BACKGROUND:Spirituality may influence coping and quality of life in inflammatory bowel disease (IBD), yet spiritual needs are rarely assessed systematically in routine care. The Spiritual Needs Questionnaire - Extended Version (SpNQ-EV) and the Interpretation of Illness Questionnaire (IIQ) explore spiritual needs and illness meanings but require cross-cultural adaptation and content validation for use in the Italian IBD context. METHODS:This protocol describes a qualitative questionnaire validation study using think-aloud cognitive interviews. Purposive sampling with planned heterogeneity and saturation-based stopping will be used to recruit adult IBD patients and healthcare professionals from two Italian IBD outpatient centers. Participants will complete the Italian versions of the questionnaires while verbalizing their thoughts, followed by retrospective probing guided by Tourangeau's cognitive model and a brief debriefing. Interviews will be audio-recorded, anonymized, and analyzed item-by-item in a matrix using predefined problem codes complemented by inductive coding. Inter-coder reliability will be assessed on a subset of transcripts; AI-assisted coding will be explored using de-identified text under human oversight. RESULTS:As this manuscript represents a research protocol, no empirical results have been generated at this stage. This protocol describes a structured approach to evaluating the content validity of two questionnaires, emphasizing transparency in translation, cognitive testing, and item-revision decision rules. The combined use of concurrent think-aloud and retrospective probing will enable observation of real-time cognitive processes and clarification of ambiguous responses. The inclusion of both patients and healthcare professionals will provide complementary perspectives. The exploratory use of AI-assisted coding may offer efficiencies for segment classification in large item-by-item matrices. CONCLUSIONS:Rigorously adapted and content-validated Italian versions of the SpNQ-EV and IIQ may support both research and clinical practice by providing a shared language for exploring existential and spiritual dimensions of living with IBD, supporting future psychometric validation and implementation of spiritual and interpretation of illness assessment.
BACKGROUND:Inflammatory bowel diseases (IBD), including Crohn's disease and ulcerative colitis, are chronic immune-mediated disorders characterized by a relapsing-remitting course and progressive intestinal damage with a significant impact on patients' quality of life and healthcare system. Traditional care models, based on periodic outpatient checkups, are often insufficient to ensure continuous disease monitoring and timely intervention in the event of a flare-up. In this context, the use of digital health tools represents a potentially innovative strategy to improve clinical and self-management of the disease. The aim of this systematic review is to investigate which digital health tools are currently used to support the management of patients with inflammatory bowel disease (IBD), including Crohn's disease and ulcerative colitis. METHODS:This systematic review was conducted and reported in accordance with the PRISMA 2020 guidelines. Searches of PubMed, CINAHL, Web of Science, Scopus, and the Cochrane Library were made covering literature from 2006 to 2025. RESULTS:Fifteen articles were analyzed, paying attention to the themes of general characteristics, methodological quality, digital health tools utilized, topics of interest of the studies and acceptability and usability. CONCLUSIONS:DHTs are promising tools for managing chronic conditions such as IBD, but require further refinement and adaptation to population-specific needs.
BACKGROUND:Despite its significant psychological burden, long-term psychosocial effects of nurse-led self-management interventions in IBD remain understudied. This study assessed longitudinal changes in psychosocial outcomes following a structured self-management program, and the moderating role of family functioning. METHODS:A single-center, non-randomized, single-arm longitudinal study was conducted in 60 IBD adults in remission who participated in a nurse-led multidisciplinary psychoeducational program in Spain. HRQoL (CCVEII-9), perceived stress (PSS-14), anxiety and depression (HADS), and family functioning (Family APGAR) were assessed at five time points over 12 months. Linear mixed-effects models evaluated temporal changes and moderating role of baseline family functioning. RESULTS:HRQoL improved significantly over 12 months (β=+6.18, 95% CI: 3.53 to 8.82; P<0.001), exceeding a clinically meaningful threshold. Depressive symptoms showed a significant sustained reduction (P=0.036; β=-0.92, 95% CI: -1.66 to -0.19 at 12 months). Perceived stress showed a non-significant decreasing trend (P=0.054), reaching significance at 6 months (β=-1.93, 95% CI: -3.63 to -0.22; P=0.028). Anxiety remained stable (P=0.471). Family functioning moderated trajectories for perceived stress (P=0.004), depression (P<0.001), and anxiety (P<0.001), with a non-significant trend for HRQoL (P=0.056); participants with normal family functioning showed earlier and stronger improvements. CONCLUSIONS:Longitudinal evidence suggests that a nurse-led psychoeducational intervention was associated with sustained improvements in HRQoL and depressive symptoms in IBD. The moderating role of family functioning in outcomes underscores the value of integrating family-sensitive self-management programs into IBD nursing care.
