Doctor-patient relationship and quality of life in Irritable Bowel Syndrome: an exploratory study of the potential mediating role of illness perceptions and acceptance

Hulme, Katrin, Chilcot, Joseph and Smith, Michael (2018) Doctor-patient relationship and quality of life in Irritable Bowel Syndrome: an exploratory study of the potential mediating role of illness perceptions and acceptance. Psychology, Health & Medicine, 23 (6). pp. 674-684. ISSN 1354-8506

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Abstract

Irritable Bowel Syndrome (IBS) is a functional gastrointestinal disorder characterised by unpredictable bowel symptoms. These can be difficult to manage, consequently impacting on sufferers’ quality of life (QoL). In addition, a strained doctor-patient relationship is independently reported in the qualitative literature. Given that the doctor is often the first port-of-call for sufferers, a difficult relationship may influence IBS sufferers’ subsequent management. Research suggests that illness perceptions are important in determining IBS outcomes in therapy; however, their association with doctor-patient relationship and QoL is yet to be investigated. This exploratory study aimed to investigate the association between doctor-patient relationship and QoL in IBS, as well as potential mediation of this relationship by illness perceptions. Online questionnaires measuring doctor-patient relationship, illness perceptions, acceptance and QoL, were completed by 167 participants (144 female, mean age=44.22 years, SD=15.91 years), who reported an IBS diagnosis from a doctor. Bootstrapped pathway analysis was used to model the relationship and mediation effects. There was a significant positive correlation between patient-doctor relationship and QoL, r=.258,n=167,p=.001. There was a significant indirect effect between doctor-patient relationship and QoL through illness coherence and acceptance (bootstrapped estimate=.058, 95%CI Lower-Upper=.02,.095, p=.002). No other indirect effects were observed in combination with good fit indices for the other illness perceptions. Findings suggest a doctor-patient relationship which fosters mutual understanding and helps patients make sense of symptoms, increases their ability to manage their IBS in a psychologically flexible manner, subsequently helping them maintain their QoL.

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