Gastroenterology · 2025
Implications of Shame for Patient-Reported Outcomes in Bowel Disorders of Gut-Brain Interaction.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Trindade Inês A, Blomsten Amanda, Nybacka Sanna, Colomier Esther, Sandberg Robert, Frändemark Åsa, Törnblom Hans, Simrén Magnus
Аннотация
BACKGROUND & AIMS: Bowel disorders of gut-brain interaction (DGBIs) are a highly stigmatized group of disorders. Although the link between stigma and shame is acknowledged overall, few studies focusing on health-related stigma mention shame, and research on shame in bowel DGBIs is nonexistent. The aim of this study was to examine the implications of shame in bowel DGBIs.
METHODS: Two Swedish population-based samples were included: a bowel DGBIs sample (n = 537) and a matched comparative sample without bowel symptoms (n = 1881). Participants completed an online survey with validated self-report scales. A cross-sectional mediation analysis via structural equation modeling and a moderation analysis were conducted to analyze the role of shame in the associations between bowel symptom severity and psychosocial outcomes.
RESULTS: The bowel DGBIs sample reported significantly higher levels of shame than the comparative sample. The mediation model, conducted with the bowel DGBIs sample, showed that shame was a mediator of the associations of bowel symptoms with general anxiety, depressive symptoms, quality of life, and activity impairment. Gastrointestinal-specific anxiety was not associated with any outcome of this model. Moderation results showed that shame was an exacerbator of the associations of bowel symptoms with higher severity of gastrointestinal-specific anxiety and depressive symptoms, and poorer quality of life.
CONCLUSIONS: Shame appears to be a particularly important emotion deriving from the experience of gastrointestinal symptoms in bowel DGBIs and influencing the associations between these symptoms and important patient-reported outcomes. An empathetic physician-patient relationship and psychological therapies may be helpful for individuals with bowel DGBIs experiencing high levels of shame.
METHODS: Two Swedish population-based samples were included: a bowel DGBIs sample (n = 537) and a matched comparative sample without bowel symptoms (n = 1881). Participants completed an online survey with validated self-report scales. A cross-sectional mediation analysis via structural equation modeling and a moderation analysis were conducted to analyze the role of shame in the associations between bowel symptom severity and psychosocial outcomes.
RESULTS: The bowel DGBIs sample reported significantly higher levels of shame than the comparative sample. The mediation model, conducted with the bowel DGBIs sample, showed that shame was a mediator of the associations of bowel symptoms with general anxiety, depressive symptoms, quality of life, and activity impairment. Gastrointestinal-specific anxiety was not associated with any outcome of this model. Moderation results showed that shame was an exacerbator of the associations of bowel symptoms with higher severity of gastrointestinal-specific anxiety and depressive symptoms, and poorer quality of life.
CONCLUSIONS: Shame appears to be a particularly important emotion deriving from the experience of gastrointestinal symptoms in bowel DGBIs and influencing the associations between these symptoms and important patient-reported outcomes. An empathetic physician-patient relationship and psychological therapies may be helpful for individuals with bowel DGBIs experiencing high levels of shame.