The effect of web-based education on disease activity, symptom management and quality of life on patients with inflammatory bowel disease

Objective: In this study; it is aimed to determine the effect of web based education on disease activity, symptom management and quality of life in inflammatory bowel diseases (IBD). Methods: The study which is randomized controlled trial conducted between July 2015 and May 2017 in a gastroenterology polyclinic of an education and research hospital in Izmir. The sample of the study consisted of 60 patients who were determined by simple stratified randomization method, 30 patients in the web-based training group and 30 patients in the standard training group. Data were collected using the Patient Identification Form, the IBD Activity Index, the IBD Symptom Check List and the IBD Quality of Life Scale (IBD QOL). Information about the disease, such as the definition, anatomy, symptoms, treatment and nutritional management of the disease is presented through the website or educational books. All data collection forms were completed in eight weeks. The first assessment was conducted face-to-face with the patients in the web-based training group, and the next evaluations were conducted on the second, fourth and eighth week through the website. In the standard training program, all the evaluations were made by face-to-face interview method. Ethical permits have been taken to implement the work. Findings: In both training groups, more than half of the patients were male. The average age was 37.26±12.99 in the web-based training group and 41.63±11.85 in the standard training group. 40.0% of the web-based education group and 53.3% of the standard education group are primary education graduates. In both training groups, 53.3% of the patients were diagnosed with ulcerative colitis. At the beginning of the study, it was determined that the patients who were mostly in the mild illness period entered into the remission mostly at the later measurement times, but there was no significant difference in the disease activities according to the measurement times. When the severity averages of gastrointestinal symptoms of patients were examined; symptoms of diarrhea, constipation, stool mucus and abdominal pain in the standard training group were significantly reduced in the web-based education group, the symptom of abdominal pain and decreased appetite. It has been determined that there is no difference in terms of educational groups between the web-based and standard education groups in terms of the time-average of severity of diarrhea, abdominal pain, stool blood, mucus in the stool, tenesmus, rectal tenderness, nausea and appetite reduction. In the web-based training group, in terms of IBD QOL total score averages, there was a significant difference between the variables of the diagnosis, the number of defecation and the evaluation of general conditions in the beginning of the study; it was found that there was a meaningful negative correlation between the disease activities in the initial phase of the patients with ulcerative colitis at the web-based education group and the systemic and social function subscales of the IBD QOL scale, and also while the disease activity was increased, the quality of life decreased in these subscales. In the process up to the end of the study, it was seen that the quality of life scores of the web-based and standardized education groups were similar, there was no significant difference in-group and between the groups, but in time there was an improvement in the quality of life of the patients. Conclusion: As a result of structured patient education using the web page and educational books created by the nurse, there was no significant difference between web-based and standardized training, and both groups showed improvement in severity of symptoms, disease activity and quality of life. The web-based IBD training program is not different from standard education in terms of affecting disease activity, symptom management and quality of life, no matter which method, it has been concluded that according to needs of the patients the structured and individualized patient education pragrams are effective and important.