Quality of life of patients with mucosal ulcerative colitis following ileal pouch anal anastomosis surgery

Traditionally, the surgical treatment for mucosal ulcerative colitis (MUC) has been a total proctocolectomy with a permanent ileostomy. Today, restorative proctocolectomy with ileal pouch anal anastomosis (IPAA) is the surgery of choice for MUC patients. The impact of IPAA and its relationship to self-esteem and social support on the IPAA patient's quality of life has not been addressed.; The purpose of this study was to examine the quality of life of individuals following IPAA and its relationship to social support and self-esteem. Roger's Science of Unitary Human Beings guided the theoretical framework.; Quality of life 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). Rosenberg's Self-Esteem Scale was used to measure self-esteem. The Duke-UNC Functional Social Support Questionnaire was used to measure social support. 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, age, gender, length of time since surgery, social support and self-esteem to quality of life.; Self-esteem was the most important predictor of quality of life. High self-esteem was related to high quality of life with each of the three quality of life instruments. Although, social support predicted quality of life when examined independently of self-esteem, it had little impact when self-esteem was considered. There were differences in the quality of life of women compared to men when measured with the RFIPC Scale and the SF36 while there were no differences when measured with the CGQL Scale. Increasing age was associated with decreasing quality of life. However, increasing age was conversely associated with decreasing scores on the RFIPC Scale. No relationship was found between the length of time since surgery and quality of life.