Shao XX, Fang LY, Guo XR, Wang WZ, Shi RX, Lin DP. Knowledge, attitude, and practice of patients living with inflammatory bowel disease: A cross-sectional study. World J Gastroenterol 2023; 29(43): 5818-5833 [PMID: 38074915 DOI: 10.3748/wjg.v29.i43.5818]
Corresponding Author of This Article
Dao-Po Lin, MD, Department of Gastroenterology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, No. 109 Xueyuan Western Road, Wenzhou 325027, Zhejiang Province, China. wmuldp@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
IBD is a group of chronic, non-specific recurrent intestinal inflammatory diseases, including UC and CD
316 (89.5)
2 (0.6)
35 (9.9)
At present, many factors, such as heredity, immunity, environment, and microorganisms, are involved in the pathogenesis of the disease
74 (21.0)
185 (52.4)
94 (26.6)
Symptoms of IBD can include abdominal pain, diarrhea, bloody stool, anemia, fever, joint swelling, pain, etc.
293 (83.0)
13 (3.7)
47 (13.3)
Extraintestinal manifestations of IBD include oral ulcers, joint injury, skin injury, eye lesions, hepatobiliary diseases, etc.
212 (60.1)
32 (9.1)
109 (30.9)
IBD often occurs in young adults and is more common between the ages of 20-50 yr
267 (75.6)
16 (4.5)
70 (19.8)
IBD is a lifelong disease, and the patient’s condition is prolonged and repeated. At present, there is no specific and effective medicine or method to cure the disease
293 (83.0)
11 (3.1)
49 (13.9)
Colonoscopy and mucosal biopsy are the best methods to establish the diagnosis and assess the disease’s severity in patients with IBD
285 (80.7)
6 (1.7)
62 (17.6)
Generally, medical treatment is the main treatment for IBD, but surgical treatment is needed when intestinal obstruction, intestinal perforation, and canceration occur
275 (77.9)
5 (1.4)
73 (20.7)
The treatment of patients with IBD varies widely among individuals, with different classifications and severity of the disease leading to different treatment outcomes and efficacy
299 (84.7)
1 (0.3)
53 (15.0)
Drugs for treating IBD include hormones, aminosalicylic acid drugs, immunosuppressants (azathioprine, methotrexate, etc.), and biological agents
274 (77.6)
5 (1.4)
74 (21.0)
There are no side effects after treatment with glucocorticoids, etc.
149 (42.2)
39 (11.0)
165 (46.7)
Currently, the biological agents approved for treating IBD in China include infliximab, vidrizumab, and ustekinumab
292 (82.7)
6 (1.7)
55 (15.6)
All patients with IBD can’t normally absorb the nutrients they intake
232 (65.7)
60 (17.0)
61 (17.3)
Emotion, smoking, drinking, and other behaviors will not affect IBD
286 (81.0)
36 (10.2)
31 (8.8)
Table 3 Attitude dimension, n (%)
Attitude
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
I am confident in the treatment of IBD
158 (44.8)
134 (38.0)
58 (16.4)
3 (0.8)
0
I think patients with IBD need to avoid certain foods
186 (52.7)
144 (40.8)
22 (6.2)
1 (0.3)
0
I think that patients with IBD combined with malnutrition need to use a combination of intestinal and extra-intestinal nutrition support according to the disease situation if necessary
171 (48.4)
151 (42.8)
29 (8.2)
1 (0.3)
1 (0.3)
I think scientific dietary guidance and management are key to managing IBD
193 (54.7)
141 (39.9)
18 (5.1)
1 (0.3)
0
I think developing a specific treatment plan for IBD needs to be tailored to the individual’s situation and developed jointly by the IBD medical specialist and the patient
208 (58.9)
129 (36.5)
15 (4.2)
1 (0.3)
0
I think the adjustment of IBD medication needs to be carried out under the guidance of specialists, and patients should not adjust their own medication
228 (64.6)
112 (31.7)
13 (3.7)
0
0
I believe that during IBD medication, patients need to monitor the side effects of their medication and provide timely feedback to their specialists
216 (61.2)
128 (36.3)
9 (2.5)
0
0
I think treatment can be stopped when the colonoscopy shows mucosal healing (i.e., complete healing of colonic erosions and ulcers)
37 (10.5)
47 (13.3)
92 (26.1)
134 (38.0)
43 (12.2)
I think the early application of biologics, in conjunction with specialist advice, will allow early control of disease activity to change the course of the disease and minimize complications and disability in the bowel
171 (48.4)
147 (41.6)
30 (8.5)
3 (0.8)
2 (0.6)
I think patients with IBD should reduce their intake of saturated fatty acids (animal oil, cream, fatty meats, meat soups, etc.)
137 (38.8)
156 (44.2)
52 (14.7)
7 (2.0)
1 (0.3)
I think that IBD patients should try to drink plain hot water and freshly squeezed juices and need to avoid strong tea, sugary drinks, coffee, alcohol, etc.
177 (50.1)
148 (41.9)
24 (6.8)
2 (0.6)
2 (0.6)
I think the IBD disease has obviously increased the family’s financial burden
172 (48.7)
133 (37.7)
42 (11.9)
5 (1.4)
1 (0.3)
I think I can get married, get pregnant, and give birth normally if my IBD disease is controlled
125 (35.4)
166 (47.0)
52 (14.7)
8 (2.3)
2 (0.6)
I think IBD has affected my normal work, study, and social interaction
98 (27.8)
134 (38.0)
86 (24.4)
30 (8.5)
5 (1.4)
Table 4 Practice dimension, n (%)
Practice
Always
Often
Sometimes
Seldom
Never
I will actively cooperate with the medical staff for my treatment and nursing
244 (69.1)
93 (26.3)
15 (4.2)
1 (0.3)
0
I will communicate with specialists regularly and follow up regularly
166 (47.0)
116 (32.9)
62 (17.6)
9 (2.5)
0
I will vent my bad emotions correctly, such as through exercise relaxation, music relaxation, and implied adjustment, to relieve mental stress
106 (30.0)
125 (35.4)
92 (26.1)
25 (7.1)
5 (1.4)
I will communicate with family members, close friends, and patients and gain encouragement and emotional support
94 (26.6)
117 (33.1)
92 (26.1)
41 (11.6)
9 (2.5)
Yes, n (%)
No, n (%)
I will take care to quit smoking and drinking
346 (98.0)
7 (2.0)
I will take care to avoid staying up late and overworking
120 (34.0)
119 (33.7)
87 (24.6)
23 (6.5)
4 (1.1)
I will take care to choose appropriate physical exercise according to my physical condition
96 (27.2)
95 (26.9)
105 (29.7)
50 (14.2)
7 (2.0)
If there is an ostomy, I will go to an IBD specialist for standard treatment
336 (95.2)
17 (4.8)
0
0
0
If I am treated with biological agents, I will pay attention to monitoring the related side effects
179 (50.7)
107 (30.3)
52 (14.7)
11 (3.1)
4 (1.1)
If a food allergy is identified, I will take care to avoid it in my daily diet
210 (59.5)
105 (29.7)
30 (8.5)
5 (1.4)
3 (0.8)
I will use a “diet diary” to identify foods that may cause discomfort, such as abdominal pain or diarrhea, and try to avoid them in my future diet
106 (30.0)
94 (26.6)
67 (19.0)
42 (11.9)
44 (12.5)
I will improve my understanding of diseases and treatment through WeChat groups, networks, and popular science lectures
100 (28.3)
85 (24.1)
104 (29.5)
52 (14.7)
12 (3.4)
I will insist on taking medicine or receiving infusion treatment of biological agents as prescribed by my physician
247 (70.0)
86 (24.4)
16 (4.5)
3 (0.8)
1 (0.3)
I will encourage and help other people with IBD as much as I can
135 (38.2)
78 (22.1)
93 (26.3)
37 (10.5)
10 (2.8)
Table 5 Correlation analysis
Knowledge dimension
Attitude
Practice
Knowledge dimension
1
Attitude
0.371 (P < 0.001)
1
Practice
0.100 (P < 0.001)
0.452 (P < 0.001)
1
Table 6 Univariate and multivariate analysis of knowledge
Citation: Shao XX, Fang LY, Guo XR, Wang WZ, Shi RX, Lin DP. Knowledge, attitude, and practice of patients living with inflammatory bowel disease: A cross-sectional study. World J Gastroenterol 2023; 29(43): 5818-5833