Coping strategy when patients with quiescent Crohn's disease recognize that their conditions are worsening

Background: Although self-management is important for Crohn's disease (CD), there is no research focusing on self-management, especially in worsening conditions. The purpose of this study was to investigate how quiescent CD patients cope with their conditions worsening. Methods: A questionnaire containing six types of coping strategy for worsening conditions was created based on a semi-structured interview. Seventy-six quiescent CD patients participated in this study. We also analyzed the related factors of each coping strategy for worsening conditions. Results: The total percentage of subjects who adopt the strategy of "change contents of meals" 'always' or 'often' was approximately 70%. On the other hand, the strategy of "see a doctor immediately" was approximately 20% in total of 'always' or 'often'. When 'sometimes' was added, "take extra medicine" was approximately 42%. The subjects with experience of hospitalization within 3 years (Z = -2.352, P = 0.019), presence of supplemental elemental diet (Z = -5.182, P < 0.001), or 1 year or less interval since last relapse (Z = -3.352, P = 0.001) showed a significant tendency to adopt the coping strategy of "take (add to) elemental diet." Conclusion: The major coping strategy was "change contents of meals," and the minor coping strategy was "see a doctor immediately." The subjects with unstable disease state adopted the coping strategy of "take (add to) elemental diet." The coping strategies for worsening conditions vary according to patients' backgrounds. The coping type should be taken into account when treating CD patients.