Mediating effect of acceptance of illness between caregivers' positive feelings and self-management behavior in patients with inflammatory bowel disease

Objective To explore the relationships of positive feelings of caregivers of inflammatory bowel disease(IBD)patients with acceptance of illness and self-management behavior of patients.

Methods A total of 214 IBD patients were selected as study subjects by convenience sampling. Patients and caregivers were investigated by general data questionnaire, Caregiver Positive Feeling Scale, Disease Acceptance Scale and Self-management Behavior Scale. Pearson correlation analysis was used to explore the correlation among the three factors, AMOS was used to establish a structural equation model, Bootstrap was used to test the model for the second time, and the mediating effect of patients' disease acceptance between the positive attitude of caregivers and patients' self-management behavior was analyzed.

Results The caregiver's positive feelings, acceptance of illness and self-management behaviors of IBD patients were in the middle level. The positive feelings of female caregivers and family caregivers of IBD patients with more times of hospitalization in recent 2 years, higher education level and work and study more affected by disease were lower (P<0.05). The positive attitude scores of female caregivers and family caregivers of patients with more times of hospitalization in recent two years, higher education level, and greater impact on work and study by disease were lower (P<0.05). The gender of the caregiver, the times of hospitalization in the past two years, and the status of work and study were all influencing factors of patients' self-management behavior (P<0.05). There were positive correlations of IBD caregivers' positive feelings, patients' acceptance of illness with self-management behavior (r=0.425, P<0.01; r=0.593, P<0.01), acceptance of illness was positively correlated with self-management behavior (r=0.607, P<0.01). The mediating effect analysis showed that patients' acceptance of illness had a certain degree of mediating effect between caregivers' positive feelings and patients' self-management behavior.

Conclusion Positive attitude and acceptance of illness of IBD patients are very important for improving patients' self-management behavior. Targeted intervention by clinical staff can provide more support channels and disease management guidance to patients and caregivers, improve caregivers' positive attitude and disease acceptance, thereby improving patients' self-management behavior.