The impact of a PERMA model-based positive psychology intervention on fear of recurrence of inflammatory bowel disease: A randomized controlled trial

Yuanyuan Qian¹Linlin Ma²Jianru Hao^1,2Lu Zhang¹Ying Liu¹Yongping Xu²Lifen Dai²Yanfang Luo^1,2*Zhenzhen Su^1*

• ¹Affiliated Hospital of Jiangnan University, Wuxi, China
• ²Wuxi Medical College, Jiangnan University, Wuxi, Jiangsu Province, China

Objective: This study aimed to investigate the effects of a positive psychological intervention based on the PERMA model on fear of recurrence, subjective well-being, psychological resilience, and quality of life in patients with inflammatory bowel disease (IBD). Methods: This study was conducted as a single-blind, two-arm randomized controlled trial at Jiangnan University Affiliated Hospital from May to July 2024. A total of 93 hospitalized patients experiencing fear of recurrence related to IBD were randomly assigned to either the intervention group (n = 47) or the control group (n = 46). Patients in the intervention group received positive psychological intervention based on PERMA model, while patients in the control group received standard nursing. The levels of fear of recurrence, subjective well-being, resilience, and quality of life were assessed at baseline (T0), day of discharge (T1), two weeks post-discharge (T2), four weeks post-discharge (T3), and eight weeks post-discharge (T4). Data were analyzed using independent sample t-tests, chi-square tests, and generalized estimating equations (GEE). Results: Resilience and quality of life scores at T2 were significantly higher in the intervention group than in the control group. As the duration of the intervention increased, there was a significant decrease in the level of fear of recurrence (T3: U = -1.978, p = 0.048; T4: U = -2.116, p = 0.034), alongside improvements in subjective well-being (T3: t = 2.731, p = 0.008; T4: t = 3.490, p < 0.001), psychological resilience (T3: t = 4.824, p < 0.001; T4: t = 5.699, p < 0.001), and quality of life (T3: U = -2.576, p = 0.010; T4: U = -2.746, p = 0.006), all of which were statistically significant. Furthermore, a significant group-related shift was noted in psychological resilience (χ² = 14.353, p < 0.001). Notably, the effects of time and interaction on fear of recurrence, subjective well-being, psychological resilience, and quality of life were statistically significant (all p < 0.05). Conclusions: Positive psychological interventions based on the PERMA model significantly reduced fear of recurrence in IBD patients, and positively affected their subjective well-being, psychological resilience, and quality of life. Clinical trial registration: https://www.chictr.org.cn/showproj.html?proj=230313.