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      Participants’ perspectives on a multimodal stress management and comprehensive lifestyle modification program for patients with Crohn’s disease—A qualitative interview study

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          Abstract

          Background

          Crohn’s disease (CD) is a type of inflammatory bowel disease (IBD) that is prevalent worldwide and associated with reduced quality of life for patients. Multimodal therapy approaches, which emphasize lifestyle modifications such as mindfulness and stress reduction, can be promising in enhancing health-related quality of life for IBD patients. However, research on multimodal therapy approaches for CD remains insufficient.

          Method

          This qualitative interview study is part of a mixed-methods approach that is embedded in a randomized controlled trial. It investigates the impact of a comprehensive 10-week day clinic lifestyle modification program on the health condition and quality of life of CD patients. Telephone interviews (n = 19) were conducted three months after the program to examine individuals’ viewpoints on the intervention, including perceived changes and transfer of elements into daily life. Reflexive thematic analysis was performed using MAXQDA software.

          Results

          The results indicate that CD can have very individual and comprehensive impacts (psychological, physical, social), leading to reduced perceived quality of life and well-being. By participating in the program, patients wanted to find self-help options to complement conventional pharmacotherapy and actively manage their disease. Patients expressed high satisfaction with the program, feeling it provided valuable support for daily disease management. They were able to integrate adequate therapy elements into their routines to complement their care. Patients recognized significant improvements in various domains, mainly in the psychological domain, e.g., improved self-efficacy, symptom management, and, also partly physical/symptomatic and social improvements.

          Conclusion

          A multimodal stress reduction and lifestyle modification day clinic appears to be beneficial as a complementary therapy for CD patients. It offers additional options and helps patients to address individual symptoms and needs, improve their understanding of the disease and their quality of life. Although promising, further research is needed to assess its long-term effects.

          Trial registration

          ClinicalTrials.gov, identifier: NCT05182645.

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          Most cited references48

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          Using thematic analysis in psychology

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            Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: a systematic review of population-based studies.

            Inflammatory bowel disease is a global disease in the 21st century. We aimed to assess the changing incidence and prevalence of inflammatory bowel disease around the world.
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              Subjective well-being.

              Ed Diener (1984)
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Writing – original draftRole: Writing – review & editing
                Role: Formal analysisRole: InvestigationRole: MethodologyRole: Writing – original draftRole: Writing – review & editing
                Role: Formal analysisRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Project administrationRole: Writing – review & editing
                Role: ConceptualizationRole: Funding acquisitionRole: Project administrationRole: SupervisionRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS One
                plos
                PLOS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                13 November 2024
                2024
                : 19
                : 11
                : e0313127
                Affiliations
                [1 ] Department of Internal and Integrative Medicine, Sozialstiftung Bamberg, Bamberg, Germany
                [2 ] Department of Integrative Medicine, Medical Faculty, University of Duisburg-Essen, Bamberg, Germany
                [3 ] Institute for Sociology, University of Bamberg, Bamberg, Germany
                Zanjan University of Medical Sciences, ISLAMIC REPUBLIC OF IRAN
                Author notes

                Competing Interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: JL was a speaker for Repha GmbH, Techlab Inc., Falk Foundation, Takeda, Celegene GmbH and Willmar Schwabe and received research funding from Repha GmbH, Techlab Inc., Falk Foundation and Willmar Schwabe. The sponsors had no role in the design and execution of the study, interpretation of the results or writing of the manuscript. The remaining authors declared that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

                Author information
                https://orcid.org/0009-0007-7241-0710
                https://orcid.org/0000-0002-7900-181X
                Article
                PONE-D-24-13340
                10.1371/journal.pone.0313127
                11559982
                39536026
                92e0dedb-7b69-41ca-8e59-f0e1d503459c
                © 2024 Schlee et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 19 April 2024
                : 19 October 2024
                Page count
                Figures: 2, Tables: 2, Pages: 17
                Funding
                Funded by: Bavarian State Ministry for Health and Care
                Award ID: Reference Number GE7-2497-GLB-19-V4
                Award Recipient :
                This study as part of the project “Integrative Medizin in Bayern 2020 (IM-BAY 2020)” was supported by the Bavarian State Ministry for Health and Care (Germany) by means of the funding program Gesund.Leben.Bayern, https://www.stmgp.bayern.de/ Reference Number GE7-2497-GLB-19-V4. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Medicine and Health Sciences
                Health Care
                Quality of Life
                Medicine and Health Sciences
                Gastroenterology and Hepatology
                Inflammatory Bowel Disease
                Computer and Information Sciences
                Software Engineering
                Computer Software
                Engineering and Technology
                Software Engineering
                Computer Software
                Medicine and Health Sciences
                Health Care
                Patients
                Biology and Life Sciences
                Nutrition
                Medicine and Health Sciences
                Nutrition
                Medicine and Health Sciences
                Clinical Medicine
                Clinical Trials
                Randomized Controlled Trials
                Medicine and Health Sciences
                Pharmacology
                Drug Research and Development
                Clinical Trials
                Randomized Controlled Trials
                Research and Analysis Methods
                Clinical Trials
                Randomized Controlled Trials
                Research and Analysis Methods
                Research Design
                Qualitative Studies
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Psychological Stress
                Biology and Life Sciences
                Psychology
                Psychological Stress
                Social Sciences
                Psychology
                Psychological Stress
                Custom metadata
                Data cannot be shared publicly because of data protection and ethical reasons. Anonymized data are available from the Department of Internal and Integrative Medicine for researchers who meet the criteria for access to confidential data. Contact: Email: FIGN@ 123456sozialstiftung-bamberg.de Sozialstiftung Bamberg Klinik für integrative Medizin und Naturheilkunde Buger Straße 80 96049 Bamberg Germany.

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