The symptoms and implications of ulcerative colitis are difficult to manage and cope with therefore there is a definite need for these individuals to seek effective therapy. But there yet remains to be one definitive treatment free from negative implications. This means that individuals need to weigh out the benefits and risks of each form of treatment and compare these options with the physical symptoms that they experience as well as the emotional and physical risks associated with longstanding ulcerative colitis. In a study done by Moayyedi it was identified that ulcerative colitis patients were dissatisfied with the current system, with a staggering 94% (80/85) of those randomized to usual management preferring another approach (p.308-309). This proves that we need to take a closer look at the experiences of these individuals in order to find better ways to meet their needs. One can see that making decisions regarding treatment would be a significant time for these individuals, and it would be a probable assumption that this time would be both confusing and stressful.

A therapeutic relationship between a patient with ulcerative colitis and the nurse is important to develop. This relationship should have trust, honesty, patience, and understanding, which will facilitate an open relationship where the patient can feel comfortable talking about themselves. The nurse should talk to the patient about the symptoms they are experiencing and how they are impacting their life. By doing this the nurse can get a sense of what the patient is going through and then the nurse and patient can brainstorm together strategies that can work to decrease their symptoms. The nurse should also provide time for the patient to talk about their experience with their treatment regime. At this time the nurse can assess the patients compliance with treatment and talk to the patient about the different treatment options that are available to them. Many individuals who seek medical help for ulcerative colitis will, at this time, experience a change in their treatment regime. By gaining a better phenomenological understanding of what it is like for these individuals when they are faced with having to make decisions regarding their treatment, nurses will be better able to make the needed support and resources available to these individuals during this time.

The long-term implications of ulcerative colitis can have a negative impact on ones emotional health. Decreased self-respect and decreased self-esteem are common implications that a nurse must address when caring for individuals with ulcerative colitis. It is important for the nurse to serve as a source of emotional support for the patient. Ulcerative colitis can occur at any age, but up to 40% of ulcerative colitis cases are diagnosed in people age 20 or younger. Due to the early onset of the disease insecurity, dependence, and sensitivity are concerns as well as the potential for the disease to interfere with the normal development, growth, and maturation of the individual. Coping mechanisms of the individual may not yet be established related to chronic disease, lifestyle changes, and pain and stress management. In order for the nurse to aid the patient in developing healthy coping behaviors one should first identify any ineffective behaviors and assist the patient in learning more effective behaviours. The more knowledge that the patient and family have about the disease and managing symptoms, the better they will be able to cope. When talking to the patient as well as the family it is important for the nurse to explain disease treatments, diagnostic tests, and medications. By doing this it increases ones understanding and may reduce the anxiety that one experiences when they have to make decisions about their treatment. It is also important to provide privacy for the patient when talking to them about their illness because the symptom of the disease may be embarrassing for the patient to talk about.

Finally, the nurse must talk to the patient about the actual disease itself to ensure that the patient understands the disease and is aware of the possible treatments. By doing this it will help the patient make informed decisions about the treatment and management of the disease. The nurse may need to refer the patient to a dietician if complex dietary changes are necessary. If the patient were to receive any new medications it would be appropriate to review these with the patient and answer any of their questions they have regarding their new medication regime and the side effects of the medication. Since the risk of developing colon cancer is increased in people with ulcerative colitis it is important for the nurse to recommend regular appointments for colon cancer screening. By the nurse taking the time to talk to the patient about all the details that different treatments entail it will foster independence in the individual and therefore they will be able to make informed decisions about the management of ulcerative colitis.

By learning about the experience that individuals with ulcerative colitis go through when making decisions about their treatment, nurses would be more sensitive to their needs and could advocate their needs to the other health care professionals working with these particular individuals. Individuals would be more satisfied with the care that they receive, which may make them more likely to seek help when it is needed. More effective care for these individuals may also result in them being more likely to try different effective forms of treatment because they will trust that the health care system will provide them with the needed support and resources throughout this process.

Brydolf, M. & Segesten, K. (1996). Living with ulcerative colitis: experiences of adolescents and young adults. Journal of Advanced Nursing, 23, (1), p.39.

Kennedy, A. P., Robinson, A. J., Thompson, D. G., & Wilkin, D. (1999). Development of a guidebook to promote patient participation in the management of ulcerative colitis. Health and Social Care in the Community, 7, (3), p. 177.

Lewis. S., Heitkemper, M., & Dirksen, S. (2000). Medical-Surgical Nursing: Assessment and Management of Clinical Problems, (5th ed.). St. Louis: Mosby.

Moayyedi, P. (2002). Helping patients to help themselves: the future for management of ulcerative colitis? Gut, 51, (3), p. 309.

Rayhorn, N. (1999). Understanding inflammatory bowel disease. Nursing 99, 29, (12), 57-61.