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Qualitative Study of the Healing and Recovery Process of Patients with Irritable Bowel Syndrome

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  • 過敏性腸症候群患者の治癒プロセスに関する質的研究
  • 過敏性腸症候群患者の治癒プロセスに関する質的研究 : 複線径路等至性モデルによる検討
  • カビンセイ チョウ ショウコウグン カンジャ ノ チユ プロセス ニ カンスル シツテキ ケンキュウ : フクセン ケイロ トウ シ セイ モデル ニ ヨル ケントウ
  • —複線径路等至性モデルによる検討—

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Abstract

<p>Objectives : This study attempts to examine the healing and recovery process of irritable bowel syndrome (IBS), focusing on psychosocial factors affecting symptoms. It is not uncommon for patients being treated for IBS to require long-term treatment. They also have been reported to have secondary problems such as depressive tendency and avoidance of social opportunities. In particular, since the quality of life of patients with severe IBS symptoms are associated with non-digestive rather than digestive symptoms, it is important to investigate the psychosocial factors that often prolong the course of the disease. However, the medium-long-term course, healing, and recovery process of IBS-affected individuals have not been investigated. Identifying major factors moving the IBS healing and recovery processes forward will contribute to development of efficient treatment and self-management. Subjects and method : The interview data were collected from 7 subjects (4 men, 3 women, mean age 35, type of IBS : 1 diarrhea, 6 alternate) affected by and recovered from IBS. Semi-structured interviews were conducted from July 2014, to October 2014. In the interview, we mainly focused on subjective experiences of the IBS healing and recovery process. The interview data were analyzed using the qualitative method of Trajectory equifinality model (TEM). Results : We found 3 types of healing and recovery processes for IBS. The final point of the process was set as state of subjective healing. At the beginning, every type took the same process : [affected with IBS], [obsessed with symptoms], and [coping behavior]. Next, they reached [partial healing] as a bifurcation point. After that point, there were two directions : [faced psychological problems] or [environmental control]. Through these processes, every type received some kind of support factor and then experienced the cognitive changes of [perfectionism], [outlook on life], and meaning of IBS experience. It was also suggested that the concept of [resignation], related with perfectionism, is one of the core factors move the process forward. In addition, it was also suggested that both “acceptance” and “change” factors given from medical professions, family members, and peer groups have the potential to move the process forward. * [ ] : Extracted concepts in the process models Conclusion : Through the analysis of the IBS healing and recovery process in this study, we found 3 types of healing and recovery processes. As a common finding of all types, cognitive changes in the meaning of IBS experience, perfectionism tendency, and outlook on life were key concepts to reach subjective healing in the process. Further study on the process may be required using a larger sample.</p>

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