Treatment of inflammatory bowel disease in the adolescent

Adolescents' Lived Experiences While Hospitalized After Surgery for Ulcerative Colitis

Adolescents are in a transitional phase of life characterized by major physical, emotional, and psychological challenges. Living with ulcerative colitis is experienced as a reduction of their life quality. Initial treatment of ulcerative colitis is medical, but surgery may be necessary when medical treatment ceases to have an effect. No research-based studies of adolescents' experience of the hospital period after surgery for ulcerative colitis exist. The objective of the study was to identify and describe adolescents' lived experiences while hospitalized after surgery for ulcerative colitis. This qualitative study was based on interviews with eight adolescents. Analysis and interpretation were based on a hermeneutic interpretation of meaning. Three themes were identified: Body: Out of order; Seen and understood; and Where are all the others? The adolescents experience a postoperative period characterized by physical and mental impairment. Being mentally unprepared for such challenges, they shun communication and interaction. The findings demonstrate the importance of individualized nursing care on the basis of the adolescent's age, maturity, and individual needs. Further study of adolescent patients' hospital stay, focusing on the implications of being young and ill at the same time, is needed.

Illness-specific anxiety: implications for functioning and utilization of medical services in adolescents with inflammatory bowel disease

PURPOSE. Adolescents with inflammatory bowel disease (IBD) may be at heightened risk for developing anxiety and depression. This cross-sectional pilot study examined the relationship between anxiety and depression and health-related behaviors. METHODS. Thirty-six adolescents with diagnosed IBD, ages 12-17, and their parents were recruited from two pediatric gastroenterology medical centers. RESULTS. Clinical levels of anxiety (22%) and depressive symptoms (30%) were reported by patients. Regression analyses revealed that IBD-specific anxiety was significantly associated with greater utilization of medical services and worsened psychosocial functioning. PRACTICE IMPLICATIONS. Results provide preliminary support that IBD-specific anxiety may play an important role in disease management, yet concerns are rarely systematically assessed by health professionals.

Young peoples' experience of living with ulcerative colitis and an ostomy

Inflammatory bowel disease is a significant illness among young people, requiring some of them to get an ostomy; however, there is minimal research that seeks to understand the meanings young people assign to their inflammatory bowel disease experiences. The purpose of this phenomenological study was to arrive at an understanding of the lived experiences of young persons with inflammatory bowel disease and an ostomy. Six young adults (19-24 years of age) diagnosed with ulcerative colitis, and who all had had an operation for a temporary ostomy, participated in individual open-ended interviews. "Concealing and Revealing the Self," which emerged as the essence of young adults' experiences, referred to how much they chose to present their "true" self to others. The concealment of their true self was, in part, due to the symptoms they experienced and the impact that the illness had on their changing bodies. It was not until they were no longer experiencing the symptoms and their bodies returned to normal that they were able to reveal themselves and have a true sense of confidence. Findings also reveal that young persons with ulcerative colitis and an ostomy experience many uneasy feelings that affect their sense of self, which nurses need to acknowledge.

Pediatric inflammatory bowel disease

The treatment of children and families affected by pediatric IBD requires an awareness of the diverse psychobiologic effects of the disorder over the course of child, adolescent [53], and adult development [52]. Optimal treatment requires careful coordination of various medical, educational, and rehabilitative services and concerned, empathetic, continuity of care by knowledgeable clinicians [4]. In many cases, this care must also include individual psychotherapeutic work with affected youngsters at crucial junctures to help deal with the social and psychological stresses of IBD, as well supportive casework for parents and siblings.