HEALTH anxiety may play a significant role in shaping self-management behaviour among patients with inflammatory bowel disease (IBD), according to new research demonstrating that health anxiety partially mediates the relationship between illness perception and self-management outcomes.
Health Anxiety and Self-Management Behaviour
The study investigated whether health anxiety influences the association between illness perception and self-management behaviour in patients with IBD. Researchers enrolled 326 patients who received treatment between June 2023 and June 2025 and assessed participants using the Brief Illness Perception Questionnaire, the Short Health Anxiety Inventory, and the IBD Self-Management Behaviour Scale.
Findings revealed that participants generally reported negative perceptions of their illness, elevated levels of health anxiety, and suboptimal self-management behaviours. Mean scores were 47.31 (SD=12.71) for illness perception, 28.89 (SD=8.81) for health anxiety, and 67.79 (SD=20.48) for self-management behaviour.
Several demographic and clinical factors were associated with self-management performance. Lower self-management scores were observed among patients aged over 60 years and among those with a disease duration exceeding 5 years. In contrast, patients with a monthly income greater than 5,000 yuan demonstrated significantly higher self-management scores (all p<0.05).
Illness Perception Associated with Poorer Outcomes
Correlation analyses showed a strong relationship between illness perception, health anxiety, and self-management behaviour. Illness perception scores were negatively correlated with self-management behaviour (r=-0.660) and positively correlated with health anxiety scores (r=0.417). Health anxiety was also negatively correlated with self-management behaviour (r=-0.501).
These findings suggest that patients who perceive their condition more negatively are more likely to experience heightened health anxiety and poorer self-management behaviours. The data indicate that psychological responses to illness may influence how effectively individuals manage their condition over time.
Mediating Role of Health Anxiety
Mediation analysis further demonstrated that illness perception was associated with self-management behaviour through both direct and indirect pathways. The direct negative association between illness perception and self-management behaviour was substantial (coefficient: -1.180), accounting for 82.69% of the total effect. An additional indirect effect mediated through health anxiety was identified (coefficient: -0.246), representing 17.31% of the total effect.
Importantly, the 95% bias corrected bootstrap confidence interval for the indirect effect did not include zero, supporting the statistical significance of the mediation pathway.
Conclusion
The authors concluded that illness perception is associated with self-management behaviour both directly and indirectly through health anxiety. Although causal relationships cannot be established from these cross-sectional data, the findings highlight the potential value of incorporating psychological assessment and intervention into routine IBD care to support improved self-management and long-term health outcomes.
Reference
Wang R et al. Mediating effect of health anxiety in patients with inflammatory bowel disease between disease perception and self-management behavior. Sci Rep. 2026; DOI:10.1038/s41598-026-57778-7.
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