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Bowel symptoms, self-image and comorbidity impact on well-being of women with coeliac disease
Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Unit of Research and Development in Local Health Care, County of Östergötland. Linköping University, Department of Medical and Health Sciences, Nursing Science.
Lunds universitet.
Lunds universitet.
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2011 (English)In: Journal of Nursing and Healthcare of Chronic Illness, ISSN 1752-9816, Vol. 3, no 3, 302-309 p.Article in journal (Refereed) Published
Abstract [en]

Aim. To explore if gastrointestinal (GI) symptoms, self-image and comorbidity are related to well-being in women with coeliac disease (CD) and whether a history of CD in childhood impacts on well-being in adulthood.

Background. Women in Sweden living with CD show a reduced level of well-being and report a high rate of GI complaints for unclear reasons. The self-image of these women is unknown.

Design. A cross-sectional survey of 231 Swedish women with CD on long-term treatment (≥5 years) with a gluten-free diet (GFD) was conducted in 2010.

Results.  The study showed that well-being is related to a high rate GI symptoms (OR 16·9, 95% CI 5·6-50·7), a negative self-image (OR 8·9, 95% CI 3·5-22·9) and comorbidity (OR 3·3, 95% CI 1·7-6·4). There was no impact of childhood symptoms on well-being, GI symptoms, self-image or comorbidity in adulthood. Half of the study population showed reduced well-being compared with norms. Practically all women (97%) declared that they were always or usually following a GFD and 62% reported at least one disease besides CD.

Conclusion. The study demonstrated that the well-being of women living with CD is affected by GI complaints, self-image and a high rate of comorbidity whereas a history of signs and symptoms of CD in childhood not seems to impact on the well-being in adulthood.

Relevance to clinical practice. Gastrointestinal symptoms, self-image and comorbidity are factors contributing to a low level of well-being of CD women living on a GFD. Launching a multi-disciplinary team for follow-up would represent a novel approach to support these women and may prove valuable in improving their subjective health.

Place, publisher, year, edition, pages
Oxford: Wiley-Blackwell , 2011. Vol. 3, no 3, 302-309 p.
Keyword [en]
adults;comorbidity;gastrointestinal symptoms;nursing;self-image;well-being
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-71428DOI: 10.1111/j.1752-9824.2011.01104.xOAI: diva2:448447
Available from: 2011-10-17 Created: 2011-10-17 Last updated: 2012-03-08Bibliographically approved
In thesis
1. Living with coeliac disease beyond the diagnosis
Open this publication in new window or tab >>Living with coeliac disease beyond the diagnosis
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Introduction: Studies show that women living in Sweden treated for coeliac disease have lower subjective health than other women. After showing signs of remission, adults who have coeliac disease and follow a gluten-free diet, are expected to handle the treatment without any further planned follow-up by health care.

Aim: The overall aim of this thesis was to study aspects of living with coeliac disease in adults in the years beyond the diagnosis.

Methods: Quantitative methods were used in Studies I, II and III. A qualitative content analysis was performed in Study IV.

Results: The results show that women with coeliac disease have a lower level of well-being than men with coeliac disease. The women who have coeliac disease reported a high rate of gastrointestinal symptoms, although they followed a gluten-free diet, and they visited health care services more frequently than women who did not have coeliac disease. A low rate of gastrointestinal symptoms, a positive self-image and few comorbidity emerged as factors that positively affected well-being. Worries also seemed to be a companion of women diagnosed with coeliac disease in adulthood, typically evident when socializing with others.

Conclusion: This thesis may provide evidence questioning the validity of declaring all women with coeliac disease showing a normalized intestinal mucosa to be in remission, and thus leaving them to self-management.

Clinical implications: Health care professionals need to be aware of that the transition to a gluten-free life may vary for individuals. It does not seem enough to follow a gluten-free diet to reach a state of good well-being for all women. A major task for health care providers is therefore to support women with CD in reaching better subjective treatment outcomes. The results may also contribute to that health care system develops routines in order to optimise the care and treatment of these patients.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2011. 85 p.
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1278
Chronic illness, Coeliac disease, Comorbidity, Gastrointestinal complaints, Health care use, Self-image, Well-being
National Category
Medical and Health Sciences
urn:nbn:se:liu:diva-71898 (URN)978-91-7393-019-2 (ISBN)
Public defence
2011-12-08, Aulan K1, Kåkenhus, Campus Norrköping, Linköpings universitet, Norrköping, 13:00 (English)
Available from: 2011-11-09 Created: 2011-11-09 Last updated: 2011-12-12Bibliographically approved

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Roos, SusanneWilhelmsson, SusanHallert, Claes
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Health, Activity, CareFaculty of Health SciencesUnit of Research and Development in Local Health Care, County of ÖstergötlandNursing ScienceDepartment of Internal Medicine VHN
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