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Theory of Unpleasant Symptoms and Irritable Bowel Syndrome. Deborah Darnell University of Central Florida NGR5800. Irritable Bowel Syndrome. Affects 10-20% adults worldwide (Ronnevig, 2009). Diagnosis based on symptomology since diagnostic examinations usually negative
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Theory of Unpleasant Symptoms andIrritable Bowel Syndrome Deborah Darnell University of Central Florida NGR5800
Irritable Bowel Syndrome • Affects 10-20% adults worldwide (Ronnevig, 2009). • Diagnosis based on symptomology since diagnostic examinations usually negative • Symptoms include: abdominal pain, diarrhea and or constipation, distension, and bloating • Patients face frustration, lack of control, disruption of daily routines
Theory of Unpleasant Symptoms • Purpose: To provide a basis for understanding of how varied symptoms and associated experiences affect patients. To encourage development and design of effective interventions to prevent, ameliorate, or manage the negative effects associated with symptoms (Lenz, 1997).
Concepts of TUS Performance Physiologic Psychologic Situational
Application of TUS to IBS • Physiologic factors: pain, constipation, diarrhea, bloating, urgent bowel movements • Psychologic factors: Feelings of frustration, loss of control, anxiety • Situational factors: Disruption of ADLs and normal lifestyle • Performance factors: Fear of traveling long distances, being away from restroom, untimely BMs lead to isolation
Applying TUS to IBS Isolation Pain, diarrhea, bloating Frustration, loss of control Disruption of ADLs
Applying research to IBS • Research suggests patients suffering with IBS can experience some relief of symptoms with dietary modifications, stress relief, and continued caregiver support (Ronnevig, 2009). • Nutritional teaching • Stress reduction teaching • Proper prescribing of medications • Allowing patient expression of concerns
Applying research to IBS • Brant, Beck & Miaskowski (2010) suggest that improving patient outcomes is the ultimate goal of symptom management research (Brant, Beck,& Miaskowski, 2010, p. 238). • Interventions should: • Promote self-esteem • Incorporate self-efficacy • Increase healthcare interactions • Incorporate attitudinal and motivational behaviors
Applying Research to IBS • Advanced practice nurses should become familiar with the dimensions of symptom burden experienced by patients with IBS in order to properly assess and treat patients with IBS. • Recognize symptoms as subjective • Understand the meanings attached to symptoms experiences • Focus on physical, psychological and situational factors
References Brant, J.M., Beck, S., & Miaskowski, C. (2010). Building dynamic models and theories to advance the science of symptom management research. Journal of Advanced Nursing, 66(1),228-240 doi:10.0000/j.1365-2648.2009.05179.x Farrell, D., & Savage, E. (2010). Symptom burden in inflammatory bowel disease: Rethinking conceptual an theoretical underpinnings. International Journal of Nursing Practice, 16, 437-442 doi: 10.1111/j.1440-172X.2010.01867.x Lenz, E.R., Pugh, L.C, Milligan, R.A., Gift, A., & Suppe,F. (1997). The middle-range theory of unpleasant symptoms: An update. Advances in Nursing Science,19(3), 14-27. Retrieved from http://ovidsp.tx.ovid.com.ezproxy.lib.ucf.edu/ Ronnevig, M., Vandvik, P.O., & Bergbom, I. (2009). Patients’ living with irritable bowel syndrome. Journal of Advanced Nursing,65(8), 1676-85. doi: 10.1111/j.1365-2648.2009.05030.x