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The cognitive behavioural treatment of irritable bowel syndrome : feasibility of a nurse delivered model of guided self-help

Background: Irritable bowel syndrome is a medically unexplained phenomena relating to the lower gastrointestinal tract with symptoms such as altered bowel habit and abdominal pain. Patients experience poor quality of life and consume significant healthcare resources. Mechanisms for the delivery of evidence based psychological interventions for irritable bowel syndrome within the National Health Service are lacking and the feasibility of these interventions is poorly understood. Methods: A novel, low-intensity, nurse-led psychological intervention has been developed and trialled within a mixed methods feasibility study. Twenty participants were randomly allocated across four treatment conditions consisting of; a treatment as usual control (n = 5), self-help (n = 5), low-intensity (n = 5) and high-intensity (n = 5) cognitive behavioural therapy interventions. A total of ten participants took part in post-intervention interviews analysed using a group thematic analysis. Results: Recruitment to this feasibility study was a significant challenge with 22 participants recruited of which, 20 were randomised to the feasibility interventions. Of the 104 patients approached within secondary care gastrointestinal clinics, 27.7% of patients volunteered to enrol into the study. Reasons provided relate to difficulties with committing to taking part and personal circumstances. Themes derived from post-intervention interviews suggest participant’s valued face-to-face therapist interaction and described their perceived treatment utility along with a variety of barriers and facilitators to engagement in CBT interventions. Conclusion: Low-intensity and self-help cognitive behavioural therapy may be feasible mechanisms for the delivery of evidence based psychological interventions for patients with IBS, although significant concerns regarding recruitment of participants to future trials will need to be addressed. Further development of these lower-intensity interventions in collaboration with service users is required in order to improve the acceptability and relevance of the interventions.

Identiferoai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:703199
Date January 2016
CreatorsDainty, Andrew David
PublisherUniversity of Nottingham
Source SetsEthos UK
Detected LanguageEnglish
TypeElectronic Thesis or Dissertation
Sourcehttp://eprints.nottingham.ac.uk/35537/

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