P342 Maladaptive coping, self-efficacy and patient reported outcomes in inflammatory bowel disease
Bibliographic record
Abstract
Background: Patient reported outcomes (PRO), key aspects in the management of inflammatory bowel disease (IBD), are strongly influenced by biopsychosocial factors. Whereas self-efficacy and coping strategies are modifiable social constructs that may improve health outcomes following dedicated intervention. This study aims to evaluate the relationship of PRO and these constructs in additional to traditional biopsychosocial factors. Methods: We conducted a cross-sectional study on patients with Crohn's disease (CD) or ulcerative colitis (UC) at McGill IBD centre between September 2015 and March 2016. Patients were assessed for quality of life, disability and productivity using validated short IBD questionnaire (SIBDQ), IBD disability index (IBDDI) and work productivity assessment index respectively. Psychological assessment was performed using hospital anxiety and depression score (HADS). Brief COPE questionnaire were used for assessing coping strategies, and general self-efficacy scale was used for efficacy. Results: 207 (144 CD/63 UC) patients, with median age of 39 (IQR 26) and 88 (42.5%) male, were included. 24.2% of patients had active disease (Harvey Bradshaw >4/Partial Mayo >2). Around one third of patients identified moderate to severe impairment on disability (31.3%), quality of life (33.3%) and productivity (29.1%); along with some degree of anxiety (32.9%) and depression (23.3%). Both poor quality of life (SIBDQ>47) and disability (IBDDI>33) were significantly associated with maladaptive coping (p=0.002 for both) and disease activity (p=0.001/p=0.002, respectively) in multivariate analysis (Table 1). Productivity loss was associated with female gender (p=0.023), active disease (p=0.003) and CD stricturing phenotype (p=0.03). In contrast, self-efficacy was protective of disability (p<0.001) and productivity loss (p=0.016). Similarly, patients with active disease (p=0.005) and maladaptive coping (p=0.014) were at risk of anxiety (HADS ≥8), whereas the inverse relationship was found for self-efficacy (p=0.013) and older age (p=0.045). Finally, maladaptive coping (p=0.014), active disease (p=0.037) and stricturing phenotype (p=0.048) was associated with depression. Table 1. Patient reported outcomes: Regression analysis results. Conclusions: Unfavorable patient reported outcomes are significantly associated with maladaptive coping and disease activity while self-efficacy had a positive effect. These modifiable social constructs could assist with identifying high-risk patients, of whom may benefit from targeted intervention to improve health outcomes.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.008 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".