Emotions and health behaviors among patients with irritable bowel syndrome: a qualitative study

Lauren Harnedy, BA

Massachusetts General Hospital – Research Assistant

Scientific Abstract

Background: Existing behavioral health interventions for irritable bowel syndrome – a highly prevalent condition associated with reduced health-related quality of life (HRQoL) – have important limitations. Namely, they do not specifically target positive psychological constructs (e.g., optimism, positive affect), which are deficient in patients with IBS and associated with improved HRQoL in other medical populations. This descriptive qualitative study aimed to better understand relationships between emotions and HRQoL, engagement in health behaviors, and health outcomes in patients with IBS to inform the development of an IBS-specific behavioral health intervention.

Methods: Individual phone interviews were conducted with adult patients who had a documented diagnosis of IBS, which was then confirmed using a modified ROME IV criteria questionnaire. Interviews asked about emotions as they relate to HRQoL, health behaviors, and perceptions about benefits, motivation, and barriers to health behavior participation. Though full analysis by two independent coders (goal reliability of K > 0.80) is ongoing, we performed a preliminary review of transcripts to identify themes frequently reported by participants.

Results: Twenty-three participants (M age = 54, 57% female) completed the interview. This sample similarly representedthe three main IBS subtypes (IBS-diarrhea (n=8); IBS-constipation (n=7); IBS-mixed (n=8)). Participants identified bidirectional associations between health behavior engagement and feelings of gratitude, joy, pride, accomplishment, and determination. Similarly, participants noted a bidirectional relationship between a lack of health behaviors and feelings of irritability, fear, and sadness. Moreover, participants endorsed links between positive psychological states and improved HRQoL and IBS symptoms.

Conclusions: Participants with IBS consistently described relationships between specific positive psychological constructs and improved health behavior engagement and HRQoL. These findings suggest that an intervention aimed at increasing positive psychological constructs may be a novel way to improve HRQoL and downstream health outcomes in IBS.


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research Areas


Lauren E. Harnedy, BA, , Helen B. Murray, PhD, Kyle Staller, MD, Brad Kuo, MD, Jeff C. Huffman, MD, and Christopher M. Celano, MD, Elizabeth N. Madva, MD

Principal Investigator

Elizabeth Madva, MD

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