Effect of self-management intervention on cortisol and daily stress levels in irritable bowel syndrome.

Abstract:

:Self-management programs that include cognitive behavioral strategies have been shown to improve gastrointestinal (GI) symptoms, psychological distress, and quality of life (QoL) in persons with irritable bowel syndrome (IBS). However, less is known about the physiological impact of such a change. As part of a randomized controlled trial using a comprehensive self-management (CSM) intervention (n = 126) compared to usual care (UC; n = 62), cortisol levels were measured in 4 weekly first morning urine samples at baseline and at 3-, 6-, and 12-month follow-up. In addition, diary (28 days) ratings of stress were recorded at baseline, 3, 6, and 12 months. The omnibus test of all three outcome times showed no differences in urine cortisol levels between the CSM and UC groups (p = .400); however, at 3 months the CSM group had significantly higher cortisol levels than the UC group (p = .012). The CSM group reported lower daily stress levels (p = .046 from the omnibus test of all 3 time points) than the UC group, with the effect getting stronger over time. Despite marked improvements in reported stress and previously reported GI and psychological distress symptoms at later follow-ups, the CSM program did not reduce urine cortisol levels in adults with IBS. These results suggest that the first-void urine cortisol levels are not reflective of self-reported daily stress in this patient population.

journal_name

Biol Res Nurs

authors

Deechakawan W,Cain KC,Jarrett ME,Burr RL,Heitkemper MM

doi

10.1177/1099800411414047

subject

Has Abstract

pub_date

2013-01-01 00:00:00

pages

26-36

issue

1

eissn

1099-8004

issn

1552-4175

pii

1099800411414047

journal_volume

15

pub_type

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