Effects Of Positive Psychology Intervention Based On Written Expression On Psychological Status Of Patients With Inflammatory Bowel Disease

Background:The incidence of inflammatory bowel disease(IBD)has increased rapidly in recent years.Patients often suffer from physical and mental torture caused by repeated episodes of disease,and their quality of life is seriously impaired.Therefore,patients’ mental health is worthy of attention.Previous researches mainly focused on the negative emotions of IBD patients but ignored their inherent positive psychological resources and quality.This research aims to analyse the current level of hope,optimism and subjective well-being of IBD patients from the perspective of positive psychology,and to explore the application of positive psychological intervention based on written expression in IBD patients,in order to provide a new idea for psychological intervention in IBD patients.Objectives:1.To investigate and analyze the levels of hope,optimism and subjective well-being in patients with IBD.2.To explore the effects of positive psychological intervention based on written expression on the psychological status of patients with IBD.Methods:1.177 IBD patients who were admitted to the outpatient clinics or the Department of Gastroenterology of three tertiary A-level hospitals in Jiangsu Province were investigated.Survey questionnaire included the self-designed general information questionnaire,Herth Hope Index(HHI),Revised The Life Orientation Test(LOT-R),General Well-Being Schedule(GWB)and Simplified Coping Style Questionnaire(SCSQ).Then we analyzed the levels of hope,optimism and subjective well-being of IBD patients,as well as analyzed the correlation and influencing factors of three kinds of positive psychological levels and coping modes.2.Under the guidance of Seligman’s positive psychological intervention program,We developed the positive psychological interventions based on written expression for IBD patients.76 patients with IBD who were admitted to a tertiary A-level hospital in Jiangsu Province were randomly assigned into intervention group or control group,and each group had 38 cases.Patients in the two groups were given routine treatment and care.Besides,patients in the intervention group received positive psychological practice guidance based on written expression for 8 weeks.The negative emotions(anxiety,depression),positive psychological status(hope,optimism,subjective well-being),coping modes and quality of life were measured at baseline,4 and 8weeks post-enrollment via a randomized controlled trial.The qualitative practice feedback of patients in the intervention group were collected after the weekly practice in the first 6 weeks and after the end of the eight-week intervention.Results:1.The score of hope level in IBD patients was(35.76±3.48),including 77(43.50%)patients with high hope and 100(56.50%)patients with moderate hope,and no one with lower hope.The overall score of hope was positively correlated with positive coping mode(r=0.442,P<0.01),and the correlation with negative coping mode was not statistically significant(r=0.054,P > 0.05).Economic pressure,optimism,and positive coping mode were the influencing factors of patients’ hope level(all P<0.05).2.The score of optimism level in IBD patients was(16.43±2.97).The overall score of optimism level was positively correlated with positive coping mode(r=0.484,P<0.01),and the correlation with negative coping mode was not statistically significant(r=-0.118,P>0.05).Positive coping mode,subjective well-being and hope were the influencing factors of patients’ optimism level(all P<0.05).3.The overall subjective well-being score of IBD patients was(75.33±14.57),and there was no significant difference between IBD patients’ subjective well-being score and the norm(all P > 0.05).Subjective well-being score was positively correlated with positive coping mode(r=0.461,P < 0.01),but the correlation with negative coping mode was not statistically significant(r=-0.143,P>0.05).Severity of disease,positive coping mode and optimism were the influencing factors of subjective well-being of IBD patients(all P<0.05).4.Compared with the control group,patients in the intervention group demonstrated greater improvement in hope,optimism and positive coping mode at 4 weeks and 8weeks(all P<0.05),as well as improvement in anxiety,depression and subjective well-being at 8 weeks(all P<0.05).Non-significant effects on negative coping mode and quality of life(total scores or dimension scores)were found between the two groups both at 4 weeks and 8 weeks(all P<0.05).As for the difference in quality of life scores compared with the baseline scores,more improvement were found in the PPI group at 4 and 8 weeks(all P<0.05).5.Participants in the intervention group rated the feasibility,acceptability and utility of writing themes all higher than 6.5 scores.Conclusions:1.IBD patients’ positive psychological status such as subjective well-being,hope and optimism have some space to improve.We should pay attention to the IBD patients with high economic pressure,moderate or severe period of diseases.Positive coping mode is the influencing factor of positive psychological status,so we can enhance the positive psychological construct of IBD patients by improving their positive coping mode.2.Positive psychology interventions based on written expression can help alleviate the negative emotions such as anxiety and depression of IBD patients,and enhance the positive psychological constructs such as hope,optimism and subjective well-being.It can also promote the positive coping mode and improve quality of life of IBD patients.Moreover,the intervention measures adopted in this research are convenient,feasible and well-accepted among patients.