The relationship between hopefulness, coping flexibility and psychological adjustment among patients suffering from inflammatory bowel disease

Abstract

(1) Objectives: Anxiety and depression are prevalent among patients with Inflammatory Bowel Disease (IBD), which is a chronic relapsing gastrointestinal disease. The aim of this study was to investigate the possible roles of hope and coping flexibility on buffering anxiety and depression levels in these patients. Another aim of this study was to compare the effects of hope and coping flexibility, and to explore whether the overall hope construct, or its components of agency or pathways, would have a more significant effect on psychological adjustment. (2) Method: The study used a cross-sectional design comprising 81 subjects with Crohn’s disease (a type of IBD) recruited from Queen Mary Hospital. Informed consents were obtained from the subjects during their follow-up in the outpatient clinic of the hospital. A questionnaire package was administered to the participants which comprises the Hospital Anxiety and Depression Scale (HADS), Adult Hope Scale (AHS), Perceived Ability to Cope with Trauma Scale (PACTS) and questions collecting demographic information. (3) Results: Hope negatively correlated with anxiety (r = -.54, p < .001) and depression (r = -.54, p < .001). Coping flexibility was also found to be negatively associated with anxiety (r = -.47, p < .001) and depression (r = -.49, p < .001). Regression analyses controlling for marital status and religion showed that hope was a significant predictor for anxiety and depression in the final model (anxiety: β = -.41, p < .01; depression: β = -.36, p < .01), but not coping flexibility. Hope was found to be a mediator of the relationship between coping flexibility and anxiety (β = -.30, 95% CI [-1.46, -.26]) and depression (β = -.26, 95% CI [-1.26, -.32]). When hope was separated into agency and pathways components, only agency was predictive of depression (β = -.32, p < .05). (4) Conclusions: Hope was found to be a significant factor in buffering the anxiety and depression levels in patients with Crohn’s disease. The effect of coping flexibility was secondary to hope. Hopeful thinking also necessitates both components of agentic and pathways thinking, although agentic thinking could be a more important factor in buffering psychopathology than pathways thinking. Implications from the study as well as future directions were discussed.