International Journal of Celiac Disease
ISSN (Print): 2334-3427 ISSN (Online): 2334-3486 Website: Editor-in-chief: Samasca Gabriel
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International Journal of Celiac Disease. 2019, 7(1), 1-8
DOI: 10.12691/ijcd-7-1-4
Open AccessArticle

Perception of Disease and Coping Attitudes in Patients with Celiac Disease

Elif Yorulmaz1, Pınar Neva Fındık2, Meltem Aksoy2, Rüya Akbayrak2, Gizem Genç2 and Hatice Yorulmaz2,

1Departments of Gastroenterology and Internal Medicine, Bağcılar Training and Research Hospital, Istanbul, Turkey

2Halic University School of Nursing, Istanbul, Turkey

Pub. Date: February 21, 2019

Cite this paper:
Elif Yorulmaz, Pınar Neva Fındık, Meltem Aksoy, Rüya Akbayrak, Gizem Genç and Hatice Yorulmaz. Perception of Disease and Coping Attitudes in Patients with Celiac Disease. International Journal of Celiac Disease. 2019; 7(1):1-8. doi: 10.12691/ijcd-7-1-4


The study was conducted to investigate the factors affecting the perception of disease and coping attitudes in patients with celiac disease. The study was conducted with 100 celiac patients in Istanbul. The data were collected by applying “Introductory Information Form”, “Illness Perception Questionnaire”, and “Coping Inventory”. In the statistical analysis, t-test, Tukey and Pearson Correlation Analysis were used. It was observed that 63% of the patients were female, 52% were single, 21% were overweight. It was determined that there was a significant difference in terms of gender, marital status and income level, diet list, difficulty in dietary compliance in coping inventory (p<0.05). It was observed that the patients were emotionally affected by their diseases and exhibited problem-focused coping behaviors from coping attitudes. It was determined that there was a negative correlation between the patients’ age and illness coherence and emotional representations and between diagnosis time and emotional representation, personal attribution, lifestyle and chance factor (p<0.01). It was determined that there was a negative correlation between the dieting duration and emotional representations, personal attribution, lifestyle and chance factor (p<0.01). It was seen that there was a positive correlation between the age and problem-focused coping method and a negative correlation between the age and the dysfunctional subscale (p<0.01). It was seen that there was a positive correlation between the timeline (acute/chronic) and emotional-focused coping subscales, between personal control and problem focused and emotional focused coping subscales and between the treatment control and emotional focused coping subscale (p<0.05). It was also observed that 88% of the patients experienced symptoms like constipation and diarrhea, perceived their diseases as chronic, and the disease affected their physical, social and psychological functions. It may be recommended to comprehensively examine especially the factors obstructing their dietary compliance and influencing perception of disease.

perception of disease coping attitudes celiac

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[1]  Cranney A, Zarkadas M, Graham ID, Switzer C. The Canadian celiac health survey – the Ottawa chapter pilot. BMC Gastroenterol 2003; 8 (3): 1469-1474.
[2]  Murray JA. The widening spectrum of celiac disease. Am J Clin Nutr 1999; 69: 354-365.
[3]  Dickson BC, Streutker CJ, Chetty R. Coeliac disease: an updateforpathologists. J ClinPathol 2006; 59: 1008-1016.
[4]  Chand N, Mihas AA. Celiac disease: current concepts in diagnosis and treatment. J Clin Gastroenterol 2006;40: 3- 14.
[5]  Fera T, Cascio B, Angelini G, Martini S, Guidetti CS. Affective disorders and quality of life in adult celiac disease patients on a gluten free diet. Eur J Gastroenterol Hepatol. 2003; 15:1287-1292.
[6]  Cronin CC, Shanahan F. Exploring the Iceberg-the spectrum of Celiac disease. Am J Gastroenterol 2003; 98 (3): 518-520.
[7]  Weinman J, Petrie KJ, Moss-Morris R, Horne R, The illness Perception Questionnaire: A new method for assessing the cognitive representation of illness. Psychology and Health 1996; 11: 431-445.
[8]  Armay Z, Özkan M, Kocaman N, Özkan S. The reliability and the validity study of Turkish adaptation of the revised Illness Perception Questionnaire. Anatolian Journal of Psychiatry 2007; 10: 192-200.
[9]  Carver CS, Scheier MF, Weintraub JK. Assessing coping strategies: A theoretically based approach. Journal of Personality and Social Psychology 1989; 56: 267-283.
[10]  Ağargün MY, Beşiroğlu L, Kıran ÜK, Özer ÖK, Kara H. COPE The psychometric properties of the COPE inventory in Turkish sample: a preliminary research Anatolian Journal of Psychiatry 2005; 6: 221-226.
[11]  Rubio-TapiaA, Kyle RA, Kaplan EL, et al. Increased prevalence and mortality in undiagnosed celiac disease. Gastroenterology 2009; 137: 88-93.
[12]  La Greca AM, Auslander WF, Greco P, Spetter D, Fisher EB Jr, Santiago JV. I get by with a little help from my family and friends: adolescents' support for diabetes care. J Pediatr Psychol. 1995; 20: 449-76.
[13]  Ptacek JT, Pierce GR, Ptacek JJ. Coping, distress, and marital adjustment in couples with cancer: an examination of the personal and social context. J Psychosoc Oncol 2007; 25(2): 37-58.
[14]  Paavola A, Kurppa K, Ukkola A, Collin P, Lahdeaho ML, Huhtala H, Maki M, Kaukinen K. Gastrointestinal symptoms and quality of life in screen-detected celiac disease. Dig Liver Dis 2012; 44: 814-8.
[15]  Wang JJ, Teseng HF, Chen KM. Development and testing of screening indicators for psychological abuse of older people, Archives of Psychiatric Nursing 2007; 21: 240-47.
[16]  Thompson T, Dennis M, Higgins LA, Lee AR, Sharrett MK. Gluten-free diet survey: are Americans with coeliac disease consuming recommended amounts of fibre, iron, calcium and grain foods? Journal of Human Nutrition and Dietetics 2005; 18 (3): 163-169.
[17]  Dall'Asta C, Scarlato AP, Galaverna G, Brighenti F,Pellegrini N. Dietary exposure to fumonisins and evaluation of nutrient intake in a group of adult celiac patients on a gluten-free diet. Molecular Nutrition & Food Research, 2001; 256 (4): 632-640.
[18]  Paganizza S, Zanotti R, DʼOdorico A, Scapolo P, Canova C. Is Adherence to a Gluten-Free Diet by Adult Patients With Celiac Disease Influenced by Their Knowledge of the Gluten Content of Foods? Gastroenterol Nurs. 2019; 42: 55-64.
[19]  Itzlinger A, Branchi F, Elli L, Schumann M. Gluten-Free Diet in Celiac Disease-Forever and for All? Nutrients. 2018; 10: 1796.
[20]  Pulido O, Zarkadas M, Dubois S, MacIsaac K, Cantin I, La Vieille S, Godefroy S, Rashid M. Cllinical features and symptom recovery on a gluten-free diet in Canadian adults with celiac disease. Can J Gastroenterol 2013; 27: 449-453.