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Impact of an Active Patient Education Programme on GastrointestinalSymptoms in Women with Celiac Disease Following a Gluten-free Diet: Randomized Controlled Trial
Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Department of LAH/Linnéa.ORCID iD: 0000-0002-9606-3238
Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Department of Internal Medicine in Norrköping.
2012 (English)In: Gastroenterology Nursing, ISSN 1042-895X, E-ISSN 1538-9766, Vol. 35, no 3, 200-206 p.Article in journal (Refereed) Published
Abstract [en]

Despite living with a gluten-free diet Swedish women with celiac disease report a higher rate of gastrointestinal symptoms than women without the disease. This study was designed to assess the impact of active patient education on gastrointestinal symptoms in women with a gluten-free diet. A total of 106 Swedish women, > 20 years, with celiac disease on a gluten free diet for minimum five years took part in a randomized, controlled trial. The intervention group (n=54) underwent a ten-session educational program “Celiac School”, based on problem-based learning. Controls (n=52) were sent information regarding celiac disease at home. Outcome measure was gastrointestinal symptoms at ten weeks and six months after intervention, assessed with the Gastrointestinal Symptom Rating Scale. After ten weeks “Celiac school” (p=0.013) the participating women reported significant improvements that remained six months later (p=0.029). The controls did not improve significantly. A comparison of the development of scores, from baseline to 10 weeks, could not demonstrate a significant difference in the overall index between the two groups but showed a significant improvement concerning one of its components, namely the index reflecting Abdominal Pain (p= 0.007). Intervention methods should be refined in order to reach an even more pronounced effect.

Place, publisher, year, edition, pages
United States: Lippincott Williams & Wilkins, 2012. Vol. 35, no 3, 200-206 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-72453DOI: 10.1097/SGA.0b013e318255fe3aISI: 000304758000005OAI: oai:DiVA.org:liu-72453DiVA: diva2:459725
Note

On the day of the defence day the status of this article was: Manuscript

Available from: 2011-11-28 Created: 2011-11-28 Last updated: 2017-12-08Bibliographically approved
In thesis
1. Daily life experiences, symptoms and well being in women with coeliac disease: A patient education intervention
Open this publication in new window or tab >>Daily life experiences, symptoms and well being in women with coeliac disease: A patient education intervention
2011 (English)Licentiate thesis, comprehensive summary (Other academic)
Abstract [en]

Background and aims: Despite living with a gluten-free diet (GFD) Swedish women with coeliac disease (CD) report a lower level of well-being than women without the disease and than men with the disease. The aims of this thesis were to describe the life experience of being a woman living with CD (I) and to assess the effects of patient education (PE) with problem based learning (PBL) on psychological well-being (II) and gastrointestinal symptoms (III).

Subjects and methods: In total 106 women, > 20 years, with confirmed CD, who had been treated with a GFD for a minimum of five years were randomized (II&III) to one of two groups: either to the intervention group (n=54) that underwent a ten-session educational program, called ‘Coeliac School’, with PBL, or to a control group (n=52) that received information regarding CD, which was sent to their home on a regular basis.

Assessments: Well-being (II & III) (the Psychological General Well-Being index and the Gastrointestinal Symptom Rating Scale) was assessed at baseline and after 10 weeks in all patients and after 6 months in the intervention group. Individual interviews (I) were carried out with purposefully selected women (n=15) before the start of the‘Coeliac School’.

Result: The qualitative study showed that CD can influence women’s lives in different ways. A desire for a normalised life-world was described. Three conditions necessary to achieve a normalised life-world were described as: being secure, being in control and being seen and included. After ten weeks of education, participants in the “Coeliac school” reported a significant improvement in psychological well-being (p=0.001) and gastrointestinal symptoms (p=0.013). The controls did not improve significantly. However, at baseline the controls, for reasons which were not apparent, and despite randomization, expressed significantly better psychological well-being and fewer gastrointestinal symptoms than women in the intervention group. Six months after completion of the PE program some of its positive effect had decreased.

Conclusions: A PE with PBL can help women with CD to benefit from a greater degree of well-being. It is important to offer PE to those women who fail to achieve a normalised lifeworld. However, intervention methods need to be refined in order to provide a more pronounced long-term effect.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2011. 47 p.
Series
Linköping Studies in Health Sciences. Thesis, ISSN 1100-6013 ; 119
Keyword
Chronic disease, illness experience, phenomenology, well‐being, Patient education, PBL
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-72454 (URN)9789173930093 (ISBN)
Presentation
2011-12-06, K52, Kåkenhus, Campus Norrköping, Linköpings universitet, Norrköping, 13:00 (English)
Supervisors
Available from: 2011-11-28 Created: 2011-11-28 Last updated: 2017-12-18Bibliographically approved

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Ring Jacobsson, LisaFriedrichsen, MariaGöransson, AnneHallert, Claes

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Division of Health, Activity and CareFaculty of Health SciencesDepartment of LAH/LinnéaSocial Medicine and Public Health ScienceDepartment of Internal Medicine in Norrköping
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