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Published on: September 12, 2019
The role of mastery in Crohn's disease: a cross-sectional study
Marina Francesca Gattoni1,2, Enrica Previtali3, Salvatore Leone3
1University of Florence, Florence, Italy.
Insights
Mastery is impaired in Crohn's disease (CD) patients, particularly men with mild symptoms, and linked to distress and anxiety. Further research is needed on mastery's role in medical adherence for CD management.
Area of Science:
- Gastroenterology
- Psychology
- Health Sciences
Background:
- Crohn's disease (CD) is a chronic autoimmune condition impacting quality of life (QoL).
- Approximately 40% of CD patients exhibit non-adherence to medical prescriptions, increasing risks of hospitalization and surgery.
- CD significantly affects mental health, with 'mastery' (ability to manage life events) being a key factor.
Purpose of the Study:
- To investigate the relationship between mastery and medical adherence in CD patients.
- To explore the association of mastery with distress, social support, QoL, and psychological symptoms.
- To examine the role of interoception in the context of mastery and CD.
Main Methods:
- A cross-sectional study involving 261 adults diagnosed with CD.
- Online questionnaires utilized validated clinical and psychological scales.
- Data collection included medical reports for context.
Main Results:
- CD patients reported varying levels of mastery, with significant differences based on clinical conditions and a gender-symptomatology interaction.
- Mastery showed a significant association with clinical conditions, QoL, stress, and interoception (adjusted R² = 0.558).
- No significant mediating role of mastery was found between psychological state and medical adherence.
Conclusions:
- Mastery is notably impaired in CD patients, especially men with mild disease.
- A positive link exists between mastery and interoception, alongside higher distress, anxiety, and depressive symptoms.
- Future research should further explore the connection between mastery and medical adherence in CD.
Background:
Crohn's disease (CD) is a chronic autoimmune inflammatory bowel disease. It is estimated that approximately 40% of individuals with CD are non-adherent to medical prescriptions. This lack of adherence to treatment plans has been linked to an increased risk of hospitalisation and surgical procedures, which can have a detrimental impact on the patient's quality of life (QoL). Furthermore, the CD can impose significant stress on individuals, affecting their mental health and sense of mastery. The term 'mastery' is used to describe an individual's awareness of their abilities and capacities that are essential for effectively managing life events and situations.
Objectives:
This study aimed to investigate the role of mastery in relation to medical adherence, distress, perceived social support, QoL, depressive and anxious symptoms and interoception in persons with a diagnosis of CD.
Design:
This is a cross-sectional study, involving 261 adults diagnosed with CD.
Methods:
Participants completed an online questionnaire comprising validated clinical and psychological scales, which lasted approximately 20 min. Participants were permitted to provide their most recently available medical report.
Results:
Patients with CD reported discrete levels of mastery. Two factorial ANOVA highlighted statistically significative differences in mastery in relation to clinical conditions (F(2, 253) = 11.22, p < 0.001) and a significative interaction effect between gender and symptomatology (F(2, 253) = 7.22, p < 0.001). Multiple linear regression illustrated a statistically significant association between mastery, clinical conditions, QoL, stress and interoception (adjusted R square = 0.558; F(14, 211) = 21.32, p < 0.001). Concerning the possible mediator role of mastery between psychological state and medical adherence, no statistically significant results emerged from the mediation model analysis.
Conclusion:
This study highlighted an effective impairment of mastery in CD patients, especially among men experiencing mild disease activity. A positive association between mastery and enteroception was outlined. The higher prevalence of distress, anxiety and depressive symptoms connected to mastery was substantiated. Future research should deepen the relationship between mastery with medical adherence.
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