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An Intervention for Person-Centered Support in Irritable Bowel Syndrome

Development and Pilot Study

Björkman, Ida PhD, RN; Ringström, Gisela PhD, RN; Simrén, Magnus PhD, MD; Myrgren, Jenny MSc, RN; Jakobsson Ung, Eva PhD, RN

doi: 10.1097/SGA.0000000000000378
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Irritable bowel syndrome is a common and often chronic functional bowel disorder that can cause severe disruption of daily functioning in those affected, with subsequent high healthcare utilization and work absenteeism. Nurses represent an underutilized group in the current management of irritable bowel syndrome. The aim of this study was to systematically develop a person-centered support intervention in irritable bowel syndrome and evaluate this in a pilot study. The development followed the revised framework for complex interventions from the Medical Research Council and involved literature reviews and multiprofessional expert groups. The intervention was then tested in a pilot study including 17 patients and evaluated through validated questionnaires measuring irritable bowel syndrome symptom severity, gastrointestinal-specific anxiety, and self-efficacy as well as through interviews. There was a significant improvement in irritable bowel syndrome symptom severity between baseline and follow-up, but not for self-efficacy or gastrointestinal-specific anxiety. The patients' perceptions of participating in the intervention were positive and induced a learning process; they were able to form a supportive relationship with the nurse and their ability to self-manage improved. The promising results from this small pilot study in terms of feasibility, potential efficacy, and the patients' positive feedback make this intervention a suitable candidate for a larger controlled trial.

Ida Björkman, PhD, RN, is Senior Lecturer, Institute of Health and Care Sciences and the Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Gisela Ringström, PhD, RN, is Head Nurse, Department of Internal Medicine & Clinical Nutrition, Institute of Medicine and the Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Magnus Simrén, PhD, MD, is Professor, Department of Internal Medicine & Clinical Nutrition, Institute of Medicine and the Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Jenny Myrgren, MSc, RN, is Nurse, Institute of Health and Care Sciences and the Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Eva Jakobsson Ung, PhD, RN, is Professor, Institute of Health and Care Sciences and the Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Correspondence to: Ida Björkman, PhD, RN, Institute of Health and Care Sciences and the Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, SE-413 45 Gothenburg, Sweden (ida.bjorkman@gu.se).

Magnus Simrén has received unrestricted research grants from Danone and AstraZeneca and served as a Consultant/Advisory Board member for AstraZeneca, Danone, Novartis, Almirall, and Shire/Movetis. Ida Björkman has served as a lecturer on behalf of Shire. Gisela Ringström, Jenny Myrgren, and Eva Jakobsson Ung report no conflicts of interests.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (www.gastroenterologynursing.com).

Received February 23, 2017

Accepted July 22, 2017

© 2019 by the Society of Gastroenterology Nurses and Associates, Inc.