gms | German Medical Science

MAINZ//2011: 56. GMDS-Jahrestagung und 6. DGEpi-Jahrestagung

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie e. V.
Deutsche Gesellschaft für Epidemiologie e. V.

26. - 29.09.2011 in Mainz

Psychosocial impairments in patients with inflammatory bowel diseases (IBD): Construction and validation of an indicator scale of perceived stress based on item response theory

Meeting Abstract

  • Juliane Hardt - Universität zu Lübeck, Institut für Sozialmedizin, Lübeck
  • Susann Conrad - Ärztliches Zentrum für Qualität in der Medizin, Abteilung Evidenzbasierte Medizin und Leitlinien, Berlin
  • Cathleen Muche-Borowski - Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF), Düsseldorf/Berlin
  • Heiner Raspe - Universität zu Lübeck/ UK S-H, Professur für Bevölkerungsmedizin, Lübeck

Mainz//2011. 56. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds), 6. Jahrestagung der Deutschen Gesellschaft für Epidemiologie (DGEpi). Mainz, 26.-29.09.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11gmds317

doi: 10.3205/11gmds317, urn:nbn:de:0183-11gmds3171

Veröffentlicht: 20. September 2011

© 2011 Hardt et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen ( Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.



Background: Inflammatory bowel diseases (IBD: Crohn‘s disease, ulcerative colitis) are chronic relapsing diseases. Manifestations of the disease affect predominantly the bowel, but also extraintestinal organ systems (e.g. skin, eyes, joints, liver). The prevalence of IBD in Germany is 320.000 patients [1], [2]. We previously reported data on the substantial psychosocial impairments of IBD patients from a German survey [3], which seem to constitute a high psychosocial/mental burden of this chronic disease. Recent studies showed associations of exposure to stress and acute episodes of active disease [1], [2]. A secondary analysis of IBD survey data investigates associations of perceived daily stress (without theoretical definition) with disease symptoms, indicators of mental health and health care utilization [4]. A short scale of perceived stress with three items was constructed and analyzed as a potential indicator for psychosocial impairments (construct/criterion validity).

Methods: Survey data of 1018 IBD patients (65 % female, 58 % CD patients, mean age 42 yrs, disease duration: 13 yrs) on perceived daily stress, mental strains associated with the disease (e.g. anxiety and depression: HADS [5]) and utilization of health care services were analyzed. Scale construction was based on item response theory. Scale properties were investigated with factor analysis, reliability analyses and model-fit statistics (Rasch modelling with Winsteps 3.68®).

Results: A unidimensional scale with good properties (Cronbach's α: .73; person reliability: .76) was constructed with three items on perceived stress (frequency of stress, impairment by stress, suffering from stress and extraordinary strains). Three groups (low, moderate, high perceived stress) were identified, which differed substantially in reported anxiety (d = 1.2) and depression (d = 0.9), in an objective disease activity score (GIBDI) and further symptoms. In addition, the three groups differ concerning preferences for and utilization of various (esp. psychosocial) health services.

Conclusions: IBD patients report multiple psychosocial impairments [1]. The scale for perceived stress seems to be able to identify IBD patients with severe psychosocial impairments and a high demand for psychosocial attendance, if confirmed in independent samples. To inhance secondary prevention of impairments of chronic disease and allowing for the optimizing of health care services [6] we propose to integrate this indicator for psychosocial impairments into the diagnostic process.


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