Enhancing self-management of patients with inflammatory bowel disease: the role of autonomy support in health goal pursuit.

Background: Inflammatory bowel disease (IBD) is a chronic condition that significantly affects patients' physical, mental, and social health, as well as their overall quality of life. Effective management of the disease demands self-management skills, enabling patients to navigate the daily challenges associated with IBD, such as unpredictable flare-ups, frequent hospitalization, severe symptoms, pain, and physical changes. Objectives: This study examines the motivational aspects of self-management for patients with IBD and focuses on the role of autonomy and directive support from healthcare professionals in enhancing their self-concordance and self-efficacy. Design: From November 2022 to February 2023, a cross-sectional questionnaire study was conducted at the IBD Center of Internal Medicine Clinic in Szeged, Hungary. Methods: A total of 374 adult patients with IBD completed the paper-pencil questionnaire, of whom 241 patients (64.4%) had Crohn's disease, and 133 patients (35.6%) had ulcerative colitis. Results: Based on the findings of the path analysis (χ2 (8) = 18.914, p = 0.01, comparative fit index = 0.935, TLI = 0.837, root mean squared error of approximation = 0.06), autonomy support positively predicted self-concordance (ß = 0.48) and self-efficacy (ß = 0.02), particularly during disease relapse. In addition, self-concordance and self-efficacy predicted more positive (ßs = 0.28 and 0.35) and fewer negative emotional experiences (ßs = -0.09 and -0.20). The model's associations varied between the relapse and remission groups, indicating distinct impacts on different states of the disease. Conclusion: Overall, autonomy support from healthcare professionals has been shown to enhance self-management in patients with IBD, particularly during disease relapse. Meanwhile, self-concordance and self-efficacy act as positive internal factors, thus reducing negative emotional experiences, especially during remission. In sum, this study underscores the need for further exploration of the motivational aspects of self-management and provides insights into developing interventions that promote the health behaviors of patients with IBD.

Self-management of inflammatory bowel disease patients Autonomy support from healthcare professionals has been shown to significantly improve the effectiveness of self-management in patients with inflammatory bowel disease (IBD) (especially during disease relapse), by enhancing their self-concordance and self-efficacy. In this case, the interplay between disease activity, positive and negative emotions, and self-regulatory mechanisms underscores the importance of examining the motivational aspects for developing interventions that promote health behaviors in patients with IBD.

Improving disease management of patients with inflammatory bowel disease: the potential role of self-concordant health goals.

Inflammatory bowel diseases (IBD) are chronic gastrointestinal conditions that significantly impact patients' quality of life. Previous research indicates that patients with IBD have a higher prevalence of anxiety compared to the general population and other chronic diseases. This pilot study aimed to investigate the relationships between goal integration, positive and negative emotions, goal self-efficacy, and trait anxiety as the outcome variable, focusing on patients' self-management strategies. Drawing from the Self-Concordance Model (SCM) of Self-Determination Theory (SDT), the study explored how goal integration is associated with more fulfilling and enjoyable experiences and fewer negative emotions, ultimately improving psychological well-being. Health-related goals were evaluated using the Personal Project Analysis technique, while the State-Trait Anxiety Inventory was utilized to measure general anxiety levels. Among the 141 participants with inflammatory bowel disease, 96 reported having health-related goals. Of these, 66 were female (68.75%), and 30 were male participants (31.25%). Path analysis revealed a moderate negative association between self-concordance (SC) and negative emotions, which, in turn, predicted higher levels of trait anxiety. Furthermore, the alternative model tested indicated that trait anxiety predicted a lower level of self-concordance. Setting well-integrated health goals involves an internal capacity, enabling patients to experience less negative emotions during self-management activities. Anxiety can hinder individuals from accessing their inner needs, resulting in less self-concordant aspirations and more negative emotions. These findings may contribute to developing prevention and intervention programs to enhance IBD patients' adherence to lifestyle changes, ultimately improving their overall well-being.

Cellular Effects of T-2 Toxin on Primary Hepatic Cell Culture Models of Chickens.

Trichothecene mycotoxins such as T-2 toxin cause severe problems for agriculture, as well as for veterinary medicine. As liver is one of the key organs in metabolism, the main aim of our study was to investigate the immunomodulatory and cytotoxic effects of T-2 toxin, using primary hepatocyte mono-culture and hepatocyte-nonparenchymal cell (predominantly Kupffer cell) co-culture models of chicken. Cultures were exposed to 10 (T10 group), 100 (T100 group) and 1000 (T1000 group) nmol/L T-2 toxin treatment for 8 or 24 h. Alterations of cellular metabolic activity, the production of reactive oxygen species (extracellular H2O2), heat shock protein 70 (HSP70), and the concentration of different inflammatory cytokines such as interleukin (IL-)6 and IL-8 were investigated. Metabolic activity was intensely decreased by T-2 toxin administration in all of the cell culture models, in every applied concentration and incubation time. Concentrations of HSP70 and IL-8 were significantly increased in hepatocyte mono-cultures exposed to higher T-2 toxin levels (both in T100 and T1000 groups for HSP70 and in T1000 group for IL-8, respectively) compared to controls after 24 h incubation. Similarly, IL-6 levels were also significantly elevated in the T100 and T1000 groups in both of mono- and co-cultures, but only after 8 h of incubation time. In spite of the general harmful effects of T-2 toxin treatment, no significant differences were observed on reactive oxygen species production. Furthermore, the two cell culture models showed different levels of H2O2, HSP70, and IL-8 concentrations independently of T-2 toxin supplementation. In conclusion, the established primary cell cultures derived from chicken proved to be proper models to study the specific molecular effects caused by T-2 toxin. Metabolic activity and immune status of the different examined cell cultures were intensively affected; however, no changes were found in H2O2 levels.