Abstract
Abstract
Background
The prevalence of Crohn’s disease (CD) has markedly increased in Saudi Arabia over the past 3 decades.Patients’ awareness of the chronic recurrent course and potential risk of disease complications can lead to a wide range of psychological and interpersonal concerns. Patients’ cognition about the disease and treatment are important mediators as they explain the occurrence of individual differences in the individuals’ adjustment to chronic diseases. The aim of this study is to assess illness cognition of Saudi patients diagnosed with CD and to identify clinical predictors.
Methods
Consecutive patients with confirmed CD seen in the adult outpatient gastroenterology clinic at King Abdulaziz university hospital were recruited between January and December of 2019. Data was collected from interviews conducted with the patients and from the hospitals’ electronic medical records.The primary endpoint of the study was patients’ illness cognition according to the illness cognition questionnaire (ICQ), which can be used to assess three cognitive functions that patients attribute to disease: helplessness (6 items), acceptance (6 items), and perceived benefits (6 items). Each item is scored from 1 to 4, with 1 corresponding to ‘Not’, and 4 corresponding to ‘Totally. Descriptive statistics were used to summarise patient characteristics and linear regression analysis was used to identify predictors of the ICQ score.
Results
A total of 88 patients were surveyed, of which 55.8% were females, 18% were smokers and 11.5% had undergone CD-related surgery. The mean age was 26.9 ± 7.7 years and the mean duration of disease was 54.7 ± 60.5 months. Perianal disease was reported by 16.1% of the cohort. Twenty eight percent of patients reported that they ‘completely’ missed things that they like to do the most because of their illness and 35% responded by ‘not at all’ when asked if they had learned to live with their disease. Forty one percent of patients reported that the illness ‘completely’ controls their life and 30% responded by ‘not at all’ when asked if they can accept their illness. Mean ICQ score was 44.3 ( ± 6.6). On linear regression analysis, duration of the disease in months (coef = −0.04, p = 0.008) and fatigue (coef = −1.40, p = 0.04) were predictive of the ICQ score.
Conclusion
A considerable proportion of Saudi patients diagnosed with CD report negative perception of their disease. Duration of illness and presence of fatigue appear to be predictive of the ICQ score.