J. Med. Internet Res. - Exploring patients' views of a cognitive behavioral therapy-based website for the self-management of irritable bowel syndrome symptoms.


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CKGROUND: Cognitive behavioral therapy (CBT) has been shown to have positive effects on the management of irritable bowel syndrome (IBS) symptoms. A factorial pilot randomized placebo-controlled trial (called MIBS) tested the potential effectiveness of a self-management CBT-based website alongside two medications: methylcellulose and mebeverine, and a placebo. The results showed no significant differences in quality of life or symptom severity measures, but enablement and participant's global assessment of relief was higher in the website groups.OBJECTIVE: To conduct a qualitative study nested within this trial, in order to explore patients' views and experiences of using the CBT-based website to facilitate self-management of IBS.METHODS: Semistructured interviews were carried out with patients who had used the website with one session of nurse support (n=16) or the website alone (n=15) while participating in the MIBS trial. An inductive thematic analysis was conducted.RESULTS: We identified three types of engagement with the CBT-based website. One group of participants, mostly in the website-only condition, had limited or no engagement with the website. One group engaged with the content and advice on practical lifestyle changes. The final group of participants engaged with the content and advice on psychological aspects related to IBS. Similarities and differences between these three groups are explored.CONCLUSIONS: Teaching self-management techniques through a Web intervention was received positively by most of the participants. Concepts linked to cognitive aspects of CBT appeared to be harder for participants to engage with. Participants who received nurse support rated the cognitive aspects more positively, suggesting that some therapy support alongside the website should be considered. However, the Web format was preferred by some who favored anonymity as well as those who appreciated the accessibility and ease of use of this type of management. Suggestions on how to encourage engagement with Web interventions are discussed.

Resumo Limpo

ckground cognit behavior therapi cbt shown posit effect manag irrit bowel syndrom ib symptom factori pilot random placebocontrol trial call mib test potenti effect selfmanag cbtbase websit alongsid two medic methylcellulos mebeverin placebo result show signific differ qualiti life symptom sever measur enabl particip global assess relief higher websit groupsobject conduct qualit studi nest within trial order explor patient view experi use cbtbase websit facilit selfmanag ibsmethod semistructur interview carri patient use websit one session nurs support n websit alon n particip mib trial induct themat analysi conductedresult identifi three type engag cbtbase websit one group particip most websiteon condit limit engag websit one group engag content advic practic lifestyl chang final group particip engag content advic psycholog aspect relat ib similar differ three group exploredconclus teach selfmanag techniqu web intervent receiv posit particip concept link cognit aspect cbt appear harder particip engag particip receiv nurs support rate cognit aspect posit suggest therapi support alongsid websit consid howev web format prefer favor anonym well appreci access eas use type manag suggest encourag engag web intervent discuss

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