Longitudinal effects of a nurse-led self-management intervention in inflammatory bowel disease.

BACKGROUND

Despite its significant psychological burden, long-term psychosocial effects of nurse-led self-management interventions in IBD remain understudied. This study assessed longitudinal changes in psychosocial outcomes following a structured self-management program, and the moderating role of family functioning.

METHODS

A single-center, non-randomized, single-arm longitudinal study was conducted in 60 IBD adults in remission who participated in a nurse-led multidisciplinary psychoeducational program in Spain. HRQoL (CCVEII-9), perceived stress (PSS-14), anxiety and depression (HADS), and family functioning (Family APGAR) were assessed at five time points over 12 months. Linear mixed-effects models evaluated temporal changes and moderating role of baseline family functioning.

RESULTS

HRQoL improved significantly over 12 months (β=+6.18, 95% CI: 3.53 to 8.82; P<0.001), exceeding a clinically meaningful threshold. Depressive symptoms showed a significant sustained reduction (P=0.036; β=-0.92, 95% CI: -1.66 to -0.19 at 12 months). Perceived stress showed a non-significant decreasing trend (P=0.054), reaching significance at 6 months (β=-1.93, 95% CI: -3.63 to -0.22; P=0.028). Anxiety remained stable (P=0.471). Family functioning moderated trajectories for perceived stress (P=0.004), depression (P<0.001), and anxiety (P<0.001), with a non-significant trend for HRQoL (P=0.056); participants with normal family functioning showed earlier and stronger improvements.

CONCLUSIONS

Longitudinal evidence suggests that a nurse-led psychoeducational intervention was associated with sustained improvements in HRQoL and depressive symptoms in IBD. The moderating role of family functioning in outcomes underscores the value of integrating family-sensitive self-management programs into IBD nursing care.