| ObjectiveTo study and fully describe the status of social support for patients with irritable bowel syndrome. To explore the relationship between the quality of life and social support in patients with irritable bowel syndrome(IBS). Preliminary discussion on the efficiency of comprehensive social support intervention on improving quality of life and social support in patients with irritable bowel syndrome.MethodsIn the investigation stage of this research,181 patients met all the diagnostic and inclusion criteria were enrolled from January 2013 to December 2014 at the First Affiliated Hospital of Guangzhou University of Chinese Medicine. The social support status of patients was assessed with the Social Support Rating Scale(SSRS) and the quality of life was tested with the Irritable Bowel Syndrome subscale in gastrointestinal disease PRO scale(GEDPRO-IBS). In the clinical trial of this research,57 patients were enrolled from March 2014 to December 2014 at the First Affiliated Hospital of Guangzhou University of Chinese Medicine, according to a random sequence of numbers by the researcher were to be two different interventions 4 weeks. The trial group was treated with both traditional Chinese medicine and comprehensive social support intervention, and the control group was treated with only traditional Chinese medicine. Comprehensive social support intervention included professional support, psychological support which used solution-focused brief therapy(SFBT) for mental health treatment, family support. Patients into 2 groups when the baseline group difference was not statistically significant, comparable. Changes of clinical syndrome integral, social support, quality of life of the patients, the scores of SAS and SDS before and after the treatment were observed. Based on the statistical analysis of the variation of data, the social support, psychological factors and quality of life of patients were discussed, the efficiency of comprehensive social support intervention was evaluated.Results1. The most common subtypes of irritable bowel syndrome was IBS-D, accounted for 92%. The frequency of TCM syndrome type:liver depression and spleen deficiency(79.6%), Spleen deficiency and dampness stagnation(9.4%), spleen-stomach damp-heat(5.5%), liver-qi invasion(3.3%), spleen-kidney yang deficiency(2.2%).2. The average total score of GEDPRO-IBS on the 181 IBS patients was (123.96±6.84), which was different from the domestic norm. The difference was statistically significant (P<0.05).The score of the physical domain (75.67±6.04), psychological domain (21.35±3.03), independent domain(6.62 ±1.20), social environment domain(20.31±2.26) and healthy status were significantly worse in the IBS patients than the Chinese norms (P<0.05).3. The average total score of SSRS on the 181 IBS patients was (32.98 ±6.07). There was no statistical difference in the score of SSRS between IBS patients and the Chinese norms (P>0.05). The patients’status of social support was well. There was no statistical difference in the score of objective support (9.32±2.43) between IBS patients and the Chinese norms (P>0.05).The living condition of the patients was fair. Only 13%of the patients lived alone. There were two to four sources of economical and spiritual comfort. There was no statistical difference in the score of subjective support (18.25±3.80) between IBS patients and the Chinese norms (P>0.05). Most of social support came from the family, including the support and care of spouse, parents, children, brothers and sisters. Social support from friends was less.64% of the patients had fewer than two close friends.41% of the patients had only a nodding acquaintance with neighbours. 45% of the patients had a little bit concerned about their colleagues when they met with difficulties. The level of using social support(5.41±1.79) in IBS patients was significantly lower than those in the normal people (P <0.05). Only 3% patients poured out their worries to others. Only 2% patients turned to others for help when they were in trouble. Only 2% patients engaged in group activities. It means that IBS patients didn’t make the most use of the social support.4. Correlation analysis was applied between social support and quality of life. Social support was significant negatively correlation with quality of life, psychological domain and physical domain in these patients (P< 0.01). Social support, objective support, subjective support and the level of using social support were significant negatively correlation with quality of life (P<0.01). Objective support was negatively correlation with psychological domain (P<0.05) and significant negatively correlation with physical domain (P< 0.01). Subjective support was significant negatively correlation with physical domain (P<0.01). The level of using social support was significant negatively correlation with psychological domain and physical domain (P<0.01).On every respect of quality of life, social support was significant negatively correlation with psychological respect, ache respect, digestive respect and stool respect (P<0.01). Social support was negatively correlation with vigor respect (P<0.05). Objective support was negatively correlation with psychological respect and digestive respect(P＜0.05). Subjective support was significant negatively correlation with ache respect and stool respect (P<0.01). The level of using social support was significant negatively correlation with psychological respect and stool respect (P<0.01) and negatively correlation with digestive respect (P<0.05)5. Clinical symptoms of patients in two groups were improved. While after one month intervention, the clinical syndrome integral of two group had a significant decline (P＜0.05). All the data were compared between the two groups. Except constipation respection, clinical efficacy of the treatment was significantly better than the control group (P<0.05)6. There was marked difference existed in the quality of life of the same group (P<0.05).In the trial group, there was statistical difference in the domains of GEDPRO-IBS before and after treatment but vigor respect. The total score of GEDPRO-IBS, psychological domain and physical domain of trial group were significantly lower than the control group (P<0.05) There was no significant difference of independent domain, social environment domain between groups (P> 0.05). There was significant difference of psychological respect, ache respect, stool respect and socil relationship respect (P<0.05). There was no significant difference of independent respect, digestive respect, vigor respect and medical respect (P>0.05)7. There was marked difference existed in the score of SSRS of the same group (P<0.05). In the trial group, there was statistical difference in the subjective support and the level of using social support before and after treatment (P<0.05). The score of objective support, subjective support and the level of using social support were significantly better than the control group after treatment (P<0.05). It was suggested that comprehensive social support intervention could improve social support of patients with IBS.8. There was marked difference existed in the score of SAS and SDS of the same group (P<0.05). The score of SDS and SAS were significantly lower than the control group after treatment (P<0.05). Comprehensive social support intervention could effectively relieve anxiety and depression of patients with IBS. ConclusionQuality of the IBS patients was significantly lower than that of general persons. The patients’status of social support was well. The score of social support was significantly associated with quality of life. By increasing the patient’s level of social support is a kind of effective means to improve the quality of life. Using the comprehensive social support interventions can significantly relieve the symptoms of IBS patients, increase the degree of patients’ social support, reduce negative emotions of the patients and improve the quality of life of the patients. Treatment of traditional Chinese medicine combined with comprehensive social support intervention is an effective intervention mode in the treatment of IBS. |
PDF Full Text Request