Keywords
Self-Care
Quality of Life
Nursing
Chronic Disease
Patient-Reported Outcome
How to Cite
Abstract
Introduction. Health-related quality of life (HRQoL) is substantially impaired in individuals living with inflammatory bowel disease (IBD). Although self-care is considered a key component of chronic disease management, the specific contributions of different self-care dimensions to physical and mental HRQoL remain poorly understood. This study examined the relationship between self-care behaviours and HRQoL in patients with IBD.
Methods. A multicentre cross-sectional study was conducted among 453 adult patients with Crohn’s disease or ulcerative colitis recruited from outpatient IBD centres in Italy. Self-care was assessed using the Self-Care of Chronic Illness Inventory (SC-CII), and HRQoL was measured using the 12-Item Short Form Health Survey (SF-12). Generalized Additive Models (GAMs) adjusted through Directed Acyclic Graph (DAG)-informed confounding control were used to investigate linear and nonlinear associations between self-care dimensions and HRQoL.
Results. Self-care monitoring showed the highest mean score, whereas self-care maintenance and management were below the established adequacy threshold. No significant associations emerged between self-care dimensions and mental HRQoL. A weak nonlinear association was observed between self-care management and physical HRQoL, suggesting that higher management behaviours may reflect increased disease burden rather than better health status. Overall model fit was limited (adjusted R² = 0.024 for PCS-12 and −0.002 for MCS-12), indicating that self-care explained only a small proportion of HRQoL variability.
Discussion. The findings suggest that self-care behaviours alone may not fully explain variations in HRQoL among patients with IBD. Physical and mental well-being appear to be influenced by a complex interplay of clinical, psychological, and behavioural factors. Future longitudinal studies should explore the role of psychosocial determinants and causal pathways linking self-care and quality of life.
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Copyright (c) 2026 Daniele Napolitano, Francesco Pastore, Nicoletta Orgiana, Ramona Eliza Turcan, Eleonora Ribaudi, Ilaria Marcomini, Greta Ghizzardi, Simone Amato, Piergiorgio Martella, Valentina Vanzi, Mattia Bozzetti