This study suggests that using community supports contributes to a better subjective outcome of surgery for IBD. Use of supportive resources was correlated with a higher quality of life in our sample, which is consistent with the reported value of social support for medical outcomes in general. Furthermore, the survey data suggest that in a metropolitan area with a broad range of disease-specific resources available, patients with IBD report good overall resource awareness and a high rate of participation, approximately 75%. This is substantially higher than the previously reported rate of 20%, which may indicate relatively greater accessibility of community agencies or higher motivation among IBD patients in our sample. The results of our study suggest a high motivation among subjects. It is important to note that the study, which targeted every patient receiving surgery for IBD during the study period, received a response rate of 68%. This suggests that this sample is likely to be typical of patients at our centre.
Different types of community resources were associated with different outcomes in our sample. Participation in professionally trained and facilitated resources was associated with a better postoperative quality of life than was nonparticipation, whereas this difference was not significant for participants in educational and social resources. Participation in professional resources is distinguished from no participation in professional resources by improved postoperative IBD emotional and systemic symptoms. These results suggest that trained personnel providing individualized services to IBD patients contribute positively to postsurgical quality of life; the contribution of less intensive services was not detected with our outcome measure and sample size.
The retrospective design of this study requires a caveat to this conclusion. Participation in community agencies may require a degree of illness stability such that people with more severe symptoms may not be physically able to participate. The results suggest that (postsurgical) disease activity was highest in subjects who were (presurgical) nonparticipa- tors, which may support disease activity as the primary determinant of both resource participation and quality of life outcome. We argue against this interpretation because the most frequently used resources in the ‘professional’ group (home visits by community nurses and lay visitors) appear to require less active effort for participation than the resources in the social/educational group (ie, in general people need to feel better to go out to an educational night or a fundraising event than to be visited by a nurse). If disease activity were the primary determinant of participation, we would expect to find the lowest level of disease activity in the users of social educational groups, which the data do not support. Clearly, further prospective research is required to investigate the interaction of presurgical disease activity, presurgical resource use and postsurgical quality of life. Failure to consider postoperative complications as a determinant of postoperative quality of life was another limitation of our study.
When you need your medication buy cialis online pharmacy
This study supports the role of community service groups in the health care system, particularly resources provided by trained personnel. As a result, greater ties between service groups and health care professionals are suggested. Working together to design programs and train program leaders may improve the overall health of patients with IBD.