The relationship between illness identity and the self-management of Inflammatory Bowel Disease

OBJECTIVES: The psychological impact of Inflammatory Bowel Disease (IBD) can be profound, leading to challenges with illness self-management. One such impact can be an identity discrepancy, where illness identity is rejected as part of the self. The aim of this study is to examine the relationship between illness identity and self-management of IBD. DESIGN: A mixed-methods approach was taken using an online survey with 167 participants living with IBD. METHODS: The Illness Identity Questionnaire and Patient Activation Measure were utilized to ascertain the correlational relationship between illness identity and self-management, triangulated with a thematic analysis of two open-ended questions on this topic. RESULTS: The results revealed a statistically significant relationship after controlling for possible confounders of age, illness duration, illness severity, and number of comorbidities. Positive illness identity types (acceptance and enrichment) had a moderate, positive correlation with self-management. Negative identity types (rejection and engulfment) had a weak, negative correlation. This was supported by three main themes found from a thematic analysis and provided further insight into this relationship. Theme 1: negotiating with self as a process of acceptance; Theme 2: resigned acceptance that protects sense of self; and Theme 3: Self-management expands from behavioural strategies to psychological processes through acceptance. CONCLUSIONS: These results suggest that the more illness is accepted into a sense of self, the better an individual is able to self-manage IBD as more psychological resources are activated. These findings provide individuals and clinicians alike insight into utilizing identity change to improve the overall self-management of IBD.