Influence of multidisciplinary team care with abundant nurse staffing on patient-reported outcomes among patients with inflammatory bowel disease in clinical remission

• Published in: Health and quality of life outcomes Vol. 22; no. 1; p. 44
• Main Authors: Tanaka, Makoto, Kawakami, Aki, Sakagami, Kayoko, Terai, Tomoko, Ito, Hiroaki
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 05.06.2024; BioMed Central; BMC
• Subjects: Adult; Biological products; Care and treatment; Clinical outcomes; Colitis, Ulcerative - therapy; Critically ill; Crohn Disease - psychology; Crohn Disease - therapy; Crohn's disease; Crohns disease; Dependent variables; Diagnosis; Effectiveness; Employment; Empowerment; Female; Health care; Humans; Inflammatory bowel disease; Inflammatory bowel diseases; Inflammatory Bowel Diseases - nursing; Inflammatory Bowel Diseases - psychology; Inflammatory Bowel Diseases - therapy; Intestine; Male; Medical personnel; Middle Aged; Multidisciplinary teams; Multiple regression models; Nurse staffing; Nurses; Nursing care; Nursing services; Outpatient care facilities; Outpatients; Patient Care Team - organization & administration; Patient compliance; Patient outcomes; Patient Reported Outcome Measures; Patient safety; Personnel Staffing and Scheduling; Professionals; Quality of Life; Regression analysis; Remission; Remission (Medicine); Risk factors; Self Efficacy; Social networks; Surveys and Questionnaires; Ulcerative colitis; Workforce planning; Japan; Inflammatory bowel diseases; Outpatients; Patient-reported outcome measures; Nurse staffing; Crohn’s disease; Ulcerative colitis
• ISSN: 1477-7525; 1477-7525
• DOI: 10.1186/s12955-024-02247-w

Patients with inflammatory bowel disease (IBD) experience difficulties in daily life and demanding self-care needs. The goal of our support for patients is to ease their difficulties and improve their belief in their capacity to self-manage their disease (self-efficacy), by increasing their ability for self-care. The nurse's contribution is vital in empowering patients and supporting them to better manage their disease. There is evidence that higher nurse staffing levels are associated with better patient outcomes in acute care settings, but little is known about the outpatient setting. The objective of this study was to explore the impact of multidisciplinary team care with abundant nurse staffing levels on patient-reported outcome measures (PROMs) among patients with IBD, encompassing Crohn's disease (CD) and ulcerative colitis (UC), in clinical remission. Patients with IBD in clinical remission were included because disease activity influences the patient's subjective evaluation. A total of 499 valid responses from two different sources were analyzed: 318 from a specialized IBD clinic with abundant nurse staffing and a multidisciplinary care team (UC: 83, CD: 235) and 181 from an online survey panel (UC: 109, CD: 72). The IBD Self-Efficacy Scale (IBD-SES) and the difficulty of life scale (DLS) were used as disease-specific PROMs. In two multiple regression models adjusted by background characteristics (age, sex, diagnosis [UC/CD], employment status, use of biologics, and disease duration) using the IBD-SES or DLS as a dependent variable, the responses from clinic patients showed a more favorable score (higher self-efficacy or lower difficulty) than the online responses. Multidisciplinary team care with abundant nurse staffing may improve self-efficacy and ease difficulties of life among patients with IBD in clinical remission. These results could help bring attention to nurse staffing in an outpatient setting, which has previously been overlooked, and be the first to provide evidence of its importance in encouraging enhanced staffing levels.