Model of Predicting Psychosocial Adaptation to Disease According to Perceived Stress and Sense of Coherence with the Mediation Role of Self-Compassion in the Patients with Irritable Bowel Syndrome

Background: Functional digestive disorders are a group of medical conditions characterized by unknown causes, unclear diagnostic criteria, long-term and unpredictable illness periods, and limited medicinal effectiveness. Doctors and gastroenterologists are often challenged by patients presenting non-specific complaints such as nausea, vomiting, abdominal pain, diarrhea, and constipation, which lack apparent anatomical explanations (Ng et al., 2018). Irritable bowel syndrome (IBS) is the most common diagnosis among gastrointestinal diseases, accounting for 25-50% of referrals to gastroenterologists. IBS primarily affects the large intestine (Tap et al., 2017). The severity of IBS symptoms ranges from mild discomfort to severe, debilitating disease, and may include urgency, fecal incontinence, and extraintestinal symptoms such as sleep disturbances, urinary issues, or sexual dysfunction. Patients with IBS experience not only painful physiological symptoms but also traumatic psychological symptoms, including anxiety, depression, and stress (Lee, Kim, & Lee, 2019). While the etiology of IBS is not fully understood, various factors such as reduced endocrine cells in the digestive system, increased visceral sensitivity, local inflammation, and psychological factors contribute to its development (Piqueras et al., 2019). Any change in human life, whether pleasant or unpleasant, requires some form of readjustment. Consequently, the occurrence of IBS necessitates adaptation to the disease, allowing patients to cope with their new conditions and engage with their treatment process.
This study aims to present a model for predicting psychosocial adaptation to disease based on perceived stress and sense of coherence, with the mediating role of self-compassion in patients with IBS.

Methods: The research method was descriptive-correlational and utilized structural equation modeling. The study’s statistical population comprised patients with IBS who visited therapy centers and gastroenterologists in Isfahan during the autumn and winter of 2020-2021. A total of 340 patients with IBS were selected through convenient sampling. The instruments used included the Psycho-Social Adaptation to Disease Scale (PSADS) (Drogits, F., 1986, as cited by Feghhi et al., 2013), the Perceived Self-compassion Scale (PSS) (Cohen, Kamarck, & Mermelstein, 1983), the Sense of Coherence Scale (SCS) (Flensborg, Ventegodt & Merrick, 2006), and the Self-Compassion Questionnaire (SCQ) (Neff, 2003). Data analysis was conducted using path analysis and the Bootstrap test via SPSS and Amos software, version 23.

Results: The results showed that perceived stress, sense of coherence, and self-compassion have significant relationships with psychosocial adaptation to disease (p<0.01). Moreover, perceived stress, sense of coherence, and self-compassion have a direct significant effect on psychosocial adaptation to disease (p<0.01). Furthermore, the Bootstrap results indicated that self-compassion plays a significant mediating role in the relationship between perceived stress and sense of coherence with psychosocial adaptation to disease (p<0.01). Finally, the model demonstrated a suitable goodness of fit.

Conclusions: Considering the significant mediating role of self-compassion, it is necessary for clinical therapists to enhance psychosocial adaptation to disease in patients with IBS by applying efficient psychological therapy methods, such as self-compassion-based therapy. Additionally, self-compassion can lead to more accurate thinking, enabling individuals to recognize their irrational evaluations. Therefore, self-compassion allows people to address the problems they face in a healthy way and adapt to the flow of life. Based on this, self-compassion can be a source of change, including changes in attitudes and beliefs. This explains the mediating role of self-compassion in the relationship between perceived stress and sense of coherence with psychosocial adaptation in patients with irritable bowel syndrome. used.