The influence of socio-demographic and clinical factors on the process of acceptance of the disease among patients with ulcerative colitis

Ulcerative colitis (UC) is a kind of inflammatory bowel disease involving rectal mucosa, or the rectum with colon, resulting in ulcerations in some cases. It is incurable and varies with periods of exacerbation and remission. The disease affects mainly population of highly-developed European or North American nations. It can relatively rarely be observed in South America, Asia and Africa. It is estimated that morbidity and incidence in those regions is about 10 times lower than in Europe and North America [1,2]. The incidence of UC in Europe is approximately 10 new cases per 100,000 people annually [3]. In Poland, epidemiology assessment is difficult due to a lack of reliable statistics. In Lower Silesia, 840 hospitalizations for UC on average are registered annually [4,5]. In UC pathogenesis, genetic, environmental and immunologic factors play an important role. UC can occur at any age, however, the peak incidence is observed between ages 20 and 40 and over 65 [6]. UC is incurable and accompanies the patient through the rest of his/her life. It varies with periods of exacerbation and remission, which impair everyday activities and lower patient’s quality of life. As a consequence, the patient generally feels bad, which is not only caused by gastrointestinal symptoms but also by emotional and psychological issues [7]. Nowadays, a clear tendency can be observed in medicine to include health and disease-related issues in biopsychosocial context, including social and psychological factors affecting the course of the disease. The assessment of such factors brings up a broader perspective on patient’s health problems [8]. Adjustment to the disease is important in many chronic diseases, which demand a change of the patient’s attitude and taking aspects such as acceptance of one’s disease into consideration [9]. The term ‘acceptance’ denotes adopting an opinion, judgment, belief, behavior, favorable attitude or to give a consent [10]. Accepting one’s disease means adjusting to limitations posed by it and accepting the associated disability. The consequences include accepting the limitations, not being self-sufficient, dependence on others and low self-esteem [11]. In a chronic and difficult therapeutic process, medical staff play the key role, in addition to other patient’s support. Bonding with other patients is an important regulating factor in the emotional sphere, while psychological counseling can turn out beneficial in accepting one’s new difficult life situation. The aim of the study was to evaluate the acceptance of the disease in patients with ulcerative colitis with respect to selected socio-demographic and clinical variables.