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

Dainty, Andrew David (2016) The cognitive behavioural treatment of irritable bowel syndrome: feasibility of a nurse delivered model of guided self-help. PhD thesis, University of Nottingham.

[img] PDF (Thesis - as examined) - Repository staff only - Requires a PDF viewer such as GSview, Xpdf or Adobe Acrobat Reader
Download (9MB)

Abstract

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.

Item Type: Thesis (University of Nottingham only) (PhD)
Supervisors: Callaghan, P.
Lewis, N.R.
Keywords: Psychological therapy, Irritable bowel syndrome
Subjects: W Medicine and related subjects (NLM Classification) > WI Digestive system
Faculties/Schools: UK Campuses > Faculty of Medicine and Health Sciences > School of Health Sciences
Item ID: 35537
Depositing User: Dainty, Andrew
Date Deposited: 03 Feb 2017 08:22
Last Modified: 20 May 2017 01:30
URI: http://eprints.nottingham.ac.uk/id/eprint/35537

Actions (Archive Staff Only)

Edit View Edit View