The irritable bowel syndrome care process from the patients’ and professionals’ views José Joaquín Mira 1,2,3 , Mercedes Guilabert 2 , Laura Sempere 4 , Isabel M. Almenta 4 , José María Palazón 4 , Emilio Ignacio García 5,6 and Enrique Rey 7,8 1 Department of Health of Alicante. Sant Joan, Alicante. Spain. 2 Department of Health Psychology. Universidad Miguel Hernández. Elche, Alicante. Spain. 3 REDISECC, Red de Servicios de Salud Orientados a Enfermedades Crónicas. 4 Department of Digestive Diseases. Hospital General Universitario de Alicante. Alicante, Spain. 5 Department of Nursing and Physiotherapy. Universidad de Cádiz. Cádiz, Spain. 6 SECA. Sociedad Española de Calidad Asistencial. 7 Department of Digestive Diseases. Hospital Clínico San Carlos. Madrid, Spain. 8 Department of Medicine. Universidad Complutense de Madrid. Madrid, Spain 1130-0108/2015/107/4/202-210 REVISTA ESPAÑOLA DE ENFERMEDADES DIGESTIVAS COPYRIGHT © 2015 ARÁN EDICIONES, S. L. REV ESP ENFERM DIG (Madrid Vol. 107, N.º 4, pp. 202-210, 2015 ORIGINAL PAPERS ABSTRACT Background and purpose of the study: This study assessed the experiences of irritable bowel syndrome patients with the healthcare system. Specifically, this study focused on the barriers that patients found. Methods: Three focus groups were conducted with the participation of 19 patients and 10 healthcare professionals. From this information a script of questions was designed and 33 structured interviews were conducted. Finally, a scale for evaluation of the perception of patients was designed for primary care (14 items) and gastroenterology (13 items). Internal consistency and construct validity were calculated. Results: The difficulties of accessibility, to clarify doubts, concerns regarding uncertainty, reduced information about prognosis and its social and labour effects were the most cited by patients. Low adherence and persistence in the treatment plan were the problems cited most often by professionals. The items of the scale for primary care were grouped into 4 factors (explained variance, 73%), while those for gastroenterology were grouped into 3 factors (explained variance, 67%). The internal consistency was 0.84 and 0.82, respectively. A total of 29 (88%) patients were satisfied with the care provided in gastroenterology, while 24 (73%) declared themselves satisfied with the primary care physician (Chi- square 2.4, p = 0.21). This study was carried out from November 2013 to July 2014. Conclusions: This study describes the most relevant problems in the assistance received by these patients. Key words: Irritable bowel syndrome. Care quality. Care path. Perception. INTRODUCTION Irritable bowel syndrome (IBS) is a highly prevalent disorder, affecting 3-10% of the Spanish population. Wom- en are more frequently affected than men (ratio 2-2.5/1) (1), and about 40% of all patients seek medical help at some point during the year (2). It has been estimated that IBS accounts for 2-15% of all consultations in primary care (PC) and up to 30% of all specialized consultations in gastroenterology (digestive diseases). Although a clinical guide on the management of IBS has been published (the AEG guide), the fact is that the diagnostic and therapeutic approaches to the disease vary among both gastroenterol- ogists and PC physicians (3). Irritable bowel syndrome has a strong impact upon patient quality of life. In effect, patients with IBS suffer disturbances in their social and professional life, and feel ashamed of their symptoms. They often change their eating habits and frequently resort to the healthcare services in a futile search for effective medical care (4,5). These are patients for which no concrete answer is available, and their medical care is conditioned by psychosocial factors, the attitudes of the professionals and patients themselves, the comorbidities and severity of the symptoms, and mis- taken concepts about the disease (6-8). The information received by the patients, the coordina- tion among different healthcare levels, and the diagnos- tic response capacity are key factors in the care process, since the physicians and patients tend to disagree on their perception of the influence of psychological variables in IBS (9). Patient scepticism characterizes the relationship with the medical professionals. Patients with IBS normal- ly are not satisfied with the treatment they are receiving and actively seek information on other possible alterna- tives. They perceive no clear benefit from the prescribed therapy and complain about significant shortcomings in the information they receive (10). Previous studies have evaluated patient perception referring to colonoscopy (11), Mira JJ, Guilabert M, Sempere L, Almenta IM, Palazón JM, García EI, Rey E. The irritable bowel syndrome care process from the patients’ and profes- sionals’ views. Rev Esp Enferm Dig 2015;107:202-210. Received: 12-10-2014 Accepted: 29-01-2015 Correspondence: Mercedes Guilabert. Department of Health Psychology. Universidad Miguel Hernández. Avenida de la Universidad, s/n. 03202 Elche, Alicante. Spain e-mail: mguilabert@umh.es Financial support: This study was funded by the pharmaceutical company Almirall, S.A. Acknowledgements: This study would not have been possible without the voluntary and altruistic contribution of its participants.