Factors Influencing Satisfaction with life in Female...

Factors Influencing Satisfaction with Life in

Female Nursing College Students with

Irritable Bowel Syndrome

Sung Hee Lee1, Hoon Jung Jeon

2*

1Professor, College of Nursing, Kyungpook National University, Daegu, Korea 2Master’s student, College of Nursing, Kyungpook National University, Daegu, Korea

Corresponding Author [email protected]

Abstract. We explored the factors influencing satisfaction with life among

female nursing college students with irritable bowel syndrome (IBS). One

hundred and thirty-five female nursing college students with IBS were recruited

from 6 nursing colleges located in D city, South Korea. Satisfaction with life,

IBS severity, and visceral sensitivity were assessed using a structured

questionnaire. Stepwise multiple regression analysis was used to identify the

factors that influenced satisfaction with life. Our results suggest that IBS

severity significantly influenced satisfaction with life, with an overall

explanatory power of 10.9%. As such, interventions targeting female nursing

college students with IBS might benefit from focusing on the severity of IBS

symptoms.

Keywords: College students, Irritable bowel syndrome, Satisfaction with life,

Nursing, Visceral sensitivity

1 Introduction

1.1. Background

Irritable bowel syndrome (IBS) is a chronic illness causing repetitive abdominal pain

(without specific organic causes) and abnormal bowel habits [1]. IBS is one of the

most common gastrointestinal diseases, with occurrence rates of 5–12% overseas [2]

and 2.2–9.6% domestically [3]. Notably, the IBS occurrence rate among female

nursing college students is reported to be remarkably high, at around 33% [4, 5].

Nursing college students often suffer from considerable stress due to their strict

curricula, excessive workloads, and psychological burden induced by the national

licensing examination, and as a result, are more likely to experience anxiety and

depression [6, 7]. Previous studies have reported that these factors also correlate with

the high IBS occurrence rate in this population [8, 9].

* Corresponding Author: Hoon Jung Jeon,

College of Nursing, Kyungpook National University. Tel: +82-10-4107-1009 email: [email protected]

Advanced Science and Technology Letters Vol.132 (Healthcare and Nursing 2016), pp.198-203

http://dx.doi.org/10.14257/astl.2016.132.35

ISSN: 2287-1233 ASTL Copyright © 2016 SERSC

IBS symptoms are not life threatening; however, their chronicity can have a

detrimental impact on daily living by causing limitations in social activities, absence

from school, or increased medical expenses [10]. Furthermore, IBS patients’ quality

of life appears to be lower than that of health people as well as individuals with other

chronic illnesses or health problems, such as hemodialysis patients or diabetic patients

[11]. Quality of life can be defined as one’s level of happiness and psychological

well-being. It is often expressed and measured as “satisfaction with life” [12].

One potential factor influencing satisfaction with life is IBS severity. More

specifically, individuals with severe IBS tend to exhibit more frequent symptoms—

thus, when IBS severity is low, IBS patients rarely experience any notable symptoms,

and thus tend to have a better quality of life and to not visit hospitals. In contrast,

when the severity is high, IBS patients tend to experience symptoms on a continuous

basis, which leads to a decrease in quality of life [11].

Another potential factor is visceral sensitivity, which has been shown to influence IBS

patients’ quality of life [12]. Previous studies have reported that visceral sensitivity

correlates with IBS patients’ daily living functions and quality of life after medical

assessments and treatments [13.14].

Although previous studies have confirmed the correlations of quality of life with

IBS severity and visceral sensitivity among IBS patients [10,15], none have looked at

the relationships of these variables with satisfaction with life among female nursing

college students with IBS. Thus, we investigated this relationship among female

nursing college students with IBS. We believe that the study results will be

fundamental data for the development of nursing interventions targeting satisfaction

with life in this population.

1.2. Purposes

• Clarify the differences in satisfaction with life according to the general charac

teristics of female nursing students with IBS

• Describe the degrees of IBS severity, visceral sensitivity, and satisfaction wit

h life among female nursing students with IBS

• Determine the correlations between IBS severity, visceral sensitivity, and sati

sfaction with life among female nursing students with IBS

• Determine what factors influence satisfaction with life among female nursing

students with IBS

2 Methods

2.1 Study Design

In this cross-sectional descriptive study, we investigated the influencing factors of

satisfaction with life among female nursing college students with IBS.

Advanced Science and Technology Letters Vol.132 (Healthcare and Nursing 2016)

Copyright © 2016 SERSC199 199

2.2 Participants and Data Collection

Study participants were sophomore students enrolled at the time of the study in the

nursing departments of six universities in D city of South Korea. We determined the

sample size with a power analysis using G*Power 3.1: the sample size for a stepwise

multiple regression analysis with an effect size of .15, a significance level of .05, a

test power of .95, and three independent variables was 119 subjects according to our

analysis.

Of the 807 students contacted, 225 were considered to have IBS according to the

Rome III criteria, while 140 understood the study purpose and provided their written

consent for participation. A total of 135 questionnaires were included in the final

analysis, after excluding five with insufficient answers. According to our power

analysis, our final sample size was sufficient.

2.3. Instruments

2.3.1. Rome III Adult Questionnaire: The Korean version of the Rome III Adult

IBS Questionnaire, developed by Drossman et al. [16], was used for the identification

of students with IBS. Translation of the questionnaire was provided by the Korean

Society of Neurogastroenterology and Motility[17]. The Rome III Questionnaire uses

the following questions to determine the severity of IBS symptoms: persistence of

symptoms for 2-3 days/month in the previous 3 months (question 1), persistence of

symptom over the non-menstrual period (question 2), and persistence of symptoms

for ≥6 months (question 3). The criteria in questions 1-3 should be associated with

two or more of the following: symptom relief with defecation (question 4); a change

in stool frequency (questions 5-6); and change in symptoms accompanying change in

the form (appearance) and hardness of stool (questions 7-8).

2.3.2 Satisfaction with Life We used the satisfaction with life scale developed by

Diener et al. [18] and adapted into Korean by Lee [19] to measure satisfaction with

life. This scale comprises 5 questions, each of which is measured on a 5-point Likert

scale ranging from 1 (“not at all”) to 5 (“very much so”). Total scores range from 5 to

25, with higher scores indicating a higher satisfaction with life. The internal

consistency reliability (Cronbach’s ⍺) of the scale in Diener et al.’s study was .87,

whereas that in this study was .80.

2.3.3 Irritable Bowel Symptom Severity IBS severity was measured using the

Irritable Bowel Syndrome Severity Scoring system–Korean Version, which was

developed by Francis et al. [20]. This scoring system comprises questions on

abdominal pain, abdominal distension, bowel habits, and the impact of IBS symptoms


200 Copyright © 2016 SERSC

on quality of life. Each section is scored on a scale of 0–100 points, with a total score

ranging from 0 to 500. Higher scores indicate more severe symptoms.

2.3.3 Visceral Sensitivity

We used the Visceral Sensitivity Index developed by Labus et al. [13] and adapted

into Korean by Jang [21] to measure visceral sensitivity. This scale comprises 15

questions in five areas of anxiety associated with GI disturbances: concern, fear,

wariness, sensitivity, and evasion. Each question is measured on a 6point Likert scale,

ranging from 0 (“strongly agree”) to 5 (“strongly disagree”). Total scores range from

0 to 75, and are calculated by reversing the item scores, so that 0 refers to “no visceral

sensitivity” associated with GI disturbances and 75 indicates “most severe visceral

sensitivity” [13]. In Labus et al.’s study [13], the Cronbach’s ⍺ of the scale was .93,

while that in the present study was .90.

2.4 Procedure

Data collection was performed in March 2015. The investigators worked

collaboratively with the nursing departments and directors of the six universities in D

city, South Korea. Self-reported questionnaires were provided to students who met the

Rome III criteria for IBS during a non-class time. Completion of the questionnaire

required about 15 min, and completed questionnaires were immediately collected by

the investigators and two research assistants.

2.5 Ethical Approval

Our study methodology was approved by the institutional review board of Kyungpook

National University (2015-0017).

2.6 Data Analyses

The collected data were analyzed using IBM SPSS Statistics 20. The subjects’ general

characteristics and variable scores were described using means and standard

deviations, and t-tests and one-way ANOVAs were used to verify the differences in

satisfaction with life by participants’ general characteristics. The correlations of IBS

severity and visceral sensitivity with satisfaction with life were determined using

Pearson’s correlation coefficient, and stepwise multiple regression was conducted to

confirm the influencing factors of satisfaction with life.



3 Results

Stepwise multiple regression analysis was conducted using IBS severity and visceral

sensitivity (which were both correlated with satisfaction with life in the correlational

analysis) as independent variables in our investigation of the influencing factors of

participants' satisfaction with life.

The assumptions of the regression analysis were tested and were all satisfied.

Specifically, in testing the autocorrelation of errors and model validation, we found a

Durbin-Watson value of 1.972, which indicated no autocorrelation between

independent variables. The variables’ tolerance was 1.00 (≥0.1), which indicated that

the regression model was appropriate. Variance inflation factor values ranged from

1.00 to 1.550, meaning that all were below the standard value of 10; thus, there was

no problem of multicollinearity.

In the regression analysis, participants’ satisfaction with life was inversely

correlated with IBS severity”(β = -.340, p < .001), which explained 10.9% of the

variance in satisfaction with life (F = 17.367, p < .001). In other words, IBS severity

was confirmed as an influencing factor of the satisfaction with life of female nursing

college students with IBS (Table 4).

Table 1. Influencing Factors of Satisfaction with Life (n = 135)

Variables B β t p R2 Adj.R

2 F (p)

(Constants) 18.747

29.614 <.001 .115 .109 17.367

(<.001)

Irritable bowel

syndrome severity

-.013 -

.340 -4.167 <.001

4 Conclusion

This study confirmed that IBS severity is a negative influencing factor for satisfaction

with life of female nursing college students with IBS. Thus, the development and

implementation of nursing interventions in consideration of the study results would be

needed to improve the satisfaction with life of this population.

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202 Copyright © 2016 SERSC

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