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Original Article

Body Image, Self Esteem, and Health related Quality of Life in Patients with Crohn's Disease

Young Jin Lee1, Eui Geum Oh2
Korean Journal of Adult Nursing 2014;26(4):383-392.
Published online: August 31, 2014

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Corresponding author: Lee, Young Jin Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Korea. Tel: +82-2-3010-5372, Fax: +82-2-3010-5400, E-mail: hygiene2@hanmail.net
• Received: October 16, 2013   • Accepted: July 27, 2014

Copyright © 2014 Korean Society of Adult Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Purpose
    The purposeof this studywas to describe thedegreesof body image, self esteem andHealth Related Quality Of Life (HRQOL), and to identify factors related to these variables in patients with Crohn's disease.
  • Methods
    A descriptive cross sectional survey design was used. The 148 participants were the patients with Crohn's disease, recruited conveniently from one metropolitan hospital located in Seoul, Korea. The collected data were analyzedwith SPSS/WIN program.
  • Results
    Patients with severeillnessactivityreported significantly lower bodyimages than those of the others. Educationlevelsand working statesaffectedself-esteempositively, while thenumber of operations and illnessactivity affected self-esteemnegatively. Hospitalizationand illnessac-tivityaffected HRQOL negatively. Body image, self esteem, and HRQOLwerepositivelycorrelated to each other with statistical significance. Illnessactivity was acommonfactor to affect body image, self esteem, andHRQOL. Body image was an influential factor on HRQOL as well as illness activity in patients with Crohn's disease.
  • Conclusion
    Asa result, this study suggesteda necessity for developing aninterventionstudytolower the illness activity and heighten the body image among the patients with Crohn's disease.
  • Key Words: Crohn disease; Body image; Self concept; Quality of life
Table 1.
Body Image, Self Esteem and Health related Quality of Life according to the Characteristics of the Subjects (N=148)
Variables Characteristics (M±SD) Categories n (%) Body image Self esteem Health related quality of life
M±SD t or F (p) M±SD t or F (p) M±SD t or F (p)
General characteristics Gender Male 99 (66.9) 63.1±12.4 0.12 31.2±5.1 0.66 159.5±32.7 0.62
Female 49 (33.1) 62.9±10.9 (.907) 30.6±4.8 (.513) 155.8±37.1 (.534)
Age (year) (30.3±8.1) 20 ＜ 3 (2.0) 46.3±8.5 2.05 27.7±5.0 0.82 169.7±39.0 0.36
20~29 80 (54.1) 64.3±12.8 (.090) 31.3±5.1 (.514) 157.4±35.8 (.838)
30~39 45 (30.4) 62.0±10.8   30.6±5.1   158.3±31.6  
40~49 15 (10.1) 61.5±8.0   32.0±4.5   155.6±37.8  
50 ≥ 5 (3.4) 67.2±9.8   29.0±3.7   173.4±17.8  
Education High school ≤ 51 (34.5) 62.7±13.6 -0.22 29.7±5.5 -2.15 155.7±36.9 -0.68
College ≥ 97 (65.5) 63.2±10.9 (.829) 31.6±4.5 (.035) 159.7±32.7 (.500)
Marital status Single 100 (67.6) 63.6±12.2 0.87 31.1±4.9 0.45 159.0±33.0 0.36
Married 48 (32.4) 61.8±11.1 (.385) 30.7±5.2 (.655) 156.8±36.8 (.721)
Occupational status Unemployed 69 (46.6) 61.5±12.6 -1.45 29.9±5.3 -2.37 152.8±34.4 -1.83
Employed 79 (53.4) 64.3±11.1 (.148) 31.9±4.4 (.019) 163.1±33.4 (.070)
Monthly income (10,000 won) 149 ≤ 85 (57.4) 62.3±11.9 -0.88 30.5±4.8 -1.40 156.0±32.9 -0.96
150 ≥ 63 (42.6) 64.0±11.9 (.382) 31.6±5.1 (.163) 161.4±35.8 (.340)
Illness related characteristics Hospitalization Inpatient 33 (22.3) 61.4±12.0 -0.89 30.1±5.1 -1.08 137.2±26.2 -4.24
Outpatient 115 (77.7) 63.5±11.9 (.374) 31.2±4.9 (.282) 164.3±33.9 (＜.001)
Duration since diagnosis (year) (6.8±4.2) 5 ＜ 63 (42.6) 64.0±11.6 0.41 30.7±4.7 0.12 158.2±32.8 0.41
5~9 58 (39.2) 62.3±12.9 (.666) 31.1±5.0 (.888) 156.0±35.2 (.668)
10 ≥ 27 (18.2) 62.2±10.6   31.2±5.5   163.3±35.7  
Experience of operation No 52 (35.1) 63.9±10.3 0.68 31.8±4.4 1.55 159.4±30.7 0.32
Yes 96 (64.9) 62.5±12.7 (.498) 30.5±5.2 (.124) 157.7±36.0 (.753)
Number of operations (N=96) (2.1±1.3) 1~2a 67 (69.8) 63.8±12.1 1.89 30.9±4.9 3.47 159.0±36.0 0.35
3~4b 21 (21.9) 61.5±13.9 (.157) 30.9±5.2 (.035) 157.0±38.9 (.706)
c 5 ≥ 8 (8.3) 54.9±12.6   26.0±6.3 a,b＞c† 147.8±30.8  
Ostomy No 138 (93.2) 63.1±11.9 0.14 30.9±5.0 -0.22 158.1±33.9 -0.22
Yes 10 (6.8) 62.5±12.3 (.887) 31.3±4.9 (.830) 160.6±39.3 (.826)
Illness activity: CDAI (124.9±94.9) 150 ＜ a 104 (70.3) 66.2±10.9 12.77 31.8±4.8 6.38 170.1±28.2 32.95
150~219b 17 (11.5) 56.1±11.5 (＜.001) 30.1±5.0 (.002) 143.3±28.2 (＜.001)
220~449c 27 (18.2) 55.9±11.1 a＞b, c† 28.2±4.7 a＞c† 122.1±30.1 a＞b＞c†

CDAI=Crohn's Disease Activity Index.

†Scheffe test. ́

Table 2.
Scores of Body Image, Self Esteem, and Health related Quality of Life (N=148)
Variables Total score Range Possible range
M±SD
Body image 63.0±11.9 34~91 19~95
Self esteem 31.0±5.0 17~40 10~40
Health related quality of life 158.3±34.2 61~220 32~224
Table 3.
Correlations among Body Image, Self Esteem, and Health related Quality of Life (N=148)
Variables Body image Self esteem Health related quality of life
r (p) r (p) r (p)
Body image 1    
Self esteem .65 1  
  (.001) ＜    
Health related .59 .47 1
quality of life (.001) ＜ (.001) ＜  
Table 4.
Factors Influencing on Body Image, Self Esteem, and Health related Quality of Life with Crohn's Disease (N=148)
Variables Categories β t p Adj. R2 F p
Body image Illness activity -.44 -5.90 .001 ＜ .19 34.81 .001 ＜
Self esteem Illness activity -.39 -4.23 .001 ＜ .16 13.65 .001 ＜
  Education .24 2.63 .010 .21    
Health related quality of life Illness activity -.43 -6.58 .001 ＜ .36 70.60 .001 ＜
  Body image .40 6.01 .001 ＜ .49    

Adj. R2=Adjusted R square.

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    Body Image, Self Esteem, and Health related Quality of Life in Patients with Crohn's Disease
    Korean J Adult Nurs. 2014;26(4):383-392.   Published online August 31, 2014
    DOI: https://doi.org/10.7475/kjan.2014.26.4.383
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    Body Image, Self Esteem, and Health related Quality of Life in Patients with Crohn's Disease
    Korean J Adult Nurs. 2014;26(4):383-392.   Published online August 31, 2014
    DOI: https://doi.org/10.7475/kjan.2014.26.4.383
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    Body Image, Self Esteem, and Health related Quality of Life in Patients with Crohn's Disease
    Body Image, Self Esteem, and Health related Quality of Life in Patients with Crohn's Disease

    Body Image, Self Esteem and Health related Quality of Life according to the Characteristics of the Subjects (N=148)

    Variables Characteristics (M±SD) Categories n (%) Body image Self esteem Health related quality of life
    M±SD t or F (p) M±SD t or F (p) M±SD t or F (p)
    General characteristics Gender Male 99 (66.9) 63.1±12.4 0.12 31.2±5.1 0.66 159.5±32.7 0.62
    Female 49 (33.1) 62.9±10.9 (.907) 30.6±4.8 (.513) 155.8±37.1 (.534)
    Age (year) (30.3±8.1) 20 ＜ 3 (2.0) 46.3±8.5 2.05 27.7±5.0 0.82 169.7±39.0 0.36
    20~29 80 (54.1) 64.3±12.8 (.090) 31.3±5.1 (.514) 157.4±35.8 (.838)
    30~39 45 (30.4) 62.0±10.8   30.6±5.1   158.3±31.6  
    40~49 15 (10.1) 61.5±8.0   32.0±4.5   155.6±37.8  
    50 ≥ 5 (3.4) 67.2±9.8   29.0±3.7   173.4±17.8  
    Education High school ≤ 51 (34.5) 62.7±13.6 -0.22 29.7±5.5 -2.15 155.7±36.9 -0.68
    College ≥ 97 (65.5) 63.2±10.9 (.829) 31.6±4.5 (.035) 159.7±32.7 (.500)
    Marital status Single 100 (67.6) 63.6±12.2 0.87 31.1±4.9 0.45 159.0±33.0 0.36
    Married 48 (32.4) 61.8±11.1 (.385) 30.7±5.2 (.655) 156.8±36.8 (.721)
    Occupational status Unemployed 69 (46.6) 61.5±12.6 -1.45 29.9±5.3 -2.37 152.8±34.4 -1.83
    Employed 79 (53.4) 64.3±11.1 (.148) 31.9±4.4 (.019) 163.1±33.4 (.070)
    Monthly income (10,000 won) 149 ≤ 85 (57.4) 62.3±11.9 -0.88 30.5±4.8 -1.40 156.0±32.9 -0.96
    150 ≥ 63 (42.6) 64.0±11.9 (.382) 31.6±5.1 (.163) 161.4±35.8 (.340)
    Illness related characteristics Hospitalization Inpatient 33 (22.3) 61.4±12.0 -0.89 30.1±5.1 -1.08 137.2±26.2 -4.24
    Outpatient 115 (77.7) 63.5±11.9 (.374) 31.2±4.9 (.282) 164.3±33.9 (＜.001)
    Duration since diagnosis (year) (6.8±4.2) 5 ＜ 63 (42.6) 64.0±11.6 0.41 30.7±4.7 0.12 158.2±32.8 0.41
    5~9 58 (39.2) 62.3±12.9 (.666) 31.1±5.0 (.888) 156.0±35.2 (.668)
    10 ≥ 27 (18.2) 62.2±10.6   31.2±5.5   163.3±35.7  
    Experience of operation No 52 (35.1) 63.9±10.3 0.68 31.8±4.4 1.55 159.4±30.7 0.32
    Yes 96 (64.9) 62.5±12.7 (.498) 30.5±5.2 (.124) 157.7±36.0 (.753)
    Number of operations (N=96) (2.1±1.3) 1~2a 67 (69.8) 63.8±12.1 1.89 30.9±4.9 3.47 159.0±36.0 0.35
    3~4b 21 (21.9) 61.5±13.9 (.157) 30.9±5.2 (.035) 157.0±38.9 (.706)
    c 5 ≥ 8 (8.3) 54.9±12.6   26.0±6.3 a,b＞c† 147.8±30.8  
    Ostomy No 138 (93.2) 63.1±11.9 0.14 30.9±5.0 -0.22 158.1±33.9 -0.22
    Yes 10 (6.8) 62.5±12.3 (.887) 31.3±4.9 (.830) 160.6±39.3 (.826)
    Illness activity: CDAI (124.9±94.9) 150 ＜ a 104 (70.3) 66.2±10.9 12.77 31.8±4.8 6.38 170.1±28.2 32.95
    150~219b 17 (11.5) 56.1±11.5 (＜.001) 30.1±5.0 (.002) 143.3±28.2 (＜.001)
    220~449c 27 (18.2) 55.9±11.1 a＞b, c† 28.2±4.7 a＞c† 122.1±30.1 a＞b＞c†

    CDAI=Crohn's Disease Activity Index.

    †Scheffe test. ́

    Scores of Body Image, Self Esteem, and Health related Quality of Life (N=148)

    Variables Total score Range Possible range
    M±SD
    Body image 63.0±11.9 34~91 19~95
    Self esteem 31.0±5.0 17~40 10~40
    Health related quality of life 158.3±34.2 61~220 32~224

    Correlations among Body Image, Self Esteem, and Health related Quality of Life (N=148)

    Variables Body image Self esteem Health related quality of life
    r (p) r (p) r (p)
    Body image 1    
    Self esteem .65 1  
      (.001) ＜    
    Health related .59 .47 1
    quality of life (.001) ＜ (.001) ＜  

    Factors Influencing on Body Image, Self Esteem, and Health related Quality of Life with Crohn's Disease (N=148)

    Variables Categories β t p Adj. R2 F p
    Body image Illness activity -.44 -5.90 .001 ＜ .19 34.81 .001 ＜
    Self esteem Illness activity -.39 -4.23 .001 ＜ .16 13.65 .001 ＜
      Education .24 2.63 .010 .21    
    Health related quality of life Illness activity -.43 -6.58 .001 ＜ .36 70.60 .001 ＜
      Body image .40 6.01 .001 ＜ .49    

    Adj. R2=Adjusted R square.
    Table 1. Body Image, Self Esteem and Health related Quality of Life according to the Characteristics of the Subjects (N=148)

    CDAI=Crohn's Disease Activity Index.

    Scheffe test. ́

    Table 2. Scores of Body Image, Self Esteem, and Health related Quality of Life (N=148)

    Table 3. Correlations among Body Image, Self Esteem, and Health related Quality of Life (N=148)

    Table 4. Factors Influencing on Body Image, Self Esteem, and Health related Quality of Life with Crohn's Disease (N=148)

    Adj. R2=Adjusted R square.

    Table 1.

    Table 2.

    Table 3.

    Table 4.

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