{"doi":"10.1101/2022.02.23.22271431","title":"The effect of self-management online modules plus nurse-led support on pain and quality of life among young adults with irritable bowel syndrome: A randomized controlled trial","abstract":"Abstract Background Irritable bowel syndrome (IBS) is a chronic pain condition that needs life-long self-management. However, the effect of self-management among young adults with IBS is limited. Objectives This study aimed to examine the effect of a nurse-led self-management program on IBS related pain and symptoms, and quality of life (QOL) among young adults with IBS. Theoretical framework The Individual and Family Self-Management Theory (IFSMT). Design A randomized controlled trial with data collected at baseline, 6- and 12-week follow up. Settings and participants Eighty young adults with IBS recruited from two campuses of a public university and two gastrointestinal clinics were randomly assigned into a Self- Management Online education and learning Modules group (SMOM, n = 41) or a Nurse-Led SMOM group (NL + SMOM, n = 39). Twenty-one healthy controls (HCs) were also recruited from these two campuses. Methods All the IBS participants received the SMOM after baseline data collection. Participants in the NL + SMOM received additional three nurse-led one-to-one consultations at baseline, 6- and 12-week follow up. Self-reported pain, symptoms, IBS-related QOL, self- efficacy for managing chronic disease, and coping were measured at baseline, and 6- and 12- week follow up among the IBS participants. The HCs completed data collection of pain and symptoms at baseline and 12-week follow up. The intervention effects across study time points and the comparisons between the two interventional groups were analyzed using linear mixed models. A longitudinal mediation analysis was also conducted to explore the mediation effects of self-management mechanisms of the interventions. Results Both the SMOM and NL + SMOM groups showed significant interventional effects on decreasing pain intensity and pain interference and increasing IBS-QOL among young adults with IBS at the 12-week follow up (all p < 0.05). The NL + SMOM also had significant effect on reducing anxiety and greater improvement in IBS-QOL compared with the SMOM at the 12- week follow up (both p < 0.05). Increased self-efficacy mediated the intervention effect of the NL + SMOM on reducing pain interference and improving IBS-QOL, while the effect of the SMOM was mediated through decreased an inefficient coping strategy-catastrophizing. Conclusions Guided by the IFSMT, this study showed that both the pain self-management online education and nurse-led interventions were effective for alleviating pain and improving QOL among young adults with IBS by targeting the self-management process. The nurse-led program had a better outcome than the online education alone in improving IBS-QOL. Registration number : NCT03332537 What is already known about the topic Irritable bowel syndrome (IBS) is a chronic condition warranting lifelong self- management. Unrelieved abdominal pain is associated with increased healthcare expenditures and decreased quality of life (QOL) in young adults with IBS. Self-management interventions have moderate effect on attenuating IBS related pain and symptoms. What this paper adds Both the IBS Self-Management Online education and learning Modules (SMOM) and Nurse-Led SMOM (NL + SMOM) developed in this study were efficient in reducing pain intensity and pain interference and ameliorating IBS-QOL among young adults with IBS. The NL + SMOM had a greater interventional effect on improving IBS-QOL compared with the SMOM alone. The NL + SMOM had an indirect effect on pain and QOL by increasing self-efficacy, while the indirect effect of SMOM on pain and QOL was derived by decreasing inefficient coping (e.g., catastrophizing).","journal":"medRxiv","year":2022,"id":302788,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.949,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":879407,"name":"Yiming Zhang","orcid":"0000-0002-1364-3051","position":1,"is_corresponding":false},{"id":227804,"name":"Zahra Amirkhanzadeh Barandouzi","orcid":"0000-0002-8537-4751","position":2,"is_corresponding":false},{"id":667709,"name":"Joochul Lee","orcid":"0000-0002-7138-7770","position":3,"is_corresponding":false},{"id":879408,"name":"Tingting Zhao","orcid":"0000-0003-2856-1048","position":4,"is_corresponding":false},{"id":495204,"name":"Wanli Xu","orcid":"0000-0001-5664-6685","position":5,"is_corresponding":false},{"id":444249,"name":"Ming‐Hui Chen","orcid":"0000-0003-1935-2447","position":6,"is_corresponding":false},{"id":328571,"name":"Bin Feng","orcid":"0000-0001-9277-211X","position":7,"is_corresponding":false},{"id":227805,"name":"Angela Starkweather","orcid":"0000-0001-7168-0144","position":8,"is_corresponding":false},{"id":227808,"name":"Xiaomei Cong","orcid":"0000-0002-4992-199X","position":9,"is_corresponding":false},{"id":667931,"name":"Jie Chen","orcid":"0000-0002-1568-8974","position":0,"is_corresponding":true}],"reference_count":45,"raw_metadata":null,"created_at":"2026-07-19T00:32:20.348385Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}