Perceived Stigma in Patients with Autoimmune Hepatitis.

Perceived stigma (PS) adversely impacts psychosocial and disease outcomes in patients with chronic liver diseases (CLD), and those with autoimmune hepatitis (AIH) may be at risk for PS given inaccurate assumptions about the origin of their diagnosis. The aims of the current study are to describe the frequency of PS in patients with AIH, compare rates of PS in AIH to rates of PS in primary biliary cholangitis (PBC) and CLD, and examine demographic correlates of PS. 262 adults with AIH (95% female, Mage = 51.53 years) completed online questionnaires on demographics, disease information, and PS. 54-68% reported PS with themes of selective disclosure, non-disclosure, or hiding diagnosis. PS was higher in those with AIH compared to those with PBC, but lower than those with various CLD. Age was inversely related to PS. Given the results, provider screening of PS and integration of clinical health psychologists may be helpful for identifying PS in patients with AIH.

Providing Trauma Informed Care During Anorectal Evaluation.

PURPOSE OF REVIEW: Patients with a history of gastrointestinal (GI) conditions report high rates of psychological trauma. This review discusses the impact of previous trauma, as well as interactions with the medical system, on a patient's physical and mental health. Trauma-informed strategies for improving patient care during gastroenterology procedures are provided. RECENT FINDINGS: History of trauma increases risk of developing GI conditions and re-traumatization during sensitive anorectal procedures (i.e., anorectal manometry, balloon expulsion testing). Trauma-informed strategies include consistent trauma screening for all patients, obtaining consent before and during procedures, creating a safe environment, allowing for privacy, and post-procedure debriefing. Due to high rates of psychological trauma in the gastroenterology setting and the risk of medical trauma from the GI procedures themselves, having an established trauma-informed plan of care for all patients can reduce risk of iatrogenic harm and improve quality of care for patients with GI conditions.

Mother-Daughter Communication about Sexual Behavior and Reproductive Health in Females with Chronic Health Conditions.

PURPOSE: Females with chronic health conditions (CHCs) engage in risky sexual behavior at least as frequently as their healthy counterparts. Among healthy youth, mother-daughter communication about sexual behavior and reproductive health protects against risky sexual behavior. Yet, little is known about the nature of this type of communication in female adolescents with CHCs or factors that contribute to communication. This study described mother-daughter communication frequency, timing, and comfort and examined the role of demographic/disease factors and maternal outcome expectancy (OE), in contributing variance to mother-daughter communication about risky sexual behavior and reproductive health. DESIGN AND METHODS: One hundred mother-daughter dyads from outpatient clinics located within a hospital participated. Daughters [ages 14-19; M(SD) age = 16.28 (1.53)] provided demographic information and mothers self-reported frequency, timing, comfort, and OE of mother-daughter communication about sexual behavior and reproductive health. RESULTS: Reproductive health topics were discussed with the greatest frequency. Condom and birth control use were discussed less often. Overall, maternal comfort levels were high across topics. Maternal positive OE was associated with all communication domains, accounting for between 11 and 21% of the variance beyond relevant demographic factors. CONCLUSIONS: Fostering positive maternal OE may enhance multiple domains of mother-daughter communication about sexual behavior and reproductive health in samples of female adolescents with various CHCs. PRACTICE IMPLICATIONS: Since mothers with positive OE talk about sexual behavior earlier, more frequently, and with greater comfort; nurses are in a unique position to empower mother-daughter communication about sexual behavior and reproductive health and enhance mother OE during clinical encounters.

Sports Participation in Youth With Inflammatory Bowel Diseases: The Role of Disease Activity and Subjective Physical Health Symptoms.

Background: Physical activity is important for youth with inflammatory bowel diseases (IBD), and sports participation is a common way in which youth are physically active. Yet, studies examining sports participation in youth with IBD and barriers to sports participation are lacking. This study examined the role of disease complications, body mass index (BMI), subjective physical health, and psychosocial functioning in influencing sports participation in a large sample of youth with IBD participating in the Crohn's and Colitis Foundation of America Partners (CCFA Partners) Kids and Teens Registry. Methods: CCFA Partners Kids and Teens is an internet-based cohort study in which participants and their parents self-report demographics, disease characteristics, anthropometrics, and validated assessments of physical health, psychosocial functioning, and perceived impairment in sports participation. We performed a cross-sectional analysis of 450 cohort participants, age 12-17 years. Results: Nearly two-thirds of the sample reported that their IBD resulted in some impairment in sports participation. IBD disease activity was associated with perceived impairment in sports participation. In a forward regression analysis controlling for disease activity, fatigue, pain, and past IBD-related surgery emerged as the most salient correlates of impairment in sports participation. Conclusions: Disease activity and subjective physical health symptoms were the most salient correlates of impairment in sports participation. Whether these barriers interfere with physical activity more generally deserves further study, as does replication of these findings longitudinally. Ultimately, a greater understanding of potential barriers to sports participation may be useful for generating targeted physical activity recommendations for youth with IBD.