ABSTRACT
INTRODUCTION: The COVID19 pandemic has been primarily mitigated with behavioralstrategies such as social distancing, mask wearing, increased hand washing, and stay athome orders. Negative consequences were increased isolation, lack of access to medicalservices, medication shortages, and scarcity of daily necessities;all of which can lead toadverse mental health consequences. The aim of the current international study was todescribe the effect of the pandemic on the well-being of people with gastrointestinal (GI)diseases. METHODS: In this cross-sectional study, participants were recruited through socialmedia ads, posted by patient organizations, opinion leaders, and the authors from May toOctober 2020, and asked to complete online surveys. Psychological distress was measuredwith the Depression, Anxiety and Stress Scale (DASS), GI symptoms with the GastrointestinalSymptoms Rating Scale (GSRS), and quality of life (QoL) with the World Health OrganizationQuality of Life scale (WHOQOL). All questionnaires were in English and answered byEnglish speakers only. Three separate regressions were run with psychosocial distress, QoL,and GI symptoms as dependent variables and self-reported impacts of the pandemic on GIdisease as the independent variables. All models controlled for gender and self-reported prepandemiclevels of the dependent variables. RESULTS: 831 people participated from 22countries (top five were: 37.7% England, 12.2% Australia, 9.5% Poland, 8.3% New Zealand,7.6% USA). Mean age was 49.3 years;82.3% female. The most common GI conditions wereinflammatory bowel disease (38.4%), celiac disease (33.6%), and irritable bowel syndrome(31.4%). Table 1 shows the self-reported impact of the pandemic on aspects of care fortheir GI condition(s). Table 2 shows significant correlations between all these challengesand ratings of psychosocial distress, GI symptoms, and QoL. Regression analyses indicatedthat increased GI symptoms during the pandemic (R2= 0.65) were associated with increaseddifficulties relayted to managing GI disease (ß=0.133, p=0.009), appointments with primarycare doctor (ß=0.152, p=0.013), and diet adherence (ß=0.143, p=0.016). Decreased QoLduring the pandemic (R2= 0.60) was associated with perceived difficulties in accessing toiletpaper (ß=-2.611, p=0.010). None of the variables were associated with psychological distressafter controlling for pre-pandemic levels. CONCLUSION: COVID19 pandemic is affectingGI patients by restricting access to care, medications, toilet paper, and usual diet. Qualityof life and GI symptoms were associated with these challenges, but no effect was found formental health. These findings indicate that the COVID19 pandemic is having adverse impactson GI patients that should be mitigated with future appropriate planning and preventionstrategies.(Table Presented) (Table Presented)
ABSTRACT
Background Although several studies have reported the impact of fears relating to COVID-19 on several chronic illness populations, there are few studies focused on gastrointestinal (GI) conditions. The aim was to compare how fear of COVID-19 is manifested in people living with Inflammatory Bowel Disease (IBD) compared to other GI conditions across different demographic backgrounds (employment status, education level and country of residence) using a large international sample. Method Participants with a GI condition (≥18years of age) were recruited from 22 countries through a web-based questionnaire. Demographic, clinical, and psychosocial information was collected in relation to the COVID-19 pandemic. An adaptation of the scale developed for IBD by Trindade & Ferreira (2020, Figure 1) measuring fear of COVID-19 (FoC;original items 1-9) and GI specific fear of COVID-19 (GI-FoC;new items 10-14) was used. Oneway ANOVA or x2 test was chosen as appropriate. Results In 831 participants (312 IBD), there were no significant differences in FoC between IBD and other GI conditions;whilst significant increases in GI-FoC were found in IBD respondents (mean [SD]: 13.5 [5.5] vs. 10.9 [5.0], p<0.01). The greatest fears of IBD respondents were: their condition would get worse;impact on access to medical support;being at increased risk of getting COVID-19;and being at increased risk of death if they got COVID-19. Having an unclassifiable employment status, e.g. redundancy, (mean [SD], unclassifiable: 33.3 [9.3], employed/students: 25.9 [8.3], unemployed: 28.6 [11.5], retired/ home duties: 27.2 [8.6], p<0.01) impacted on IBD respondents having FoC (and near significant GI-FoC [p=0.051]). Those individuals were more afraid of contracting COVID-19 or having contact with other people. Participants living in a rural setting had significantly more FoC and GI-FoC (mean [SD], rural setting: 28.9 [9.9] & 13.3 [5.5], regional setting: 25.5 [7.9] & 12.9 [5.0], metropolitan setting: 27.0 [8.9] & 13.3 [5.5], p=0.04 & 0.03, respectively). These participants were more afraid of having contact with other people, going outside, and believed that they are more likely to get COVID-19 and more likely to die if they got COVID-19 due to their IBD. There were no differences in FoC and GI-FoC by education levels. However, participants with higher education were less afraid of dying from COVID-19 (question 9, p<0.01). Conclusion Respondents with IBD are more afraid of the consequences of COVID-19 due to their disease compared to other GI diseases;especially, persons with undefinable employment status or persons living in a rural setting. Persons with higher education were less afraid of dying from COVID-19. These findings should be taken into consideration to personalize the support health care providers can offer in mitigating fear related to COVID-19 in IBD patients.(Table Presented)
ABSTRACT
Introduction: Although several studies have reported the impact of fears relating to COVID-19 on several chronic illness populations, there are few studies focused on gastrointestinal (GI) conditions1-4. The aim was to compare how fear of COVID-19 is manifested in people living with Inflammatory Bowel Disease (IBD) compared to other GI conditions;and, how fear of COVID-19 is manifested across different demographic backgrounds (employment status, education level and country of residence) among IBD respondents using a large international sample. Aims & Methods: Participants with a GI condition (≥18years of age) were recruited from 22 countries through a web-based questionnaire. Demographic, clinical, and psychosocial information was collected in relation to the COVID-19 pandemic. An adaptation of the scale developed for IBD by Trindade & Ferreira (2020)5 measuring fear of COVID-19 (FoC;original items 1-9) and GI specific fear of COVID-19 (GI-FoC;new items 10-14) was used. Results: In 831 participants (312 IBD), there were no significant differences in FoC between IBD and other GI conditions;whilst significant increases in GI-FoC were found in IBD respondents (mean [SD]: 13.5 [5.5] vs. 10.9 [5.0], p<0.01). The greatest fears of IBD respondents were: their condition would get worse;impact on access to medical support;being at increased risk of getting COVID-19;and being at increased risk of death if they got COVID-19. Among IBD respondents, persons on sick leave had significantly more FoC than those employed (median [IQR], 31.0 [28.5-39.5] vs 26.0 [20.0-33.0], p=0.035), and significantly more GI-FoC compared to the employed (18.0 [14.5-22.0] vs 13.0 [9.0-17.0], p=0.033) or respondents outside of the labour market (12.0 [7.0-16.0], p=0.022). Persons living in a rural setting had significantly more FoC compared to persons living in regional setting (29.5 [22.0-37.8] vs 25.0 [20.0-31.3], p=0.007) and GI-FoC (15.0 [11.0-19.8] vs 12.0 [9.0-16.0], p=0.02). These persons were fearful of contracting COVID-19, having contact with someone with respiratory symptoms, having contact with healthcare professionals, going outside, meeting people, having contact with someone who was in contact with an infected person, having contact with someone infected with COVID-19, and that their IBD means being at increased risk of death if they got COVID-19. There were no differences in general FoC and GI-FoC according to educational background. However, respondents with higher education were less afraid of dying from COVID-19. Conclusion: Respondents with IBD are more afraid of the consequences of COVID-19 due to their disease compared to other GI diseases;especially, persons on sick leave or persons living in a rural setting. Persons with higher education were less afraid of dying from COVID-19. These findings should be taken into consideration to personalise the support health care providers can offer in mitigating fear related to COVID-19 in IBD patients.