Upload
vonhu
View
218
Download
1
Embed Size (px)
Citation preview
Factors Influencing Satisfaction with Life in
Female Nursing College Students with
Irritable Bowel Syndrome
Sung Hee Lee1, Hoon Jung Jeon
2*
1Professor, College of Nursing, Kyungpook National University, Daegu, Korea 2Master’s student, College of Nursing, Kyungpook National University, Daegu, Korea
Corresponding Author [email protected]
Abstract. We explored the factors influencing satisfaction with life among
female nursing college students with irritable bowel syndrome (IBS). One
hundred and thirty-five female nursing college students with IBS were recruited
from 6 nursing colleges located in D city, South Korea. Satisfaction with life,
IBS severity, and visceral sensitivity were assessed using a structured
questionnaire. Stepwise multiple regression analysis was used to identify the
factors that influenced satisfaction with life. Our results suggest that IBS
severity significantly influenced satisfaction with life, with an overall
explanatory power of 10.9%. As such, interventions targeting female nursing
college students with IBS might benefit from focusing on the severity of IBS
symptoms.
Keywords: College students, Irritable bowel syndrome, Satisfaction with life,
Nursing, Visceral sensitivity
1 Introduction
1.1. Background
Irritable bowel syndrome (IBS) is a chronic illness causing repetitive abdominal pain
(without specific organic causes) and abnormal bowel habits [1]. IBS is one of the
most common gastrointestinal diseases, with occurrence rates of 5–12% overseas [2]
and 2.2–9.6% domestically [3]. Notably, the IBS occurrence rate among female
nursing college students is reported to be remarkably high, at around 33% [4, 5].
Nursing college students often suffer from considerable stress due to their strict
curricula, excessive workloads, and psychological burden induced by the national
licensing examination, and as a result, are more likely to experience anxiety and
depression [6, 7]. Previous studies have reported that these factors also correlate with
the high IBS occurrence rate in this population [8, 9].
* Corresponding Author: Hoon Jung Jeon,
College of Nursing, Kyungpook National University. Tel: +82-10-4107-1009 email: [email protected]
Advanced Science and Technology Letters Vol.132 (Healthcare and Nursing 2016), pp.198-203
http://dx.doi.org/10.14257/astl.2016.132.35
ISSN: 2287-1233 ASTL Copyright © 2016 SERSC
IBS symptoms are not life threatening; however, their chronicity can have a
detrimental impact on daily living by causing limitations in social activities, absence
from school, or increased medical expenses [10]. Furthermore, IBS patients’ quality
of life appears to be lower than that of health people as well as individuals with other
chronic illnesses or health problems, such as hemodialysis patients or diabetic patients
[11]. Quality of life can be defined as one’s level of happiness and psychological
well-being. It is often expressed and measured as “satisfaction with life” [12].
One potential factor influencing satisfaction with life is IBS severity. More
specifically, individuals with severe IBS tend to exhibit more frequent symptoms—
thus, when IBS severity is low, IBS patients rarely experience any notable symptoms,
and thus tend to have a better quality of life and to not visit hospitals. In contrast,
when the severity is high, IBS patients tend to experience symptoms on a continuous
basis, which leads to a decrease in quality of life [11].
Another potential factor is visceral sensitivity, which has been shown to influence IBS
patients’ quality of life [12]. Previous studies have reported that visceral sensitivity
correlates with IBS patients’ daily living functions and quality of life after medical
assessments and treatments [13.14].
Although previous studies have confirmed the correlations of quality of life with
IBS severity and visceral sensitivity among IBS patients [10,15], none have looked at
the relationships of these variables with satisfaction with life among female nursing
college students with IBS. Thus, we investigated this relationship among female
nursing college students with IBS. We believe that the study results will be
fundamental data for the development of nursing interventions targeting satisfaction
with life in this population.
1.2. Purposes
• Clarify the differences in satisfaction with life according to the general charac
teristics of female nursing students with IBS
• Describe the degrees of IBS severity, visceral sensitivity, and satisfaction wit
h life among female nursing students with IBS
• Determine the correlations between IBS severity, visceral sensitivity, and sati
sfaction with life among female nursing students with IBS
• Determine what factors influence satisfaction with life among female nursing
students with IBS
2 Methods
2.1 Study Design
In this cross-sectional descriptive study, we investigated the influencing factors of
satisfaction with life among female nursing college students with IBS.
Advanced Science and Technology Letters Vol.132 (Healthcare and Nursing 2016)
Copyright © 2016 SERSC199 199
2.2 Participants and Data Collection
Study participants were sophomore students enrolled at the time of the study in the
nursing departments of six universities in D city of South Korea. We determined the
sample size with a power analysis using G*Power 3.1: the sample size for a stepwise
multiple regression analysis with an effect size of .15, a significance level of .05, a
test power of .95, and three independent variables was 119 subjects according to our
analysis.
Of the 807 students contacted, 225 were considered to have IBS according to the
Rome III criteria, while 140 understood the study purpose and provided their written
consent for participation. A total of 135 questionnaires were included in the final
analysis, after excluding five with insufficient answers. According to our power
analysis, our final sample size was sufficient.
2.3. Instruments
2.3.1. Rome III Adult Questionnaire: The Korean version of the Rome III Adult
IBS Questionnaire, developed by Drossman et al. [16], was used for the identification
of students with IBS. Translation of the questionnaire was provided by the Korean
Society of Neurogastroenterology and Motility[17]. The Rome III Questionnaire uses
the following questions to determine the severity of IBS symptoms: persistence of
symptoms for 2-3 days/month in the previous 3 months (question 1), persistence of
symptom over the non-menstrual period (question 2), and persistence of symptoms
for ≥6 months (question 3). The criteria in questions 1-3 should be associated with
two or more of the following: symptom relief with defecation (question 4); a change
in stool frequency (questions 5-6); and change in symptoms accompanying change in
the form (appearance) and hardness of stool (questions 7-8).
2.3.2 Satisfaction with Life We used the satisfaction with life scale developed by
Diener et al. [18] and adapted into Korean by Lee [19] to measure satisfaction with
life. This scale comprises 5 questions, each of which is measured on a 5-point Likert
scale ranging from 1 (“not at all”) to 5 (“very much so”). Total scores range from 5 to
25, with higher scores indicating a higher satisfaction with life. The internal
consistency reliability (Cronbach’s ⍺) of the scale in Diener et al.’s study was .87,
whereas that in this study was .80.
2.3.3 Irritable Bowel Symptom Severity IBS severity was measured using the
Irritable Bowel Syndrome Severity Scoring system–Korean Version, which was
developed by Francis et al. [20]. This scoring system comprises questions on
abdominal pain, abdominal distension, bowel habits, and the impact of IBS symptoms
Advanced Science and Technology Letters Vol.132 (Healthcare and Nursing 2016)
200 Copyright © 2016 SERSC
on quality of life. Each section is scored on a scale of 0–100 points, with a total score
ranging from 0 to 500. Higher scores indicate more severe symptoms.
2.3.3 Visceral Sensitivity
We used the Visceral Sensitivity Index developed by Labus et al. [13] and adapted
into Korean by Jang [21] to measure visceral sensitivity. This scale comprises 15
questions in five areas of anxiety associated with GI disturbances: concern, fear,
wariness, sensitivity, and evasion. Each question is measured on a 6point Likert scale,
ranging from 0 (“strongly agree”) to 5 (“strongly disagree”). Total scores range from
0 to 75, and are calculated by reversing the item scores, so that 0 refers to “no visceral
sensitivity” associated with GI disturbances and 75 indicates “most severe visceral
sensitivity” [13]. In Labus et al.’s study [13], the Cronbach’s ⍺ of the scale was .93,
while that in the present study was .90.
2.4 Procedure
Data collection was performed in March 2015. The investigators worked
collaboratively with the nursing departments and directors of the six universities in D
city, South Korea. Self-reported questionnaires were provided to students who met the
Rome III criteria for IBS during a non-class time. Completion of the questionnaire
required about 15 min, and completed questionnaires were immediately collected by
the investigators and two research assistants.
2.5 Ethical Approval
Our study methodology was approved by the institutional review board of Kyungpook
National University (2015-0017).
2.6 Data Analyses
The collected data were analyzed using IBM SPSS Statistics 20. The subjects’ general
characteristics and variable scores were described using means and standard
deviations, and t-tests and one-way ANOVAs were used to verify the differences in
satisfaction with life by participants’ general characteristics. The correlations of IBS
severity and visceral sensitivity with satisfaction with life were determined using
Pearson’s correlation coefficient, and stepwise multiple regression was conducted to
confirm the influencing factors of satisfaction with life.
Advanced Science and Technology Letters Vol.132 (Healthcare and Nursing 2016)
Copyright © 2016 SERSC201 201
3 Results
Stepwise multiple regression analysis was conducted using IBS severity and visceral
sensitivity (which were both correlated with satisfaction with life in the correlational
analysis) as independent variables in our investigation of the influencing factors of
participants' satisfaction with life.
The assumptions of the regression analysis were tested and were all satisfied.
Specifically, in testing the autocorrelation of errors and model validation, we found a
Durbin-Watson value of 1.972, which indicated no autocorrelation between
independent variables. The variables’ tolerance was 1.00 (≥0.1), which indicated that
the regression model was appropriate. Variance inflation factor values ranged from
1.00 to 1.550, meaning that all were below the standard value of 10; thus, there was
no problem of multicollinearity.
In the regression analysis, participants’ satisfaction with life was inversely
correlated with IBS severity”(β = -.340, p < .001), which explained 10.9% of the
variance in satisfaction with life (F = 17.367, p < .001). In other words, IBS severity
was confirmed as an influencing factor of the satisfaction with life of female nursing
college students with IBS (Table 4).
Table 1. Influencing Factors of Satisfaction with Life (n = 135)
Variables B β t p R2 Adj.R
2 F (p)
(Constants) 18.747
29.614 <.001 .115 .109 17.367
(<.001)
Irritable bowel
syndrome severity
-.013 -
.340 -4.167 <.001
4 Conclusion
This study confirmed that IBS severity is a negative influencing factor for satisfaction
with life of female nursing college students with IBS. Thus, the development and
implementation of nursing interventions in consideration of the study results would be
needed to improve the satisfaction with life of this population.
References
1. Longstreth, G.F.: "Clinical Diagnosis of IBS.” In: Camilleri, M., Spiller, R.C., Irritable
bowel syndrome, WB Saunders, London, pp.1-10 (2002)
2. Choung, R.S., Locke, G.R.: “Epidemiology of IBS,” Gastroenterology Clinics of North
America, Vol.40, No.1, pp.1-10 (2011)
3. Asian Postgraduate Course on Neurogastroenterology and Motility.: Irritable Bowel
Syndrome, Medicine Book, Seoul (2011)
Advanced Science and Technology Letters Vol.132 (Healthcare and Nursing 2016)
202 Copyright © 2016 SERSC
4. Park, S.H.: “Koryo Hand Therapy on Bowel Symptoms and Stress of College Women
With Irritable Bowel Syndrome,” Master's thesis, Chung-Ang University, Seoul (2011)
5. Youn, J.H.: “A Study on IBS and Stress Perceived by College Women and Their Dietary
Habit and Sleeping Quality,” Master's thesis, Ewha Womans University, Seoul (2004).
6. Jeong, M.H., Shin, M.A.: “The Relationship between Self-esteem and Satisfaction with
Major among Nursing Students,” Journal of Korean Academic Society of Nursing
Education, Vol.12, No.2, pp.170-177 (2006)
7. Son, Y.J., Choi, E.Y., Song, Y.A.: “The Relationship between Stress and Depression in
Nursing College Students,” Korean Journal of Stress Research, Vol.18, No.4, pp.345-351
(2010)
8. Lee, H.J.: “The Effect of Su-Ji Foods on Bowel Symptoms in Nurses with Irritable Bowel
Syndrome,” Master's thesis, Ewha Womans University, Seoul (2006)
9. Yang, K.S.: “A Study on the Effect of the Hand Acupuncture on IBS-affected College
Women's Bowel Symptoms and Psychologic Health,” Journal of Korean Academy of
Adult Nursing, Vol.17, No.5, pp.802-812 (2005)
10. Drossman, D.A., Chang, L., Bellamy, N., Gallo-Torres, H.E., Lembo, A., Mearin, F.,
Mearin, F., Norton, N.J., Whorwell, P.: “Severity in Irritable Bowel Syndrome: A Rome
Foundation Working Team Report,” American Journal of Gastroenterology, Vol.106,
No.10, pp.1749-1759 (2011)
11. Cho, H.S., Park, J,M., Lim, C,H., Cho, Y,K., Lee, I,S., Kim, S,W., Choi, M,S., Chung,
I,S., Chung, Y,K.: “Anxiety, Depression and Quality of Life in Patients with Irritable
Bowel Syndrome,” Gut and Liver, Vol.5, No. 1, pp29-36 (2011)
12. Kang, H.W, Jung, H.K.: “Special Review: Pathophysiology and Diagnosis of Irritable
Bowel Syndrome,” Korean Journal of Medicine, Vol.80, No.5, pp.491-498 (2011)
13. Labus, J,S., Bolus, R., Chang, L., Wiklund, I., Naesdal, J., Mayer, E,A., Naliboff, B,D., .:
“The Visceral Sensitivity Index: Development and Validation of a Gastrointestinal
Symptom-Specific Anxiety Scale”, Alimentary Pharmacology & Therapeutics, Vol.20,
No.1,pp.89-97(2004)
14. Kennedy, T.M., Chalder, T., McCrone, P., Darnley, S., Knapp, M., Jones, R.H., Wessely,
S .: “Cognitive Behavioural Therapy in Addition to Antispasmodic Therapy for Irritable
Bowel Syndrome in Primary Care: Randomised Controlled Trial", BMJ, Vol.10, No.19,
pp.1-67 (2006)
15. Ki, H.J.: “The Effect of University Student's Life Stress on Psychological Well-Being: A
Focus On The Moderating Effect Of Mindfulness,” Master's thesis, Sookmyung Women's
University, Seoul, pp.1-65 (2010)
16. Drossman, D.A., Dumitrascu, D.L.: “Rome III: New standard for functional
gastrointestinal disorders.” Journal of Gastrointestinal Liver Diseases. Vol.15, No.3,
pp.237-241 (2006)
17. Park, J.M., Choi, M.G., Cho, Y.K., Lee, I.S., Kim, J.I., Kim, S.W., Chung, I.S.:
“Functional Gastrointestinal Disorders Diagnosed by Rome III Questionnaire in Korea”,
Journal of Neurogastroenterology & Motility. Vol.17, No.3, pp.279-286 (2011)
18. Diener, E., Emmons, R., Larsen, R., Griffin, S.: “The Satisfaction With Life Scale”,
Journal of Personality Assessment, Vol.49, No.1, pp71-75 (1985)
19. Lee, E,K.: “The Effects Of Neuroticism and Extraversion on Subjective Well-Being: The
Importance of Depression and Positive Emotions,” Master's thesis, Yonsei University,
Seoul (2005)
20. Francis, C.Y., Morris, J., Whorwell, P.J.: “The Irritable Bowel Severity Scoring System: A
Simple Method of Monitoring Irritable Bowel Syndrome and Its Progress,” Alimentary
Pharmacology & Therapeutics, Vol.11, No.2, pp.395-402 (1997)
21. Jang AL.: “The Effects of Cognitive Behavior Therapy for Nursing College Students with
Irritable Bowel Syndrome,” Dissertation, Pusan National University, Pusan (2014)
Advanced Science and Technology Letters Vol.132 (Healthcare and Nursing 2016)
Copyright © 2016 SERSC203 203