title: Coping strategy when patients with quiescent Crohn's disease recognize that their conditions are worsening.
abstract: BACKGROUND
  Although self-management is important for Crohn's disease (CD), there is no research focusing on self-management, especially in worsening conditions. The purpose of this study was to investigate how quiescent CD patients cope with their conditions worsening.
  
  
  METHODS
  A questionnaire containing six types of coping strategy for worsening conditions was created based on a semi-structured interview. Seventy-six quiescent CD patients participated in this study. We also analyzed the related factors of each coping strategy for worsening conditions.
  
  
  RESULTS
  The total percentage of subjects who adopt the strategy of "change contents of meals" 'always' or 'often' was approximately 70%. On the other hand, the strategy of "see a doctor immediately" was approximately 20% in total of 'always' or 'often'. When 'sometimes' was added, "take extra medicine" was approximately 42%. The subjects with experience of hospitalization within 3 years (Z = -2.352, P = 0.019), presence of supplemental elemental diet (Z = -5.182, P < 0.001), or 1 year or less interval since last relapse (Z = -3.352, P = 0.001) showed a significant tendency to adopt the coping strategy of "take (add to) elemental diet."
  
  
  CONCLUSIONS
  The major coping strategy was "change contents of meals," and the minor coping strategy was "see a doctor immediately." The subjects with unstable disease state adopted the coping strategy of "take (add to) elemental diet." The coping strategies for worsening conditions vary according to patients' backgrounds. The coping type should be taken into account when treating CD patients.
authors: Department of Adult Nursing/Palliative Care Nursing, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan. hmakoto-tky@umin.ac.jp
authors: Makoto
authors: M
authors: Tanaka
authors: Yasushi
authors: Y
authors: Iwao
authors: Susumu
authors: S
authors: Okamoto
authors: Haruhiko
authors: H
authors: Ogata
authors: Toshifumi
authors: T
authors: Hibi
authors: Keiko
authors: K
authors: Kazuma
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D003424:Crohn Disease / Q000503:physiopathology / Q000523:psychology*; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012648:Self Care / Q000379:methods*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D055815:Young Adult