İrritabl Bağırsak Sendromlu Bireylerin Beslenme ve Yaşam Kaliteleri: Niteliksel Araştırma Örneği

Yıl 2023, Cilt: 8 Sayı: 2, 381 - 386, 21.06.2023

Nazlı Nur Aslan Çin , Kezban Şahin , Hülya Yardımcı

Öz

Amaç: Bu çalışmada, irritabl bağırsak sendromu olan bireylerin mevcut sağlık durumlarına yönelik beslenme ve yaşam kalitelerinin niteliksel olarak araştırılması amaçlanmıştır.

Gereç ve Yöntem: Araştırma, 13 Mayıs-16 Eylül 2019 tarihleri arasında 20 irritabl bağırsak sendromu olan birey ile yürütülmüştür. Bireyler ile yüz-yüze derinlemesine gerçekleştirilen görüşmelerde yarı yapılandırılmış görüşme tekniği kullanılmıştır. Görüşmelerde bireylerin beslenme ve yaşam kalitelerine yönelik açık uçlu sorular sorulmuştur. Niteliksel verilerin analiz edilmesinde yorumlayıcı fenomenolojik analiz yöntemi kullanılmıştır.

Bulgular: Araştırmaya katılan bireylerin cevaplarından elde edilen veriler dört ana tema altında kategorize edilmiştir. Bu temalar sırasıyla 1. Tedavi alternatifleri ile ilgili düşünce ve deneyimler, 2. Beslenme alışkanlıkları ve iştah durumuna etkisi, 3. Verilen diyet ile ilgili duygu, düşünce ve deneyimler, 4. Hastalığın günlük yaşama etkisi başlıklarından oluşmuştur. Bireylerden bazıları doktor/diyetisyen önerileri dışında alternatif tedavi yöntemi arayışına girdiklerini belirtmişlerdir. Bireyler İBS semptomları nedeni ile beslenme alışkanlıklarında ve iştah durumlarında değişiklik olduğunu bildirmişlerdir.

Sonuç: İrritabl bağırsak sendromlu bireylerde tıbbi beslenme tedavisine yönelik farkındalığın artırılmasının bireylerin yaşam kalitelerinin artmasına katkı sağlayabileceği saptanmıştır. Hastalığın kramp, ağrı, şişkinlik, gaz, ishal veya kabızlık gibi günlük yaşamdaki olumsuz etkilerinin azaltılması, sağlık profesyonellerinin irritabl bağırsak sendromu tedavi eğitiminde hedeflerine ulaşmalarına katkı sağlayabilir.

Anahtar Kelimeler

İrratabl bağırsak sendromu, Beslenme tedavisi, Niteliksel Araştırma, Yaşam kalitesi

Teşekkür

Bireylerin çalışmaya katılmalarındaki yardımlarından dolayı Diyetisyen TENEKECİ'ye teşekkür ederiz. Ayrıca, bu çalışmaya katıldıkları için İBS hastalarına teşekkür ederiz.

Nutrition and Quality of Life of Individuals with Irritable Bowel Syndrome: A Qualitative Study Example

Öz

Objective: The aim of this study was to qualitatively investigate the nutrition and quality of life of individuals with irritable bowel syndrome towards their current health status.

Material and Method: This study was conducted with 20 individuals with irritable bowel syndrome between May 13th and September 16th in 2019. Semi-structured interview technique was used in face to face, in-depth interviews with individuals. In the interviews, open-ended questions were asked about nutrition and quality of life. The interpretive phenomenological analysis method was used in the analysis of qualitative data.

Results: The data obtained from the answers of the individuals participating in the research were categorized under four main themes. These themes were 1. Thoughts and experiences related to the treatment alternatives, 2. Nutritional habits and their effect on appetite, 3. Emotions, thoughts, and experiences related to the given diet, 4. The effect of the disease on daily life, respectively. Some of the individuals stated that they looked for alternative treatment methods besides the recommendations of the physician/dietitian. Individuals reported changes in their eating habits and appetite due to IBS symptoms.

Conclusion: It was determined that raising the awareness of medical nutrition therapy in individuals with irritable bowel syndrome may contribute to increasing the quality of life of individuals. Reducing the negative effects of the disease in daily life such as cramps, pain, bloating, gas, diarrhea or constipation may contribute to the achievement of health professionals' goals in irritable bowel syndrome treatment education.

Anahtar Kelimeler

Irritable bowel syndrome, nutrition therapy, qualitative study, quality of life

Kaynakça

• Defrees DN, Bailey J. Irritable bowel syndrome: epidemiology, pathophysiology, diagnosis, and treatment. Prim. Care- Clin. Off. Pract. 2017 Dec 1;44(4):655-71.
• Hayes PA, Fraher MH, Quigley EM. Irritable bowel syndrome: the role of food in pathogenesis and management. J. Gastroenterol. Hepatol. 2014 Mar;10(3):164.
• Enck P, Aziz Q, Barbara G, Farmer AD, Fukudo S, Mayer EA, Niesler B, Quigley EM, Rajilić-Stojanović M, Schemann M, Schwille-Kiuntke J, Simren M, Zipfel S, Spiller RC. Irritable bowel syndrome. Nat Rev Dis Primers. 2016 Mar 24;2:16014.
• Lovell RM, Ford AC. Global prevalence of and risk factors for irritable bowel syndrome: a meta-analysis. J. Gastroenterol. Hepatol. 2012 Jul 1;10(7):712-21.
• Celebi S, Acik Y, Deveci SE, Bahcecioglu IH, Ayar A, Demir A, Durukan P. Epidemiological features of irritable bowel syndrome in a Turkish urban society. J. Gastroenterol. Hepatol. 2004 Jul;19(7):738-43.
• Karaman N, Türkay C, Yönem O. Irritable bowel syndrome prevalence in city center of Sivas. Turk J Gastroenterol. 2003 Jun 1;14(2):128-31.
• Frändemark Å, Törnblom H, Jakobsson S, Simrén M. Work productivity and activity impairment in irritable bowel syndrome (IBS): a multifaceted problem. Am. J. Gastroenterol. 2018 Oct 1;113(10):1540-9.
• Shorey S, Demutska A, Chan V, Siah KT. Adults living with irritable bowel syndrome (IBS): A qualitative systematic review. J. Psychosom. Res. 2021 Jan 1; 140:110289.
• Buono JL, Carson RT, Flores NM. Health-related quality of life, work productivity, and indirect costs among patients with irritable bowel syndrome with diarrhea. Health Qual. Life Outcomes. 2017 Jan;15(1):1-8.
• Khan S, Chang L. Diagnosis and management of IBS. Nat. Rev. Gastroenterol. Hepatol. 2010 Oct;7(10):565-81.
• Cozma-Petruţ A, Loghin F, Miere D, Dumitraşcu DL. Diet in irritable bowel syndrome: What to recommend, not what to forbid to patients!. World J Gastroenterol. 2017 Jun 6;23(21):3771.
• Farndale R, Roberts L. Long-term impact of irritable bowel syndrome: a qualitative study. Prim Health Care Res Dev. 2011 Jan;12(1):52-67.
• Lacy BE, Weiser K, Noddin L, Robertson DJ, Crowell MD, Parratt‐ Engstrom C, Grau MV. Irritable bowel syndrome: patients’ attitudes, concerns and level of knowledge. Aliment. Pharmacol. Ther. 2007 Jun;25(11):1329-41.
• Ford AC, Sperber AD, Corsetti M, Camilleri M. Irritable bowel syndrome. Lancet. 2020 Nov 21;396(10263):1675-1688.
• McIntosh K, Reed DE, Schneider T, Dang F, Keshteli AH, De Palma G, Madsen K, Bercik P, Vanner S. FODMAPs alter symptoms and the metabolome of patients with IBS: a randomised controlled trial. Gut. 2017 Jul 1;66(7):1241-51.
• Staudacher HM, Lomer MC, Farquharson FM, Louis P, Fava F, Franciosi E, Scholz M, Tuohy KM, Lindsay JO, Irving PM, Whelan K. A diet low in FODMAPs reduces symptoms in patients with irritable bowel syndrome and a probiotic restores bifidobacterium species: a randomized controlled trial. Gastroenterol. 2017 Oct 1;153(4):936-47.
• Harvie RM, Chisholm AW, Bisanz JE, Burton JP, Herbison P, Schultz K, Schultz M. Long-term irritable bowel syndrome symptom control with reintroduction of selected FODMAPs. World J Gastroenterol. 2017 Jul 7;23(25):4632.
• Björkman I, Dellenborg L, Ringström G, Simrén M, Jakobsson Ung E. The gendered impact of Irritable Bowel Syndrome: a qualitative study of patients' experiences. J Adv Nurs. 2014 Jun;70(6):1334-43.
• Harvey JM, Sibelli A, Chalder T, Everitt H, Moss‐Morris R, Bishop FL. Desperately seeking a cure: treatment seeking and appraisal in irritable bowel syndrome. Br. J. Health Psychol. 2018 Sep;23(3):561-79.
• Skrastins O, Fletcher PC. “It just is what it is”: The positive and negative effects of living with inflammatory bowel disease and irritable bowel syndrome. Clin Nurse Spec. 2018 Jan 1;32(1):43-51.
• Kilic SP, Kiliç N, Sevinç S, Demirel C. A qualitative study of the experiences of complementary and alternative medicine use in patients with IBS-C. Holist. Nurs. Pract. 2020 May 1;34(3):171-9.
• Krouwel M, Jolly K, Greenfield S. How do people with refractory irritable bowel syndrome perceive hypnotherapy: qualitative study protocol. Eur. J. Integr. Med. 2019 Feb 1; 26:50-5.
• Ung EJ, Ringstrom G, Sjövall H, Simrén M. How patients with longterm experience of living with irritable bowel syndrome manage illness in daily life: a qualitative study. Eur J Gastroenterol Hepatol. 2013 Dec 1;25(12):1478-83.
• McCormick JB, Hammer RR, Farrell RM, Geller G, James KM, Loftus EV, Mercer MB, Tilburt JC, Sharp RR. Experiences of patients with chronic gastrointestinal conditions: in their own words. Health Qual. Life Outcomes. 2012 Dec;10(1):1-1.
• Mohebbi Z, Sharif F, Peyrovi H, Rakhshan M, Naini MA, Zarshenas L. Experience lived by Iranian patients with irritable bowel syndrome: Transitory crisis and liberation. Investig. Educ. Enferm. 2019 Sep;37(3):e10.
• Sibelli A, Moss-Morris R, Chalder T, Bishop FL, Windgassen S, Everitt H. Patients’ perspectives on GP interactions after cognitive behavioural therapy for refractory IBS: a qualitative study in UK primary and secondary care. Br J Gen Pract. 2018 Sep 1;68(674):e654-62.
• Dhaliwal SK, Hunt RH. Doctor–patient interaction for irritable bowel syndrome in primary care: a systematic perspective. Eur J Gastroenterol Hepatol. 2004 Nov 1;16(11):1161-6.