2025 Volume 76 Pages 1-15
Inflammatory bowel disease (IBD), comprising ulcerative colitis (UC) and Crohn’s disease (CD), is designated as an intractable disease in Japan. Achieving treatment goals requires attention to patients’ self-care, which reflects their proactive engagement in managing daily life with a chronic illness. Although previous studies have highlighted the need to assess and make visible the self-care agency of individuals with IBD, few have examined its actual status. In diabetes care, the Instrument of Diabetes Self-Care Agency (IDSCA) has been developed to evaluate self-care agency. Given the similarities between diabetes and IBD as chronic conditions, the IDSCA may serve as a useful reference framework. This study aimed to clarify the self-care agency of outpatients with IBD using a partially modified version of the IDSCA, referred to as the Instrument of IBD Self-Care Agency (IIBDSCA).
We analyzed data from 226 outpatients with IBD. The sample included more males than females (2:1 ratio), with a mean age of 38.8±10.7 years. Of the participants, 153 had CD and 72 had UC. Among the subscales of self-care agency, the highest average score was observed for “motivation for self-management,” followed by “basic knowledge regarding illness and self-management” and “application and adjustment ability.” No significant correlations were found between self-care agency and either age or disease duration. However, women scored significantly higher than men in “motivation for self-management” and “basic knowledge regarding illness and self-management.”
These findings suggest that self-care agency among patients with IBD is characterized by the difficulty in perceiving the benefits of self-management, stemming from the inherent nature of the disease. Therefore, it is important to provide nursing support that helps patients find meaning in their self-management efforts. Furthermore, the observed gender-related differences and the absence of correlations with age and disease duration—contrary to previous studies—suggest that other factors may influence self-care agency in individuals with IBD. Further research is warranted to identify and explore these contributing factors.
