Paper
Saturday, July 24, 2004
Self Esteem: Major Predictor of Quality of Life in Patients with Ulcerative Colitis Following Ileal Pouch Anal Anastomosis Surgery
Mary T. Quinn Griffin, PhD, MSN, MEd, RN, Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA and Victor Fazio, MB, BS, FRACS, FACS, Department of Colorectal Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA.
| Learning Objective #1: Enumerate the determinants of quality of life in patients With ulcerative colitis |
| Learning Objective #2: Describe the self-esteem scale used in this study |
Purpose: Self-esteem has been shown to a predictor of quality of life in chronic illness. This study sought to determine if it was an important predictor of the quality of life (QOL) in ulcerative colitis (UC) patients following ileal pouch anal anastomosis (IPAA). Methods: Self-esteem was measured using the Rosenberg Self Esteem Scale. Other determinants of QOL measured included Social Support. QOL was measured using the Cleveland Global Quality of Life Scale (CGQL), the Ratings Form of Inflammatory Bowel Disease Patient Concerns (RFIPC) and the Medical Outcomes Study Short Form Survey (SF36). Data were collected by mailed questionnaire and database review from 585 patients who had undergone IPAA between January 1989 and December 1999. Multiple regression analysis was used to determine the relationship of the key variables. Results: Self-esteem was the most important predictor of QOL. High self-esteem was related to high QOL with each of the three quality of life instruments, t=2.67 (p=.008) with the CGQL scale, t=-8.278 (p=.000) with the RFIPC scale and with the SF36 scale a range of t=3.69 (p=.000) for the SF36 Physical Functioning Subscale to t=12.72 (p=.000) for the SF36 Mental Health Subscale. Self-esteem, social support, age, gender, and length of time since surgery combined explained 2.4% of the variance in the CGQL scale (p=.015), 21% in the RFIPC Scale (p=.000), and ranged from 6.5% (p=.000)in the SF36 Physical Functioning Subscale to 31% (p=.000)in the SF36 Mental Health Subscale. Conclusions: 1. Self-esteem is the most important predictor of QOL following IPAA for UC. 2. Further studies are needed to determine how self esteem can be improved in patients with chronic illness 3. Prospective evaluation of QOL following IPAA is warranted with interventions aimed at improving self-esteem in this important group of patients
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Sigma Theta Tau International
July 22-24, 2004