Individualni obrasci reagovanja na simptome bolesti kod obolelih od hroničnih zapaljenskih bolesti creva

Abstract

Hronične zapaljenske bolesti creva (engl. Inflammatory Bowel Disease - IBD), koje uključuju ulcerozni kolitis (engl. Ulcerative colitis - UC) i Kronovu bolest (engl. Crohn’s disease - CD), su hronična recidivirajuća oboljenja nepoznate etiologije i nedovoljno razjašnjene patogeneze. Tok bolesti je nepredvidiv i na njega utiču brojni psihosocijalni faktori, uključujući i ličnost obolelog. Cilj: Ciljevi ovog istraživanja su bili ispitivanje karakteristika ličnosti obolelih od hroničnih zapaljenskih bolesti creva, ispitivanje individualnih obrazaca reagovanja na simptome bolesti u fazi remisije i procena moderirajućeg efekta pojedinih crta ličnosti na individualne obrasce reagovanja. Metodologija: Studija je obavljena u Univerzitetskom Kliničko bolničkom Centru “Zvezdara” u Beogradu. Prvi deo studije je dizajniran kao longitudinalna opservaciona studija preseka a drugi deo je dizajniran po principima studije vremenskih serija tipa dnevnika sa dnevnim intervalima. U studiju je bilo uključeno 150 ispitanika, oba pola, sa dijagnozama UC (50.7%) i CD (49.3%) u remisiji, starosti od 18-65 godina, bez drugih hroničnih somatskih oboljenja i bez psihijatrijskih oboljenja. Sociodemografski podaci i podaci o bolesti su prikupljeni iz bolničke medicinske dokumentacije. Procenjivanje crta ličnosti obavljeno je primenom upitnika za samoprocenu The Revised NEO personality inventory (NEO PI - R) i DELTA 10. Tokom 14 uzastopnih dana ispitanici su popunjavali Inventare dnevnih događaja, misli i emocija koji su konstruisani za potrebe ove studije i tako su za svakog ispitanika dobijene multiple dnevne samoprocene u vidu vremenskih serija. U analizi dobijenih podataka korišćeni su odgovarajući parametarski testovi i serija hijerarhijskih modelovanja slučajnim koeficijentima (engl. Multilevel random coefficient modeling – MRCM). Podaci su analizirani primenom statističkog programa IBM SPSS 21 i softvera HLM 6.06. Rezultati: U poređenju sa normativnim uzorkom, oboleli od IBD su imali značajno više skorove Neuroticizma i značajno niže skorove Dezintegracije. Na nivou faceta, oboleli od IBD su imali značajno više skorove na facetima Anksioznost, Asertivnost, Blaga narav i Dužnost i značajno niže skorove na facetima Toplina, Potraga za uzbuđenjem, Pozitivne Emocije, Akcija, kao i na svim facetima Dezintegracije osim Depresije, Somatoformne Disregulacije i Socijalne Anhedonije. Razlike između UC i CD nađene su samo na nivou faceta...

Inflammatory Bowel Disease (IBD), including Ulcerative Colitis (UC) and Crohn’s disease (CD), are chronic relapsing diseases of unknown aetiology and insufficiently explained pathogenesis. The course of disease is unpredictable and it is influenced by many psychosocial factors, including personality of the patient. Purpose: The purpose of this study was to observe the personality traits of the patients suffering from IBD, to examine individual patterns of reaction to the symptoms of diseases in remission stage and to evaluate the moderating effects of personality traits on individual patterns of reaction. Methodology: The study has been conducted at the University Clinical Hospital Centre “Zvezdara” in Belgrade. The first part of the study was designed as a longitudinal observational cross-section study, while the second part was designed according to the principles of time-based diary study as daily-diary study. The study included 150 participants of both genders, suffering from UC (50.7%) and CD (49.3%) in the remission, from 18 to 65 years of age. None of the participants suffered from other chronic somatic diseases or psychiatric disorders. Socio-demographic data and the disease related data were collected from the clinical medical documentation. The personality traits related data were collected using the self-assessment survey - The Revised NEO personality inventory (NEO PI - R) and DELTA 10. During the period of 14 consecutive days, the subjects were filling in the Inventories of daily events, thoughts and emotions, specially designed for the needs of this study. This provided us with the multiple daily self-assessments formed as time series for each subject. The analysis of the obtained data used appropriate tests of parameters and the serial of multilevel random coefficient modelling (MRCM). The data were analysed by means of statistical software IBM SPSS 21 and software HLM 6.06. Results: In comparison to the normative sample, the subjects suffering from IBD had significantly higher scores of Neuroticism and significantly lower scores of Disintegration. On the facet level, the subjects suffering from IBD had significantly higher scores in the following facets: Anxiety, Assertiveness, Tender-mindedness and Dutifulness, and significantly lower scores in facets Warmth, Excitement Seeking, Positive Emotions, Activity, and in all other Disintegration facets, with the exception of Depression, Somatoform Dysregulation and Social Anhedonia...