title: Psychological well-being and quality of life in Crohn's disease patients with an ostomy: a preliminary investigation.
abstract: OBJECTIVE
  The aims of this research were to explore associations among elective versus emergency surgery, type of ostomy (permanent vs temporary), illness perceptions and coping style, anxiety, depression, and health-related quality of life in persons with Crohn's disease. A further aim was to determine the extent of current and past use of psychological care and use of psychotropic medications.
  
  
  METHODS
  The sample comprised 31 persons (17 men and 14 women; mean age 45 years) with Crohn's disease and an ostomy from 2 large teaching hospitals in Melbourne, Australia.
  
  
  METHODS
  Data were collected using a descriptive, cross-sectional design. The questionnaire incorporated 3 validated instruments: the Brief Illness Perceptions Questionnaire, the Hospital Anxiety and Depression Scale, and the Stoma Quality of Life Scale.
  
  
  RESULTS
  Poor illness perception correlated significantly with increased anxiety, depression, and reduced health-related quality of life (specifically, sexuality and body image, work and social functioning, stoma function, and financial concerns). Forty-eight percent of patients scored more than the cutoff for anxiety, and 42% scored more than the cutoff for depression on the Hospital Anxiety and Depression Scale. Of these, only 20% and 31%, respectively, reported currently receiving psychological care. The timing of ostomy surgery (planned vs emergency) or ostomy type (permanent vs temporary) was not significantly associated with anxiety, depression, or health-related impaired quality of life.
  
  
  CONCLUSIONS
  In this exploratory, cross-sectional study, patients with Crohn's disease and a stoma had high rates of psychological comorbidity and low scores on quality of life. Adverse illness perception appeared to explain some of these findings, but most were not receiving psychological help. Psychological care is indicated for many of these patients and further research is indicated.
authors.affiliation: Fang Cheng, MD, RN, Ostomy Nurse, Jiang Su Cancer Hospital, the Affiliated Hospital of Nanjing Medical University, No. 42, Baiziting, Nanjing, China. Ai-Feng Meng, BS, RN, Superintendent, Nursing Department, Jiang Su Cancer Hospital, the Affiliated Hospital of Nanjing Medical University, No. 42, Baiziting, Nanjing, China. Li-Fang Yang, BS, RN, ET, Enterostomal Therapist, Jiang Su Cancer Hospital, the Affiliated Hospital of Nanjing Medical University, No. 42, Baiziting, Nanjing, China.
authors.forename: Simon R
authors.initials: SR
authors.lastname: Knowles
authors.forename: Jarrad
authors.initials: J
authors.lastname: Wilson
authors.forename: Annette
authors.initials: A
authors.lastname: Wilkinson
authors.forename: William
authors.initials: W
authors.lastname: Connell
authors.forename: Michael
authors.initials: M
authors.lastname: Salzberg
authors.forename: David
authors.initials: D
authors.lastname: Castle
authors.forename: Paul
authors.initials: P
authors.lastname: Desmond
authors.forename: Michael A
authors.initials: MA
authors.lastname: Kamm
mesh_terms: D003424:Crohn Disease / Q000523:psychology* / Q000601:surgery*; D003430:Cross-Sectional Studies; D017558:Elective Surgical Procedures; D004630:Emergencies; D005260:Female; D006801:Humans; D008297:Male; D008347:Manifest Anxiety Scale; D008875:Middle Aged; D010030:Ostomy; D011788:Quality of Life; D011795:Surveys and Questionnaires