, Kapraali M. (2007). Scand J Gastroenterol. 21: 1–8Google Scholar
  25. Joachim G. (1998). Gastroenterol Nurs. 21: 119–124.PubMedCrossRefGoogle Scholar
  26. Jones SC, Gallacher B, Lobo AJ, Axon ATR. (1993). J Clin Gastroenterol. 17: 21–24.PubMedCrossRefGoogle Scholar
  27. Kennedy AP, Rogers AE. (2002). Patient Educ Couns. 47: 257–263.PubMedCrossRefGoogle Scholar
  28. Langius-Eklöf A. (2001). Salutogenes och känsla av sammanhang (Salutogenesis and sense of coherence) Swedish. In: Klang Söderkvist B Patientundervisning. Studentlitteratur, Lund, pp. 40–66.Google Scholar
  29. Langius A, Björvell H, Antonovsky A. (1992). Scand J Car Sci. 6: 165–171.Google Scholar
  30. Larsson K, Sundberg Hjelm M, Karlbom U, Nordin K, Anderberg M, Lööf L. (2003). Scand J Gastroenterol. 7: 763–769.Google Scholar
  31. Lazarus R, Folkman S. (1984). Stress, Appraisal and Coping. Springer, New York.Google Scholar
  32. Levenstein S, Prantera C, Varvo V, Scribano ML, Andreoli A, Luzi C, et al. (2000). Am J Gastroenterol. 95: 1213–1220.PubMedCrossRefGoogle Scholar
  33. Loftus EV Jr. (2004). Gastroenterology. 126: 1504–1517.PubMedCrossRefGoogle Scholar
  34. Marshall J. (1979). Patient Couns Health Educ. 4: 142–145.CrossRefGoogle Scholar
  35. Martin A, Leone L, Castagliuolo I, Di Mario F, Naccarato R. (1992). Ital J Gastroenterol. 24: 477–480.PubMedGoogle Scholar
  36. Maunder RG, Esplen MJ. (2001). Can J Psychiatry. 46: 622–626.PubMedGoogle Scholar
  37. Moser G, Tillinger W, Sachs G, Genser D, Maier-Dobersberger T, Spiess K, et al. (1995). Eur J Gastroenterol Hepatol. 7: 853–858.PubMedGoogle Scholar
  38. Mussel M, Böcker U, Nagel U, Olbrich R, Singer MV. (2003). Scand J Gastroenterol. 38: 755–762.CrossRefGoogle Scholar
  39. Oxelmark L, Magnusson A, Löfberg R, Hillerås P. (2007). Inflamm Bowel Dis. 13: 182–190.PubMedCrossRefGoogle Scholar
  40. Oxelmark L, Nordström G, Sjöqvist U, Löfberg R. (2004). Inflamm Bowel Dis. 10: 612–617.PubMedCrossRefGoogle Scholar
  41. Rogers C. (1987). Group Analysis. 20(2): 99–107.CrossRefGoogle Scholar
  42. Satsangi J, Sutherland L. (2003). Inflammatory Bowel Diseases. Churchill Livingstone, London.Google Scholar
  43. Schölmerich J, Sedlak P, Hoppe-Seyler P, Gerok W. (1987). Hepato-Gastroenterology. 34: 182–185.PubMedGoogle Scholar
  44. Schreiber S, Hamling J, Wedel S, Nikolaus SN, Buhr HJ, Raedler A. (1999). Gastroenterology. 116: A815.Google Scholar
  45. Schwarz SP, Blanchard EB. (1991). Behav Res Ther. 29, 167–177.PubMedCrossRefGoogle Scholar
  46. Sibaja MAD, Moreno MIC, Hesse BM. (2007). Rev Esp Enferm Dig, 99: 593–598.Google Scholar
  47. Takacs L, Kollman C. (1994). Gastroenterology Nursing. 17: 11–13.PubMedCrossRefGoogle Scholar
  48. Travis SG, Jewell D. (2003). Ulcerative Colitis: Clinical Presentation and Diagnosis. In: Satsangi J, Sutherland L Inflammatory Bowel Diseases. Churchill Livingstone, London, pp. 169–181.Google Scholar
  49. Ware JE, Jr, Sherbourne CD. (1992). Med Care. 30: 473–483.PubMedCrossRefGoogle Scholar
  50. Verma S, Tsai HH, Giaffer MH. (2001). Dig Dis Sci. 46: 865–869.PubMedCrossRefGoogle Scholar
  51. Wewers ME, Lowe NK. (1990). Res Nurs Health. 13: 227–236.PubMedCrossRefGoogle Scholar
  52. Zigmond A, Snaith R. (1983). Acta Psychiatr Scand. 67: 361–370.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media LLC 2010

Authors and Affiliations

  • L. Oxelmark

There are no affiliations available

Personalised recommendations