ABSTRACT
OBJECTIVE: Stress is an important component in the pathophysiology of irritable bowel syndrome (IBS). Long term Hypothalamus Pituitary Adrenal (HPA)-axis activity can be studied by measuring hair cortisol concentrations (HCC). Some previous studies have indicated a dysregulated HPA-axis in IBS patients, but cortisol levels in hair have not yet been studied. We investigated whether HCC and self-reported stress differentiate IBS patients from controls. METHODS: In a cross-sectional study within 10 Swedish Primary Health Care Centers we compared patients in working age with active IBS to patients without GI complaints. The participants donated hair samples and completed questionnaires including a scale of self-reported perceived stress (PSS). 169 Rome III-fulfilling IBS patients and 316 non-IBS patients were available for final analyses. RESULTS: IBS patients had significantly lower HCC, median=16.3pg/mg, IQR=26.9pg/mg, compared to non-IBS patients, median=22.8pg/mg, IQR=29.1pg/mg. There was also a difference in the distribution of HCC quintiles between the two groups, with 30.2% IBS patients and 14.2% of non-IBS patients in the lowest quintile of HCC. PSS was higher among IBS patients with a mean (SD) total score of 25.3 (8.0) compared to controls 21.4, (7.5). Quintiles of HCC and PSS stayed significantly but very weakly related to IBS (B=-0.332, Std error=0.146, p<0.005) in multivariable analyses. CONCLUSION: This study suggests a possible suppression of the HPA-axis activity in a considerable portion of IBS patients.
Subject(s)
Hair/chemistry , Hydrocortisone/blood , Irritable Bowel Syndrome/physiopathology , Irritable Bowel Syndrome/psychology , Adolescent , Adult , Aged , Case-Control Studies , Cross-Sectional Studies , Female , Humans , Hypothalamo-Hypophyseal System/physiopathology , Male , Middle Aged , Pituitary-Adrenal System/physiopathology , Primary Health Care , Stress, Psychological/complications , Stress, Psychological/physiopathology , Stress, Psychological/psychology , Sweden , Young AdultABSTRACT
AIM: The aim of the study was to examine the usability of an interactive web-based mobile reminder calendar (RemindMe) developed for supporting individuals in organizing, planning and executing activities in everyday life, from the perspectives of professionals. METHODS AND MATERIAL: Eleven professionals working in community services evaluated the usability of RemindMe in their clinical practice. Data were collected using semi-structured interviews and analysed with inductive qualitative analysis. RESULTS: The professionals perceived that RemindMe was useful, easy to use, and intuitive. There was a need among professionals for a web-based reminder calendar that requires the active acknowledgement of reminders. RemindMe's feedback system offering self-monitored information based on the user's interaction with the system supported the professionals in discussions, evaluation, and follow-up based on the needs of the persons with cognitive impairments. CONCLUSION: The results indicate that RemindMe may be potentially useful to professionals who provide support to individuals with cognitive impairments. However, further research is needed to evaluate experience of using RemindMe from the perspective of individuals with cognitive impairments.
