Patients’ experience of living with irritable bowel syndrome (IBS): A hermeneutic phenomenology

Mohebbi, Zinat; Sharif, Farkhondeh; Peyrovi, Hamid; Rakhshan, Mahnaz; Alizade Naini, Mahvash; Zarshenas, Ladan

doi:10.22062/jqr.2020.91000

Authors

¹ assistant professor, Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Irany of medical sciences

² Professor, Community Based Psychiatric Care Research Center, Shiraz Geriatric Research Center, Department of Mental Health and Psychiatric Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran

³ Professor, Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran

⁴ Associate Professor, Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran

⁵ Associate Professor, Gastroenterology and Hepatology Research Center, Department of Gastroenterology and Hepatology, School of Medical, Shiraz University of Medical Sciences, Shiraz, Iran

⁶ Assistant Professor, Community Based Psychiatric Care Research Center, Department of Mental Health and Psychiatric Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran

https://doi.org/10.22062/jqr.2020.91000

Abstract

Introduction: Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder with a wide range of effects on the individual’s quality of life, emotional state, and identity. Given the lack of knowledge about patients’ perceptions of life with irritable bowel syndrome, this study aimed to describe and interpret patients' experience of living with irritable bowel syndrome
Methods: The present qualitative study was conducted using a hermeneutic phenomenological approach on 15 patients with irritable bowel syndrome who referred to three central clinics. The data were collected through in-depth semi-structured interviews with the participants who were selected through purposive sampling. Thematic analysis was carried out using Van Manen’s six-step methodological framework as a guide. Besides, MAXQDA software was used for data management.
Results: The analysis of the data yielded four themes and eight subthemes. The patients’ experiences of living with IBS were manifested through the themes of “crisis and transient release” (with “storm in the corporeality” and “relief” subthemes); “surrender and harassment” (with “mandatory submitting” and “feeling of helplessness” subthemes); “looking for adaptation” (with “struggle in obtaining insight” and “seeking help from coping strategies” subthemes); and “different self-perceptions” (with “threatened self” and “deep self-knowledge” subthemes).
Conclusion: Understanding the life experience of IBS patients can be effective in improving the interdisciplinary medical-care programs and reducing their psychological, social, and physical problems. Therefore, carrying out more studies to promote the quality of life of IBS patients is suggested.

Keywords

References

1. Attara GP, Gray J, Aumais G. A269 Irritable bowel syndrome patient experience in Canada. Journal of the Canadian Association of Gastroenterology 2018; 1(1): 467-8. doi: 10.1093/jcag/gwy008.270. 2. Jemilohun AC, Abayomi O, Adebayo PB. Prevalence of irritable bowel syndrome, psychological ill-health, and health-seeking behavior in a population of Nigerian medical students. Journal of Advances in Medicine and Medical Research 2018; 25(4): 1-9. doi: 10.9734/JAMMR/2018/39235. 3. Lacy BE, Mearin F, Chang L, Chey WD, Lembo AJ, Simren M, et al. Bowel disorders. Gastroenterology 2016; 150(6): 1393-407. 4. Mahmudi S, Pourshams A, Akbari M, Malekzadeh R. The prevalence of irritable bowel syndrome and gastroesophageal reflux disease among Tehran University students. Govaresh 2012; 8(4):159-62. [in Persian]. 5. Khademolhosseini F, Mehrabani D, Nejabat M, Beheshti M, Heydari ST, Mirahmadizadeh A, et al. Irritable bowel syndrome in adults over 35 years in Shiraz, southern Iran: prevalence and associated factors. J Res Med Sci 2011; 16(2): 200-6. 6. Mohebbi Z, Sharif F, Peyrovi H, Rakhshan M, Alizade Naini M, Zarshenas L. Self-perception of Iranian Patients during their life with irritable bowel syndrome: A qualitative study. Electron Physician 2017; 9(12): 5885-93. doi:10.19082/5885. 7. Canavan C, West J, Card T. Review article: The economic impact of irritable bowel syndrome. Aliment Pharmacol Ther 2014; 40(9): 1023-34. doi: 10.1111/apt.12938. 8. Roshandel D, Rezailashkajani M, Shafaee S, Zali MR. A cost analysis of functional bowel disorders in Iran. Int J Colorectal Dis 2007; 22(7): 791-9. doi: 10.1007/s00384-006-0226-2. 9. Jahangiri P, Hashemi Jazi MS, Hassanzadeh Keshteli A, Sadeghpour S, Amini E, Adibi P. Irritable Bowel Syndrome in Iran: SEPAHAN Systematic Review No. 1. Int J Prev Med 2012; 3(Suppl 1): S1-9. 10. Pourshams A, Zendehdel N, Semnani M, Semnani U. Irritable bowel syndrome, and psychiatric disorders among university freshmen. Govaresh 2006; 11(1): 22-6. [In Persian]. 11. Ganji A, Malekzadeh F, Safavi M, Nassri-Moghaddam S, Nourie M, Merat S, et al. Digestive and liver disease statistics in Iran. Middle East Journal of Digestive Diseases 2009; 1(2): 56-62. 12. International Foundation for Gastrointestinal Disorders. Functional GI Disorders. [cited 2019 Oct 12] Available from: https://www.iffgd.org/functional-gi-disorders.html. 13. Vila AV, Imhann F, Collij V, Jankipersadsing SA, Gurry T, Mujagic Z, et al. Gut microbiota composition and functional changes in inflammatory bowel disease and irritable bowel syndrome. Sci Transl Med 2018; 10(472):eaap8914. doi: 10.1126/scitranslmed.aap8914. 14. Spiller R, Garsed K. Post infectious irritable bowel syndrome. Gastroenterology 2009; 136(6): 1979-88. doi: 10.1053/j.gastro.2009.02.074. 15. Lackner JM, Mesmer C, Morley S, Dowzer C, Hamilton S. Psychological treatments for irritable bowel syndrome: A systematic review and meta-analysis. J Consult Clin Psychol 2004; 72(6): 1100-13. doi: 10.1037/0022-006X.72.6.1100. 16. Ladabaum U, Boyd E, Zhao WK, Mannalithara A, Sharabidze A, Singh G, et al. Diagnosis, comorbidities and management of irritable bowel syndrome in patients in a large health maintenance organization. Clin Gastroenterol Hepatol 2012; 10(1): 37-45. doi: 10.1016/j.cgh.2011.08.015. 17. Levy RL, Olden KW, Naliboff BD, Bradley LA, Francisconi C, Drossman DA, et al. Psychosocial aspects of the functional gastrointestinal disorders. Gastroenterology 2006; 130(5): 1447-58. doi: 10.1053/j.gastro.2005.11.057. 18. Healio. AGA survey results highlight physical, emotional burden of IBS. [cited 2017 Dec 20] Available from: https://www.healio.com/news/gastroenterology/20160414/aga-survey-results-highlight-physical-emotional-burden-of-ibs. 19. Ballou S, Bedell A, Keefer L. Psychosocial impact of irritable bowel syndrome: A brief review. World J Gastrointest Pathophysiol 2015; 6(4): 120-3. doi: 10.4291/wjgp.v6.i4.120. 20. Sibelli A, Chalder T, Everitt H, Workman P, Windgassen S, Moss-Morris R. A systematic review with meta-analysis of the role of anxiety and depression in irritable bowel syndrome onset. Psychol Med 2016; 46(15): 3065-80. doi: 10.1017/S0033291716001987. 21. Weaver KR, Melkus GD, Henderson WA. Irritable Bowel Syndrome: An evidence-based. Am J Nurs 2017; 117(6): 48-55. doi: 10.1097/01.NAJ.0000520253.57459.01. 22. Canavan C, West J, Card T. The epidemiology of irritable bowel syndrome. Clin Epidemiol 2014; 6:71-80. doi: 10.2147/CLEP.S40245. eCollection 2014. 23. Longstreth GF, Wilson A, Knight K, Wong J, Chiou CF, Barghout V, et al. Irritable bowel syndrome, health care use, and costs: A U.S. managed care perspective. Am J Gastroenterol 2003; 98(3): 600-7. doi: 10.1111/j.1572-0241.2003.07296.x. 24. Mcfarland LV. State-of-the-art of irritable bowel syndrome and inflammatory bowel disease research in 2008. World J Gastroenterol 2008; 14 (17): 2625-9. doi: 10.3748/wjg.14.2625. 25. Inadomi JM, Fennerty MB, Bjorkman D. Systematic review: The economic impact of irritable bowel syndrome. Aliment Pharmacol Ther 2003; 18(7): 671-82. doi: 10.1046/j.1365-2036.2003.t01-1-01736.x. 26. Silk DB. Impact of irritable bowel syndrome on personal relationships and working practices. Eur J Gastroenterol Hepatol 2001; 13(11): 1327-32. doi: 10.1097/00042737-200111000-00011. 27. Hahn BA, Yan S, Strassels S. Impact of irritable bowel syndrome on quality of life and resource use in the United States and the United Kingdom. Digestion 1999; 60(1): 77-81. doi: 10.1159/000007593. 28. Minocha A, Johnson WD, Abell TL, Wigington WC. Prevalence, sociodemography, and quality of life of older versus younger patients with irritable bowel syndrome: A population-based study. Dig Dis Sci 2006; 51(3): 446-53. doi: 10.1007/s10620-006-3153-8. 29. Li FX, Patten SB, Hilsden RJ, Sutherland LR. Irritable bowel syndrome health-related quality of life: A population-based study in Calgary, Alberta. Can J Gastroenterol 2003; 17(4): 259-63. doi: 10.1155/2003/706891. 30. El-Serag HB, Olden K, Bjorkman D. Health-related quality of life among persons with irritable bowel syndrome: a systematic review. Aliment Pharmacol Ther 2002; 16(6): 1171-85. doi: 10.1046/j.1365-2036.2002.01290.x. 31. Enck P, Aziz Q, Barbara G, Farmer AD, Fukudo S, Mayer EA, et al. Irritable bowel syndrome. Nat Rev Dis Primers 2016; 2:16014. doi: 10.1038/nrdp.2016.14. 32. Wood J. Hypnotherapy may ease irritable bowel syndrome symptoms. [cited 2019 Jan 26] Available from: https://psychcentral.com/news/2018/11/24/hypnotherapy-may-ease-irritable-bowel-syndrome-symptoms/140628.html. 33. Thompson WG. The treatment of irritable bowel syndrome. Alimentary Pharmacology & Therapeutics 2002; 16(8): 1395-406. doi: 10.1046/j.1365-2036.2002.01312.x. 34. Whitehead WE, Levy RL, Von Korff M, Feld AD, Palsson OS, Turner M, et al. The usual medical care for irritable bowel syndrome. Alimentary Pharmacology & Therapeutics 2004; 20(11-12): 1305-15. doi: 10.1111/j.1365-2036.2004.02256.x. 35. Woodgate RL. Health professionals caring for chronically ill adolescents: Adolescents' perspectives. J Soc Pediatr Nurs 1998; 3(2): 57-68. doi: 10.1111/j.1744-6155.1998.tb00029.x. 36. Patton MQ. Qualitative Evaluation and Research Methods. 2nd ed. Newbury Park: Sage; 1990. 37. Drossman DA, Chang L, Schneck S, Blackman C, Norton WF, Norton NJ. A focus group assessment of patient perspectives on irritable bowel syndrome and illness severity. Dig Dis Sci 2009; 54(7): 1532-41. doi: 10.1007/s10620-009-0792-6. 38. Schneider MA, Fletcher PC. ‘I feel as if my IBS is keeping me hostage!’Exploring the negative impact of irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) upon university‐aged women. Int J Nurs Pract 2008; 14(2): 135-48. doi: 10.1111/j.1440-172X.2008.00677.x. 39. Farndale R, Roberts L. Long-term impact of irritable bowel syndrome: A qualitative study. Prim Health Care Res Dev 2011; 12(1): 52-67. doi: 10.1017/S1463423610000095. 40. Fletcher PC, Schneider MA. Is there any food I can eat? Living with inflammatory bowel disease and/or irritable bowel syndrome. Clin Nurse Spec 2006; 20(5): 241-7. doi: 10.1097/00002800-200609000-00011. 41. Fletcher PC, Jamieson AE, Schneider MA, Harry RJ. "I know this is bad for me, but...": a qualitative investigation of women with irritable bowel syndrome and inflammatory bowel disease: Part II. Clin Nurse Spec 2008; 22(4): 184-91. doi: 10.1097/01.NUR.0000311707.32566.c8. 42. Fletcher PC, Schneider MA, Ravenswaay VV, Leon Z. I am doing the best that I can! Living with inflammatory bowel disease and/or irritable bowel syndrome (part II). Clin Nurse Spec 2008; 22(6): 278-85. doi: 10.1097/01.NUR.0000325382.99717.ac. 43. McCormick JB, Hammer RR, Farrell RM, Geller G, James KM, Loftus EV, et al. Experiences of patients with chronic gastrointestinal conditions: In their own words. Health Qual Life Outcomes 2012; 10:25. doi: 10.1186/1477-7525-10-25. 44. Håkanson C, Sahlberg‐Blom E, Nyhlin H, Ternestedt BM. Struggling with an unfamiliar and unreliable body: The experience of irritable bowel syndrome. Journal of Nursing and Healthcare of Chronic Illness 2009; 1(1): 29-38. doi: 10.1111/j.1365-2702.2008.01001.x. 45. Ronnevig M, Vandvik PO, Bergbom I. Patients’ experiences of living with irritable bowel syndrome. J Adv Nurs 2009; 65(8): 1676-85. doi: 10.1111/j.1365-2648.2009.05030.x. 46. van Manen M. Researching Lived Experience. 2nd ed. USA: Routledge; 2018. 47. Grove S, Burns N, Gray J. The Practice of Nursing Research. 7th ed. Elsevier; 2013. 48. van Manen M. Phenomenology of Practice. USA: Left Coast Press; 2014. 49. Lämås K, Anundsson E, Stare AC, Jacobsson C. An interview study of the experiences of middle-aged women living with constipation. Clinical Nursing Studies 2015; 3(2): 1-7. 50. Bertram S, Kurland M, Lydick E, Locke 3rd GR, Yawn BP. The patient's perspective of irritable bowel syndrome. J Fam Pract 2001; 50(6): 521-5. 51. Jakobsson Ung E, Ringstrom G, Sjövall H, Simrén M. How patients with long-term experience of living with irritable bowel syndrome manage illness in daily life: a qualitative study. Eur J Gastroenterol Hepatol 2013; 25(12): 1478-83. 52. Bengtsson M, Ohlsson B, Ulander K. Women with irritable bowel syndrome and their perception of a good quality of life. Gastroenterol Nurs 2007; 30(2): 74-82. doi: 10.1097/01.SGA.0000267924.24180.1a. 53. Faulkner TL. Young adults living with inflammatory bowel disease - a phenomenological study [dissertation]. Newfoundland: Memorial University; 2008. 54. Pogge SM. The experience of living with chronic illness: A heuristic study [dissertation]. Texas: Texas Woman’s University; 2013. 55. Bezzina K. The lived experience of irritable bowel syndrome sufferers [dissertation]. Malta: University of Malta; 2015. 56. Sharpe H, Collins S. An exploration of positive identity development in women living with chronic pain. The Qualitative Report 2013; 18(15): 1-22.

Journal of Qualitative Research in Health Sciences

Patients’ experience of living with irritable bowel syndrome (IBS): A hermeneutic phenomenology

References

References

Volume 9, Issue 1
May 2020
Pages 28-37

Patients’ experience of living with irritable bowel syndrome (IBS): A hermeneutic phenomenology

References

References

Volume 9, Issue 1May 2020Pages 28-37

Volume 9, Issue 1
May 2020
Pages 28-37