Cross-cultural variation in disease-related concerns among patients with inflammatory bowel disease

OBJECTIVE: The aim of this work was to study cross-cultural variations in t he impact of inflammatory bowel disease (IBD) on health-related quality of life by an international comparison of disease-related concerns. METHODS: Item and factor scores on the Rating Form of Inflammatory Bowel Di sease Patient Concerns and overall mean concern levels were compared by ana lysis of variance among 2002 IBD patients in eight countries. RESULTS: The overall level of concern varied from 51 out of 100 in Portugal to 19 in Sweden, with intermediate scores for Italy (43), Canada (40), Uni ted States (39), France (39), Austria (33), and Israel (25). Having surgery , an ostomy, the uncertain nature of the disease, and medication side effec ts were each rated among the first five in importance in six countries. Oth er items varied considerably. For example, concern regarding pain and suffe ring was high in Israel and low in Portugal, whereas concern over developin g cancer was low in Italy. Concern over financial issues and access to high -quality health care were inversely associated with measures of national ec onomic prosperity. CONCLUSIONS: 1) Cross-cultural comparisons of patient concerns related to I BD are feasible using translated scales. 2) Reporting tendencies vary great ly; within Europe, patients from southern countries report greater overall concern. 3) The complications and the variable evolution of disease elicit general concern, but the importance of specific issues varies among countri es. 4) The reasons for national differences may have social, cultural, and/ or economic determinants with relevance to the patient-physician relationsh ip, patient education, and therapeutic decision making. (C) 2001 by Am. Cel l. of Gastroenterology.