Implementing and Evaluating Virtual Mindfulness-Based Stress Reduction for Adults with Inflammatory Bowel Disease

• Author / Creator

  Chappell, Kaitlyn

• Inflammatory bowel diseases (IBD), which include Crohn’s disease and ulcerative colitis, are chronic diseases of the gastrointestinal tract. Individuals living with IBD suffer from chronic symptoms of fatigue and malnutrition and unpredictable flares of acute symptoms including abdominal pain, diarrhea, and rectal bleeding. The unknown timing and duration of flares can cause feelings of stress, anxiety, and depression in those with IBD which in turn can induce flares in individuals or increase their duration. Despite the connection between these psychiatric co-morbidities and flares, an interdisciplinary approach, that includes integrated mental health care, is often not used when treating people with IBD, despite the evidence that suggests it may improve IBD-related outcomes.

  Mindfulness-based stress reduction (MBSR) is an eight-week program that helps individuals overcome stress, alleviate anxiety and improve quality of life. The techniques learned in MBSR can help mediate the negative effects of stress. MBSR is deliverable by psychiatrists to large groups and may also be delivered virtually allowing it to be more accessible than traditional psychiatric therapy groups, that ordinarily require participants to make additional trips to the hospital.

  The aim of this study was twofold: to assess the feasibility of a virtually-delivered MBSR group program for patients with IBD, and then subsequently to evaluate participants’ experiences in the program. This project used a mixed methods approach and gathered both quantitative and qualitative data. The first study, a feasibility trial, recruited patients with self-identified stress or anxiety via referral from their gastroenterologist. The second study, a qualitative interview follow-up, recruited patients that participated in the MBSR group and examined the barriers and benefits of the program, as well as the participants’ experiences in the group.

  Sixteen of 64 (25%) referred patients agreed to participate in MBSR with the most common reason for decline being noted as a lack of time. The enrolled participants reported a variety of age, gender, disease type and severity, and employment statues; however, only female participants completed the program. The 7 (43.8%) participants who completed the program saw encouraging effects including decreased anxiety and depressions scores and increased health-related quality of life, with both improvements remaining stable at 6-month follow-up. The participants that agreed to participate in the interviews described perceived benefits from the program including increased coping strategies and improved disease management techniques. All five interview participants described positive experiences in the program and noted they would recommend the program to others. The participants identified the main barrier of the intervention as the time commitment, with all of them noting the intensity of the intervention was challenging. An interesting finding of the interviews was that all participants expressed a desire for integrated mental health care within their current IBD care.

  This study assessed the feasibility and preliminary effectiveness of virtually-delivered MBSR for patients with IBD. Only 25% of patients with anxiety or depression symptoms were willing to participate in the intensive 8-week virtual mindfulness group with the biggest barrier to participation being the time required. For participants that completed MBSR, the long-term effects were promising, and participants expressed positive experiences and a variety of perceived benefits. Importantly, the interest in this intervention and the feedback from participants provides evidence that IBD patients want to receive interdisciplinary IBD care, with a strong focus on mental health.

• Subjects / Keywords

  • Mindfulness
  • Inflammatory bowel disease
  • stress
  • anxiety
  • intervention
  • MBSR
  • mindfulness based stress reduction
  • Crohn's disease
  • Ulcerative colitis

• Graduation date

  Fall 2023

• Type of Item

  Thesis

• Degree

  Master of Science

• DOI

  https://doi.org/10.7939/r3-c402-4x79

• License

  This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.