Nurse-led self-management support to improve symptom management and self-reported outcomes in people with irritable bowel syndrome.

Abstract

Objectives: Irritable bowel syndrome (IBS) is a disorder of gut-brain interaction with an unknown precise etiology. Intricate mechanisms underlying the disruption of bidirectional communication between the brain and the gut may influence the severity of symptoms as well as the response to self-management interventions. Management of IBS can be particularly challenging due to recurrent and resistant symptoms to therapeutic approaches. The present study aimed to evaluate the role of nurse-led self-management support on symptom management and self-reported outcomes in people with IBS.

Methods: In the current study, which was part of a parent randomized controlled trial, participants with IBS received one-on-one self-management intervention either by phone or in-person by Registered Nurses (RNs) in 3 sessions over 12 weeks. Each intervention was between 15 and 30 minutes. During the first intervention, the RN asked open-ended questions on symptom episodes, stress, physical activity, Quality of Life (QOL), and diet to provide recommendations for improved self-management. At the second and the third nurse-led self-management sessions, the RN helped in problem-identification and solving throughout the intervention. Quantitative content analysis was performed using the coding system developed by 2 authors for analyzing the participants' responses.

Results: In total, 24 participants with IBS completed the 3 nurse-led self-management sessions. Participants' mean age was 21.37 (±2.55) years old, and 83.33% were female. At the first nurse-led self-management session, 79% of participants reported pain, 62.5% reported bloating, 50% reported diarrhea, 37.5% reported constipation, 100% reported stress, and 95.6% had physical activity as part of their routines, while only 33.3% of the participants reported having a "high" QOL. After 3 nurse-led self-management sessions, participants reported improved IBS symptoms in pain 73%, bloating 73.7%, diarrhea 76.8%, constipation 50%, stress 42.1%, and physical activity 45%, as well as 66.7% of the participants experienced a "high" QOL. Dairy, fast/processed foods, and high-fat foods were the most frequent triggers of the symptoms, with a frequency of 40%, 24.5%, and 12%, respectively. After receiving nurse-led support, 69.20% of the participants reported improved dietary habits.

Conclusions: Nurse-led self-management can support participants to manage various IBS symptoms and improve their QOL. The unique strength of this study was evaluating participant needs and offering individualized solutions. A further study utilizing novel nurse-led self-management approaches may provide a valuable platform for empowering IBS patients' self-management.