The Role of Social Support, its Sources, Stress and Locus of Control on Clinical Activity in Crohn’s Disease

Abstract

Background/Objectives: Crohn's disease (CD), is a chronic, inflammatory, and fluctuating condition, that affects the lives of patients significantly. Research on chronic illnesses has consistently shown that social support, especially the specific source from which it is received, plays a crucial role in helping individuals adapt to their condition as well as reduce perceived stress levels. The same can be said for a patient's sense of control over their disease. This study had two main objectives: (1) examine the roles of perceived stress, perceived social support, received social support, different sources of social support, and health-related locus of control at various stages of CD; and (2) analyse how these variables relate to, and potentially influence, the occurrence of CD flare-ups. Methods: A cross-sectional observational study was conducted on a total sample of 160 individuals diagnosed with Crohn's disease, either in an active or inactive phase. The instruments used included the Perceived Stress Scale (PSS), the Social Support Questionnaire (assessing both perceived and received social support from multiple sources: family, friends, health professionals, and peers), and the Health Locus of Control Scale. All instruments used were validated beforehand. The Student's t-test was used to explore significant differences between groups, and binary logistic regression was utilised to identify variables that act as predictors for the occurrence of CD flare-ups. Results: Higher levels of total perceived social support, especially from friends and health professionals, together with a stronger internal health locus of control, were found to be significantly related to a lower likelihood of CD flare-ups. To the contrary, high levels of stress were associated to a greater likelihood of CD flare-ups. Conclusions: We suggest that programmes or initiatives aimed at improving the quality of life, disease management and clinical stability of individuals with Crohn's disease (CD), be put into place. These initiatives would help to increase the protective effects of social support, strengthen an internal health locus of control, as well as both reduce and effectively manage stress.