title: Illness perceptions mediate the relationship between bowel symptom severity and health-related quality of life in IBS patients.
abstract: OBJECTIVE
  Irritable bowel syndrome (IBS) is a functional bowel disorder with a large negative impact on HRQOL. The present study examines whether severity of bowel symptoms is directly related to HRQOL, and/or indirectly, mediated by the patients' illness perceptions.
  
  
  METHODS
  Patients were recruited from an IBS support group (N = 123), and data were collected online. HRQOL was measured with the Quality of Life Measure for Persons with IBS and illness perceptions with the brief Illness Perception Questionnaire. Mediation models were tested using the bootstrapping procedure developed by Hayes.
  
  
  RESULTS
  Irritable bowel syndrome symptom severity is directly related to total HRQOL and its subscales; after entering the mediator variables (i.e. the patients' illness perceptions) into the model, this direct association remained only significant for total HRQOL. The relationship between bowel symptom severity and total HRQOL was partially mediated by illness perceptions, and its relationship with each of the HRQOL subscales was fully mediated by the patients' illness perceptions. Perceived consequences were a mediator of the relationship between bowel symptom severity, total HRQOL as well as its subscales, with the exception of Sexuality.
  
  
  CONCLUSIONS
  Bowel symptom severity not only has a direct relationship with HRQOL, but also an indirect relationship via the patients' cognitive and emotional representations of their illness. In order to better understand this relationship, future research should not only include illness perceptions but also assess cognitive and behavioural coping responses. Clinicians wanting to improve patients' HRQOL should not only focus on the patients' symptoms, but also on their illness beliefs and coping responses.
authors: Health Psychology Unit, Faculty of Social Sciences, Institute of Psychology, Leiden University, Wassenaarseweg 52, PO BOX 9555, 2300 RB, Leiden, The Netherlands, degucht@fsw.leidenuniv.nl.
authors: Véronique
authors: V
authors: De Gucht
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D003071:Cognition; D004644:Emotions; D005260:Female; D006304:Health Status; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010465:Perception; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D055815:Young Adult