Source: Dissertation Abstracts International, Volume: 78-07(E), Section: B.

Adviser: Nancy Redeker.

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Inflammatory bowel disease (IBD) is a chronic inflammatory disease of the gastrointestinal tract. It primary consists of Crohn's disease and ulcerative colitis and follows and unpredictable course of active disease and remission. It is estimated that 1.4 million people in the United States have IBD. There is no cure of IBD and people with IBD face a high symptom burden, including the symptoms of pain, fatigue, depression, anxiety, and sleep disturbance. In other chronic conditions, it is known that symptoms do not occur in isolation, but symptoms occur in clusters. However, little is known about how symptoms cluster in IBD. Examining symptom clusters in IBD will provide foundational knowledge for future research into the etiology of symptom clusters and the development of self-management interventions that target symptom clusters.

This dissertation focuses on self-management and symptoms clusters in IBD. The first paper is a systematic review of self-management interventions in IBD. In the second paper, a discussion of methods for using latent class analysis, we propose using latent class analysis in conjunction with biomarkers and genetics to understand better the etiology of symptom clusters. The third paper presents the results of my study of symptom clusters among patients with IBD. The study was comprised of a secondary analysis of data obtained from a national cohort of participants with IBD. I used latent class and latent transition analysis to examine the nature of symptom clusters, changes in symptom clusters over time, and the associations between clinical and demographic factors and these clusters. The results of this dissertation paper provide foundational knowledge needed to understand the nature of symptom clusters in patients with IBD.