Psychological Distress and Related Factors in Patients with Crohn's Disease: A Path Analysis Based on the Common-Sense Model.

PURPOSE: This study aimed to investigate the associations of disease activity, disease-related knowledge, illness perception, and coping strategies on psychological distress in patients with Crohn's disease, using a path analysis based on the common-sense model.

METHODS

This was a cross-sectional study. A total of 399 adult patients were recruited from an online support community in Korea between October and December 2024. Data were collected through online self-reported questionnaires, using the Harvey-Bradshaw Index, the inflammatory bowel disease knowledge, the Korean version of the Brief Illness Perception Questionnaire, the Korean version of the Coping Strategy Indicator, and the Korean version of the Kessler Psychological Distress Scale. The data were analyzed using SPSS/WIN 24.0 and AMOS 29.0. Path analysis was used to examine how disease-related knowledge and disease activity influences psychological distress through illness perception and coping strategies.

RESULTS

Both disease activity and disease-related knowledge were found to influence psychological distress through a serial mediation effect of illness perception and avoidance coping. The avoidance coping model showed acceptable model fit. (χ2/df = 2.52; AGFI = .96; RMSEA = .06; TLI = .91; CFI = .98; NFI = .97; IFI = .98). Disease activity and disease-related knowledge had a negative effect on avoidance coping. The direct path from disease-related knowledge to avoidance coping showed the strongest effect within the research model (β = -0.29, p < .001). Significant serial indirect effect through illness perception and avoidance coping was identified between disease activity and psychological distress (95% CI: 0.02, 0.07) and between disease-related knowledge and psychological distress (95% CI: -0.02, 0.00).

CONCLUSIONS

This study demonstrated the need for an integrated approach to reduce disease activity and increase disease-related knowledge as factors to effectively alleviate psychological distress in patients with Crohn's disease.