title: Relationship between health status, illness perceptions, coping strategies and psychological morbidity: a preliminary study with IBD stoma patients.
abstract: OBJECTIVE
  Individuals living with IBD and a stoma are at an increased risk of anxiety and depression and it is likely that several factors mediate these relationships, including illness perceptions and coping strategies. Using the Common Sense Model (CSM), this study aimed to characterize the mediators of anxiety and depression in an IBD stoma cohort.
  
  
  METHODS
  Eighty-three adults (23 males) with a stoma (25 ileostomy, 58 colostomy; 26 emergency, 57 planned, 55 permanent, 28 temporary) completed an online survey. Health status was measured with the Health Orientation Scale (HOS), coping styles assessed with the Carver Brief COPE scale, illness perceptions explored with the Brief Illness Perceptions Questionnaire (BIPQ), and anxiety and depression were measured using the Hospital Anxiety and Depression Scale (HADS).
  
  
  RESULTS
  Combining the questionnaire data using structural equation modeling resulted in a final model with an excellent fit (χ(2) (11)=12.86, p=0.30, χ(2)/N=1.17, SRMR<0.05, RMSEA<0.05, GFI>0.96, CFI>0.99). Consistent with the CSM, health status directly influenced illness perceptions, which in turn, influenced coping (emotion-focused and maladaptive coping). Interestingly, months since surgery was found to influence illness perceptions and emotion-focused coping directly, but not health status. While depression was influenced by illness perceptions, emotion-focused coping and maladaptive coping, anxiety was only influenced by illness perceptions and maladaptive coping.
  
  
  CONCLUSIONS
  The preliminary results provide further evidence for the complex interplay between psychological processes. In terms of directions for psychological interventions, a focus on identifying and working with illness perceptions is important.
authors.affiliation: Faculty of Life and Social Sciences, Swinburne University of Technology, Melbourne, Australia; Faculty of Medicine, Dentistry, & Health Sciences, The University of Melbourne, Melbourne, Australia; Colorectal Medicine and Genetics, The Royal Melbourne Hospital, Melbourne, Australia. Electronic address: sknowles@swin.edu.au.
authors.forename: S R
authors.initials: SR
authors.lastname: Knowles
authors.forename: S I
authors.initials: SI
authors.lastname: Cook
authors.forename: D
authors.initials: D
authors.lastname: Tribbick
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001007:Anxiety / Q000209:etiology / Q000523:psychology*; D003125:Colostomy / Q000523:psychology; D003863:Depression / Q000209:etiology / Q000523:psychology*; D004644:Emotions; D005260:Female; D006304:Health Status; D006801:Humans; D007081:Ileostomy / Q000523:psychology; D015212:Inflammatory Bowel Diseases / Q000523:psychology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010465:Perception; D011569:Psychiatric Status Rating Scales; D013997:Time Factors
keywords: Anxiety and depression; Common Sense Model; Coping; Illness perceptions; Inflammatory Bowel Disease; Stoma