The implementation of mindfulness-based cognitive therapy for patients with inflammatory bowel disease: a qualitative
Sabien J E Bosman1,2, Myrthe van der Leegte3, Milou M Ter Avest3,4,5
1Department of Psychiatry, Expertise Centre for Mindfulness, Radboud University Medical Centre, Nijmegen, Postbus 9101, 6500 HB, the Netherlands. sabien.bosman@radboudumc.nl.
Background:
Our recent trial studying mindfulness-based cognitive therapy (MBCT) for Inflammatory Bowel Disease (IBD) patients demonstrated reductions in psychological distress and improvements in well-being. Building on these findings, the present study aimed to explore barriers and facilitators for implementation and scenarios to overcome these.
Methods:
We conducted a sequential two-part study consisting of qualitative interviews followed by a survey. Semi-structured interviews were conducted with key stakeholders (n = 32) on barriers and facilitators for implementation. The Consolidated Framework for Implementation Research guided data collection and framework analysis. Based on interview outcomes, implementation scenarios were formulated and presented in a survey to stakeholders (n = 21) to explore their perspectives on the most suitable scenario.
Results:
Key barriers identified were scepticism and misconceptions about MBCT and its lack of evidence, and limited funding, time, and perceived competency to discuss mental health in medical consultations. Facilitators included the presence of a local champion, growing attention to lifestyle factors in society and healthcare, and the group-based design of MBCT providing peer support. Stakeholders preferred integrating MBCT within a regional network, but opinions differed. Irrespective of the preferred scenario, stakeholders emphasized the need for a strong business case, including evidence on long-term (cost-)effectiveness, to secure broad support and insurance coverage.
Conclusions:
Although implementing MBCT for IBD patients is worthwhile, several prominent barriers currently hinder this process. A strong business case is needed to gain broad support and insurance coverage. Further research is required to determine the most suitable and feasible implementation scenario and associated strategies.
Clinical Trial Number:
not applicable.
Related Concept Videos
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the colonic...
01:26Inflammatory Bowel Disease I: Introduction
01:29Inflammatory Bowel Disease IV: Pharmacological Management
Pharmacologic...
01:25Inflammatory Bowel Disease III: Crohn's Disease
01:30Inflammatory Bowel Disease II: Crohn's Disease
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by transmural...
01:17Irritable Bowel Syndrome I: Introduction
IBS is a chronic condition that can persist over a long period or recur frequently.
The pathogenesis of IBS involves a complex interplay of the following factors:
Altered...