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Research Project: Pediatric Clinical Nutrition

Location: Children's Nutrition Research Center

Title: Patient health communication mediating effects between gastrointestinal symptoms and gastrointestinal worry in pediatric inflammatory bowel disease

Author
item Varni, James - Texas A&M University
item Shulman, Robert - Children'S Nutrition Research Center (CNRC)
item Self, Mariella - Texas Children'S Hospital
item Saeed, Shehzad - Children'S Hospital - Cincinnati, Ohio
item Patel, Ashish - University Of Texas Southwestern Medical Center
item Nurko, Samuel - Boston Children'S Hospital
item Neigut, Deborah - Children'S Hospital - Denver, Colorado
item Saps, Miguel - Northwestern University
item Zacur, George - Children'S Hospital - Cincinnati, Ohio
item Dark, Chelsea - Texas A&M University
item Bendo, Cristiane - Federal University Of Minas Gerais
item Pohl, John - University Of Utah

Submitted to: Inflammatory Bowel Diseases
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 1/18/2017
Publication Date: 5/1/2017
Citation: Varni, J.W., Shulman, R.J., Self, M.M., Saeed, S.A., Patel, A.S., Nurko, S., Neigut, D.A., Saps, M., Zacur, G.M., Dark, C.V., Bendo, C.B., Pohl, J.F. 2017. Patient health communication mediating effects between gastrointestinal symptoms and gastrointestinal worry in pediatric inflammatory bowel disease. Inflammatory Bowel Diseases. 23(5):704-711.

Interpretive Summary: Stomach and intestinal problems are common in children and adults. They often cause worry and stress. We studied what factors surrounding stomach and intestinal problems contribute to worry. One of the most important factors that could contribute to worry about stomach and intestinal problems is how well or poorly a person is able to communicate their concerns to a doctor or significant other. This study points to the need to develop better lines of communication so that people with stomach and intestinal problems worry less.

Technical Abstract: To investigate the effects of patient health communication regarding their inflammatory bowel disease (IBD) to their health care providers and significant others in their daily life as a mediator in the relationship between gastrointestinal symptoms and gastrointestinal worry in pediatric patients. The Pediatric Quality of Life Inventory Gastrointestinal Symptoms, Gastrointestinal Worry, and Communication Scales, and Pediatric Quality of Life Inventory 4.0 Generic Core Scales were completed in a 9-site study by 252 pediatric patients with IBD. Gastrointestinal Symptoms Scales measuring stomach pain, constipation, or diarrhea and patient communication were tested for bivariate and multivariate linear associations with Gastrointestinal Worry Scales specific to patient worry about stomach pain or bowel movements. Mediational analyses were conducted to test the hypothesized mediating effects of patient health communication as an intervening variable in the relationship between gastrointestinal symptoms and gastrointestinal worry. The predictive effects of gastrointestinal symptoms on gastrointestinal worry were mediated in part by patient health communication with health care providers/significant others in their daily life. In predictive models using multiple regression analyses, the full conceptual model of demographic variables, gastrointestinal symptoms (stomach pain, constipation, or diarrhea), and patient communication significantly accounted for 46, 43, and 54 percent of the variance in gastrointestinal worry (all Ps < 0.001), respectively, reflecting large effect sizes. Patient health communication explains in part the effects of gastrointestinal symptoms on gastrointestinal worry in pediatric patients with IBD. Supporting patient disease-specific communication to their health care providers and significant others may improve health-related quality of life for pediatric patients with IBD.