The Silent Face of Inflammatory Bowel Diseases: A Mixed Method Study on Knowledge and Attitudes of Young Adults

The Silent Face of Inflammatory Bowel Diseases: A Mixed Method Study on Knowledge and Attitudes of Young Adults | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article The Silent Face of Inflammatory Bowel Diseases: A Mixed Method Study on Knowledge and Attitudes of Young Adults Amine Terzi, Yağmur Artan, Yasemin Yıldırım This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8918052/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 11 You are reading this latest preprint version Abstract Background: Inflammatory bowel disease is a chronic condition with increasing prevalence worldwide, particularly among young adults, profoundly affecting individuals' social lives, psychological well-being, and labor force participation. Lack of knowledge about these diseases in society leads to stigmatization of patients and disruptions in treatment processes. The attitudes of university students, who are the professionals of the future, are critical for building a more inclusive society. Objective: The aim of this study is to assess university students' knowledge, attitudes, and perceptions regarding inflammatory bowel diseases and to evaluate their level of awareness on this subject from the perspective of different academic disciplines. Methods: The study adopted a mixed-methods research design using both quantitative and qualitative data. The study sample comprised 461 students. Semi-structured interviews were conducted with 25 students. Research data were collected between June 1, 2025, and August 1, 2025. Data were collected using the Participant Information Form and the Semi-structured Interview Form. Quantitative data were evaluated using frequency, percentage distribution, arithmetic mean, and standard deviation values, as well as binary and multiple group comparisons. Qualitative data were evaluated using the inductive approach method. Results: Participants' knowledge about the etiology of IBD showed significant differences depending on their field of study. Nursing students more frequently identified immune system disorders and genetics as the main causes (p < .001), while students from non-health fields showed a higher level of uncertainty. A similar trend was observed in the identification of symptoms; fatigue, abdominal pain, and bloody stools were more accurately recognized by students in the health field (p < .001). Nursing students were found to be more willing to participate in IBD awareness campaigns than students from other departments (p < .001). A significant social distance was revealed, with 29.8% of students from non-health-related departments stating that they felt uncomfortable sharing a classroom with someone diagnosed with IBD. When participants' individual interpretations of IBD were evaluated, the themes of “Emotional and Psychological Burden,” “Social and Life Restrictions,” and “Coping and Acceptance” came to the fore. Conclusion: The study shows that attitudes toward IBH vary significantly depending on the discipline in which education is received. While nursing students' high level of advocacy reflects the positive impact of professional education, the finding of social distance in non-health fields highlights the need for community-based education. Awareness programs and digital educational tools to be included in university curricula are thought to both fill clinical knowledge gaps and reduce the social stigma experienced by patients. Clinical trial number: Not applicable. inflammatory bowel disease attitude information Figures Figure 1 Introduction Inflammatory Bowel Diseases (IBD), comprising Crohn's Disease and Ulcerative Colitis, are chronic gastrointestinal diseases with rapidly increasing global prevalence that threaten public health. These diseases severely undermine an individual's quality of life with their characteristic cycles of remission and flare-ups (Agrawal & Jess, 2022; Borowitz, 2023). The fact that inflammatory bowel diseases are often diagnosed during young adulthood, when education, career, and social identity formation are at their peak, further complicates the management process (Alexakis et al., 2015; Ruan et al., 2020). Indeed, IBD is not only a physical ailment but can also be a debilitating process that directly disrupts a person's daily routines and social functioning (Bernstein et al., 2020; Su et al., 2022). Inflammatory bowel diseases can be described as a “silent” disease due to the unpredictability of their symptoms and the fact that they cannot be detected from the outside. However, this silence is not only a clinical condition but also involves the suppression of patients' experiences, such as fear of defecation and incontinence, due to social taboos (Zhou et al., 2024; Lenti et al., 2020). Patients' avoidance of sharing certain symptoms and the difficulties they experience in social relationships can also fuel social stigma (Lenti et al., 2020; Rohde et al., 2018). A systematic review found that perceived stigma among individuals with IBD had a prevalence rate of 85.6% in adults and 87% in children (Giri et al., 2025). Social stigma not only worsens patients' psychological health but also limits their treatment compliance processes and their fundamental rights in public spaces. Consequently, individuals with the disease may experience social isolation due to the fear of their illness being discovered and the emergence of disease-related symptoms in society (Rohde et al., 2018; Muse et al., 2021). Therefore, the level of knowledge about IBD among the general public and, in particular, among university students who form the peer group, is of critical importance for the social integration of patients (Polak et al., 2020; Rohde et al., 2018). There may be a lack of knowledge on many topics related to inflammatory bowel diseases, and this situation may cause differences in attitudes towards the disease (Tan et al., 2012; Groshek et al., 2017; Ribaudi et al., 2025). In this context, although there are studies in the literature examining the perception and knowledge level of IBD (Tan et al., 2012; Groshek et al., 2017; Rohde et al., 2018), it can be said that there is a limited number of studies that address the underlying reasons for young adults' attitudes and the social origins of this silence from a holistic perspective. While quantitative methods are successful in reporting general trends, qualitative approaches are essential for understanding the deep traces of silence and stigma in individual lives (Zhou et al., 2024; Muse et al., 2021). Our study adopts a mixed-method approach to comprehensively examine young adults' knowledge levels and attitudes toward IBD. Thus, the aim is to reveal the silent face of the disease in society through both statistical generalizations and in-depth individual narratives. Methods Study design This study is a mixed-methods research conducted to assess the knowledge levels, attitudes, and perceptions of university students within the young adult population regarding IBD. Population and Sample The study population consisted of university students aged 18–30 studying in different faculties in a university where Black Sea Region, Türkiye. Participants were included in the study on a voluntary basis. No requirement to be studying in a health-related field was imposed for participation; thus, IBD awareness among students from different disciplines was evaluated comparatively. Purposive sampling was used to select the sample, and 461 participants were included in the study. Semi-structured interviews were conducted with 25 students. Research data were collected between June 1 and August 1, 2025. Tools Research data were collected by reviewing the relevant literature (Tan et al., 2012; Rohde et al., 2018; Zhou et al., 2024; Muse et al., 2021; Polak et al., 2020; Yoon et al., 2019) and collected through the “Participant Information Form” and the “Semi-Structured Interview Form,” which enabled in-depth data collection. Participant Information Form: This measurement tool essentially consists of two main sections. The first section identified participants' socio-demographic variables such as age, gender, faculty of study, and health education status. The second section includes multiple-choice questions designed in line with the literature to objectively measure young adults' knowledge, awareness, and attitudes toward IBD (Suppl. File 1). The draft form was revised based on the results of a pilot study conducted with ten participants to test its content validity and comprehensibility, resulting in the final form. Semi-Structured Interview Form: Participants were given approximately 15 minutes of information about inflammatory bowel diseases in order to collect qualitative data for the study. Following the briefing, participants were asked the question, “How would you describe having inflammatory bowel disease from your own perspective?” to reveal their individual interpretations of having the disease. During the form's development process, content validity was ensured by consulting three different experts on the suitability of the questions for qualitative research techniques and the scope of the content. The form, shaped according to feedback from the expert panel, was included in the study protocol after its effectiveness was confirmed through pilot interviews with three participants. Data analysis Advanced analytical techniques were utilized in the analysis of the quantitative and qualitative data obtained within the scope of the research. The statistical analysis of quantitative data was performed using SPSS (Statistical Package for the Social Sciences) v. 26.0 software. Descriptive statistics, including frequency, percentage distribution, minimum-maximum values, median, arithmetic mean, and standard deviation, were used to summarize the participants' descriptive characteristics and their level of knowledge about IBD. To examine the differences and relationships between variables, binary and multiple group comparisons were made according to the distribution characteristics of the data; a p < 0.05 value was taken as the criterion for statistical significance in the analyses. The data obtained from the qualitative phase of the study were subjected to content analysis using an inductive approach. In this process, the participants' responses to open-ended questions were examined line by line to identify units of meaning, and then these units were conceptualized to create codes with common characteristics. In the final stage, related codes were brought together to construct main themes representing the phenomenological framework of the study. The mixed-methods analysis was completed by synthesizing the generalizability of the quantitative findings with the in-depth insights provided by the qualitative data. Results The study included 461 students with a mean age of 21.87 years (SD = 4.32), the majority being female (62.9%). Among them, 40.3% were nursing students, 17.4% studied other health-related disciplines, and 42.3% were from non-health fields. Notably, only 24.1% had received any prior education or training on IBD, and a mere 11.3% reported knowing someone diagnosed with the condition (Table 1). Table 1 . Demographic characteristics of participants (n=461) Variables n(%) Sex Female Male 290 (62.9) 171 (37.1) Disciplines Nursing Other health fields Non-health fields 186 (40.3) 80 (17.4) 195 (42.3) Class 1 2 3 4 105 (22.8) 199 (43.2) 96 (20.8) 61 (13.2) Have you ever received any training on IBD, or attended any seminars, congresses, or talks related to it? Yes No 111 (24.1) 350 (75.9) Has anyone in your family or close circle been diagnosed with IBD? Yes No 52 (11.3) 409 (88.7) Age (years)(mean + SD)= 21.87 + 4.32 When asked about diseases classified under IBD, a higher proportion of nursing students accurately identified Crohn’s disease and ulcerative colitis compared to those from non-health fields (p < .001). However, misconceptions—such as confusing IBD with irritable bowel disease or colon cancer—were also significantly more prevalent among non-health students (p < .001) (Table 2). Participants’ knowledge about the etiology of IBD varied markedly by field of study. While nursing students more frequently identified immune system disorders and genetics as main causes (p < .001), students from non-health fields exhibited higher levels of uncertainty. A similar trend was observed in identifying symptoms, with fatigue, abdominal pain, and bloody stool more accurately recognized by health field students (p < .001) (Table 2). Awareness of diagnostic and treatment methods also differed significantly. Nursing students were more likely to correctly cite colonoscopy, imaging techniques, and pharmacological treatment as key elements in IBD management (p < .001). Interestingly, misconceptions about curability and the rarity of IBD were more common in non-health disciplines (p < .001) (Table 2). Table 2 . IBD related knowledge of participants (n=461) Questions Total (n=461) n (%) Nursing (n=186) Other health fields (n=80) Non-health fields (n=195) p Which of the following disease(s) is/are included under IBD? Crohn disease Ulcerative colitis Constipation Irritable Bowel Disease Colon cancer I have no idea 239 (51.8) 295 (64.0) 134 (29.1) 193 (41.9) 135 (29.3) 91 (19.7) 151 (63.1) 167 (56.6) 54 (40.3) 109 (56.5) 63 (46.6) 9 (9.9) 32 (13.4) 39 (13.2) 30 (22.4) 30 (15.5) 33 (24.5) 19 (20.9) 56 (23.5) 89 (30.2) 50 (37.3) 54 (28.0) 39 (28.9) 63 (69.2) <.001 .05 <.001 <.001 <.001 What is the main cause of IBD? Genetic Environmental factors Immune system disorders I have no idea 142 (30.8) 62 (13.4) 190 (41.2) 67 (14.5) 93 (65.5) 27 (43.5) 60 (31.5) 6 (9.0) 13 (14.0) 13 (21.0) 37 (19.5) 17 (25.3) 36 (20.5) 22 (35.5) 93 (49.0) 44 (65.7) <.001 What is/are the most common symptom(s) of IBD? Abdominal pain Diarrhea Weight loss Fatigue Urgency to defecate Bloody stool I have no idea 267 (57.9) 268 (58.1) 185 (40.1) 143 (31.0) 181 (39.3) 257 (55.7) 84 (18.2) 142 (53.2) 141 (52.6) 98 (53.0) 74 (51.7) 101 (55.8) 123 (47.9) 10 (11.9) 40 (15.0) 37 (13.8) 31 (16.8) 24 (16.8) 24 (13.3) 42 (16.3) 24 (28.6) 85 (31.8) 90 (33.6) 56 (30.2) 45 (31.5) 56 (30.9) 92 (35.8) 50 (59.5) <.001 <.001 <.001 <.005 <.001 <.001 <.001 Does IBD affect any organs in the body other than the intestines? Yes No I have no idea 293 (63.6) 40 (8.7) 128 (27.8) 149 (50.8) 11 (27.5) 26 (20.3) 51 (17.4) 12 (30.0) 17 (13.3) 93(31.8) 17 (42.5) 85 (66.4) <.001 Can stress trigger IBD flare-ups? Yes No I have no idea 354 (76.8) 27 (5.9) 80 (17.4) 171 (48.3) 7 (25.9) 8 (10.0) 56 (15.8) 6 (22.2) 18 (22.5) 127 (35.9) 14 (51.9) 54 (67.5) <.001 Do you know how IBD is diagnosed? Blood tests Endoscopy/colonoscopy Imaging techniques (MRI, CT) Ultrasonography I have no idea 173 (37.5) 299 (64.9) 120 (26) 74 (16.1) 108 (23.4) 99 (57.2) 162 (54.2) 78 (65.0) 31 (41.9) 7 (6.50) 26 (15.0) 48 (16.0) 18 (15.0) 15 (20.3) 24 (22.2) 48 (27.8) 89 (27.8) 24 (20.0) 28 (37.8) 77 (71.3) <.001 <.001 .05 <.001 Do you know the treatment methods used for IBD? Pharmacological treatment Dietary modification Surgical treatment Complementary and alternative medicine I have no idea 293 (63.6) 217 (47.1) 177 (38.4) 102 (22.1) 98 (21.3) 159 (54.2) 131 (60.4) 93 (52.5) 56 (54.9) 10 (10.2) 49 (16.8) 32 (14.8) 31 (17.5) 16 (15.7) 18 (18.4) 85 (29.0) 54 (24.8) 53 (30.0) 30 (29.4) 70 (71.4) <.001 <.001 <.001 <.005 <.001 Do you think IBD is a disease that can be completely cured? Yes No I have no idea 160 (34.7) 164 (35.6) 137 (29.7) 80 (50.0) 82 (50.0) 24 21 (13.1) 29 (17.7) 30 59 (36.9) 53 (32.3) 83 <.001 Do you have any knowledge about the prevalence of IBD in the general population? Frequently Occasionaly Rarely I have no idea 23 (5.0) 228 (49.5) 95 (20.6) 115 (24.9) 13 (56.5) 113 (49.6) 39 (41.0) 21 (18.3) 2 (8.7) 44 (19.3) 12 (12.6) 22 (19.1) 8 (34.8) 71 (31.1) 44 (46.4) 72 (62.6) <.001 Regarding social and psychological aspects, 54.4% believed they were informed about the daily challenges faced by individuals with IBD. However, detailed understanding of specific difficulties—such as professional hindrances, psychological impacts, and social isolation—was again more pronounced among those in health-related fields (p < .001) (Table 3). Participants also demonstrated varying perceptions about dietary implications. While a majority correctly identified spicy, fried, and processed foods as inappropriate for IBD patients, responses on items like gluten, citrus fruits, and dairy revealed knowledge gaps, particularly among non-health students (p < .001) (Table3 ). Table 3 . Participants’ Knowledge Regarding the Challenges Faced by Individuals with IBD and Their Dietary Considerations Questions Total (n=461) n (%) Nursing (n=186) Other health fields (n=80) Non-health fields (n=195) p To what extent are you informed about the major difficulties encountered by individuals living with IBD in their everyday lives? Yes No 251 (54.4) 210 (45.6) 155 (61.8) 31 (14.8) 33 (13.1) 47 (22.4) 63 (25.1) 132 (62.8) <.001 What are the potential difficulties individuals with IBD may encounter in their daily lives? Persistent urge to defecate Abdominal pain and discomfort Fatigue and weakness Dietary restrictions Stress and anxiety Sleep disturbances Social isolation Challenges in professional and academic life Economic challenges Psychological impacts (depression, reduced self-esteem, etc.) Struggles within intimate or social relationships Healthcare appointments and clinical procedures 374 (81.1) 369 (80.0) 266 (57.7) 211 (45.8) 293 (63.6) 219 (47.5) 199 (43.2) 195 (42.3) 94 (20.4) 232 (50.3) 153 (33.2) 149 (32.3) 175 (46.8) 158 (42.9) 127 (47.8) 105 (49.8) 144 (49.1) 110 (50.2) 123 (61.8) 103 (52.8) 53 (56.4) 109 (47.0) 83 (54.2) 61 (41.0) 54 (14.4) 60 (16.3) 46 (17.3) 38 (18.0) 40 (13.7) 35 (16.0) 28 (14.0) 32 (16.4) 8 (8.5) 35 (15.1) 20 (13.1) 23 (15.4) 145 (38.8) 151 (41.0) 93 (34.9) 68 (32.2) 109 (37.2) 74 (33.8) 48 (24.2) 60 (30.8) 33 (35.1) 88 (37.9) 50 (32.7) 65 (43.6) .05 <.001 <.001 <.001 <.001 <.001 <.001 <.005 <.05 .05 Do you have any knowledge about the dietary habits of individuals with IBD? Yes No 195 (42.3) 266 (57.7) 122 (62.6) 64 (24.1) 28 (14.4) 52 (19.5) 45 (23.1) 150 (56.4) <.001 Which of the following foods do you consider potentially inappropriate or contraindicated for individuals living with inflammatory bowel disease (IBD)? Spicy foods Fried foods Processed foods Dairy products High-fiber foods Alcohol Carbonated beverages Processed meat products Caffeinated beverages Citrus fruits (e.g., oranges, lemons, grapefruits) Chocolate and sweets Foods containing gluten 390 (84.6) 366 (79.4) 312 (67.7) 146 (31.7) 140 (30.4) 328 (71.1) 308 (66.8) 256 (55.5) 235 (51.0) 230 (49.9) 176 (38.2) 166 (36.0) 174 (44.6) 171 (46.7) 147 (47.1) 69 (47.3) 59 (42.1) 155 (47.3) 142 (46.1) 125 (48.8) 112 (47.7) 113 (49.1) 103 (58.5) 77 (46.4) 60 (15.4) 60 (16.4) 53 (17.0) 19 (13.0) 34 (24.3) 51 (15.5) 54 (17.5) 43 (16.8) 38 (16.2) 37 (16.1) 22 (12.5) 23 (13.9) 156 (40.0) 135 (36.9) 112 (35.9) 58 (39.7) 47 (33.6) 122 (37.2) 112 (36.4) 88 (34.4) 85 (36.1) 80 (34.8) 51 (29.0) 66 (39.7) <.001 <.001 .05 <.05 <.001 <.001 <.001 <.005 <.001 .05 Analysis of students’ attitudes toward IBD awareness revealed a moderate yet significant willingness to engage in advocacy efforts. While 44.0% expressed readiness to participate in awareness campaigns, this willingness was highest among nursing students (52.2%) and lowest among those in non-health fields (33.5%) (p < .001) (Table 4). A substantial majority (82.0%) agreed that universities should enhance initiatives to raise awareness of chronic illnesses; however, this attitude did not significantly differ between academic disciplines (p > .05). Interestingly, although most participants (81.3%) reported they would feel comfortable sharing a classroom with someone diagnosed with IBD, discomfort was still evident in a minority—especially among non-health students (29.8%)- a statistically significant difference (p < .005) (Table 4). Support for promoting the educational and social participation of individuals with chronic illnesses was notably high (88.7%), and over 70% indicated an interest in expanding their knowledge about IBD. Despite this interest, the preferred methods for accessing information—online courses, seminars, or written sources—did not significantly vary between groups (p > .05) (Table 4). Table 4 . Participants’ Attitudes Toward Awareness of IBD Questions Total (n=461) n (%) Nursing (n=186) Other health fields (n=80) Non-health fields (n=195) p Would you consider participating in a campaign aimed at raising awareness about IBD? Yes No Undecided 203 (44.0) 91 (19.7) 167 (36.2) 106 (52.2) 24 (26.4) 56 (33.5) 29 (14.3) 27 (29.7) 24 (14.4) 68 (33.5) 40 (43.9) 87 (52.1) <.001 Do you believe that universities should enhance initiatives aimed at raising awareness of the challenges faced by individuals living with chronic illnesses? Yes No Undecided 378 (82.0) 45 (9.8) 38 (8.2) 157 (41.5) 18 (40.0) 11 (28.9) 62 (16.4) 12 (26.7) 6 (15.8) 159 (42.1) 15 (33.3) 21 (55.3) >.05 Would you feel uncomfortable sharing a classroom with an individual diagnosed with IBD? Yes No Undecided 47 (10.2) 375 (81.3) 39 (8.5) 25 (53.2) 155 (41.3) 6 (15.4) 8 (17.0) 60 (16.0) 12 (30.8) 14 (29.8) 160 (42.7) 21 (53.8) <.005 Do you support the promotion of educational and social participation of individuals living with chronic illnesses? Yes No Undecided 409 (88.7) 24 (5.2) 28 (6.1) 173 (42.3) 9 (37.5) 4 (14.3) 67 (16.4) 5 (20.8) 8 (28.6) 169 (41.3) 10 (41.7) 16 (57.1) >.05 Are you interested in enhancing your knowledge about IBD? Yes No Undecided 328 (71.1) 70 (15.2) 63 (13.7) 144 (43.9) 31 (44.3) 11 (17.5) 48 (14.6) 15 (21.4) 17 (27.0) 136 (41.5) 24 (34.3) 35 (55.5) <.001 What methods would you utilize to obtain information about IBD? Online courses Seminars and conferences Written sources (books, articles, etc) 121(26.2) 341 (74.0) 154 (33.4) 58 (47.9) 148 (43.4) 68 (44.2) 14 (11.6) 56 (16.4) 23 (14.9) 49 (40.5) 137 (40.2) 63 (40.9) >.05 >.05 >.05 When the qualitative data of the study were analyzed, three main themes and eight sub-themes emerged (Table 5). Table 5. Data on Themes, Subthemes, and Participants Main Theme Sub-Theme Relevant Participant No. (Gender, age) n(%) Sample Participant Statements Emotional and Psychological Burden Constant Anxiety and Uncertainty 1 (M, 21) 6 (F 19) 23 (F, 20) 3 (%12) “Not knowing when the disease would flare up constantly worried me...” (K1), “The uncertainty about the future made me think...” (K6) Psychological Burnout and Difficulty 10 (M, 20) 15 (F, 20) 21(F, 19) 3 (%12) “During flare-ups, I felt physically and psychologically exhausted.” (K10), “Sometimes I would ask myself, ‘Why me?’” (K21) Loneliness and Misunderstanding 3 (F, 22) 12 (M, 22) 18 (M, 20) 20 (M, 19) 4 (%16) “I was afraid that people would think I was ‘exaggerating’...” (K12), “I sometimes felt lonely because people find it difficult to understand invisible illnesses.” (K3) Social and Life Restrictions Social Withdrawal and Barriers 2 (M, 21) 11 (F, 21) 17 (M, 20) 19 (F, 20) 4 (%16) “The thought of suddenly needing to use the bathroom at school or in crowded places would make me anxious.” (K2), “I would avoid social situations...” (K11) Physical and Academic Limitations 7 (F, 21) 13 (F, 22) 2 (%8) “I would feel sad that the constant feeling of fatigue might hold me back academically.” (K7), “I would feel stressed that it might affect my performance because there might be days when I couldn't attend classes.” (K13) Lifestyle Change 5 (M, 23) 16 (M, 22) 24 (F, 21) 3 (%12) “I felt I would struggle in social settings due to dietary restrictions.” (K5), “I would have to live my life in a more planned and organized way.” (K24) Coping and Acceptance Positive Adjustment and Empowerment 4 (F, 22) 9 (M, 20) 22 (M, 21) 25 (F, 23) 4 (%16) “Living under constant control would be exhausting, but I think I could adapt over time.” (K4), “Even if I faced difficulties, I believed I could learn to live with them.” (K25) Search for Support 8 (F, 20) 14 (M, 21) 2 (%8) “I would need emotional support from my family and friends.” (K8), “I would try to trust the healthcare team during the treatment process.” (K14) When the participants' responses to the semi-structured interview form were examined, the most frequently occurring words in the participants' statements were anxiety, isolation, fear, fatigue, adaptation, and acceptance (Figure 1). Discussion Our findings reveal that nursing students have a significantly higher level of knowledge regarding the definition, etiology, and symptom management of IBD compared to their peers studying in non-healthcare fields. Indeed, the study by Groshek et al. (2017) similarly shows that the public's level of knowledge about IBD is low and that the disease is often confused with other gastrointestinal problems (Groshek et al., 2017). The fact that nursing students successfully identified symptoms such as fatigue, abdominal pain, and bloody stools is a critical finding. Fatigue is a symptom that most significantly reduces the quality of life of IBD patients but is often neglected in clinical interviews (Czuber-Dochan et al., 2014). The low awareness of these specific symptoms among non-health students may be one of the factors contributing to the disease remaining “invisible” or “silent” in society. This silence increases the risk of stigmatization for patients as a result of symptoms being associated with social taboos (Taft et al., 2017; Rohde et al., 2018). Interestingly, our study revealed misconceptions in non-healthcare disciplines that IBD has a curative treatment or that the disease is very rare. IBD is a chronic condition requiring lifelong management, and even primary care physicians may sometimes struggle with the complexity of this chronic management (Alharbi et al., 2019). Although data from our study showed that more than half of the participants believed they were knowledgeable about the difficulties IBD patients face in daily life, in-depth analyses revealed that this self-perception did not always correspond to their actual level of knowledge. In particular, the significantly higher awareness among health sciences students in specific areas such as occupational barriers, psychological effects, and social isolation confirms the impact of clinical education in understanding the unseen aspects of this chronic condition. In the literature, IBD is defined as a process that threatens not only patients' physical health but also their social identity and professional development (Lesnovska et al., 2014). In this context, the fact that students in non-health fields have less understanding of this deep psychosocial burden can be considered a reflection of the perception of “invisible disability” in society (Taft et al., 2017). Another noteworthy finding of our study is the heterogeneous level of knowledge among participants regarding nutrition. While the vast majority of participants correctly identified that spicy, fried, and processed foods are unsuitable for IBD patients, confusion about specific foods such as gluten, citrus, and dairy products was particularly pronounced in the non-health group. Similarly, a recent review by Ribaudi et al. (2025) reports that there is a lack of evidence-based information and significant gaps in the general public's knowledge about the IBD diet (Ribaudi et al., 2025). This uncertainty about nutrition is a significant factor contributing to patients' fear of eating in social settings and, consequently, leading to social isolation (Shao et al., 2023). In the context of psychosocial effects, health sciences students' better understanding of social isolation and psychological effects demonstrates that this group is more sensitive to the risk of stigma experienced by patients. IBD patients are frequently exposed to social stereotypes due to the nature of their symptoms, and this situation seriously undermines their quality of life (Groshek et al., 2017). As emphasized by Lenti et al. (2020), the perception of stigma in society reduces patients' psychological resilience and alienates them from society (Lenti et al., 2020). Although the majority of students in the study stated that they felt comfortable sharing a classroom with an individual diagnosed with IBD, the discomfort felt by some students in non-health-related departments indicates that misconceptions about the disease create social distance. Rohde et al. (2018) found that university students' lack of knowledge about IBD not being contagious or controllable, combined with misconceptions, can fuel social distancing (Rohde et al. 2018). This is consistent with our findings. More than half of the participants want to learn more about IBD. The high desire for information is particularly important because it will increase individuals' knowledge about the disease, thereby increasing awareness and reducing social stigma. Polak et al. (2020) found that in both patient and community samples, the level of knowledge and awareness was inversely proportional to stigmatization (Polak et al., 2020). Our study reveals that participants' individual interpretations of IBD show that the disease is perceived not only as a physical condition but also as a deep psychological burden, even by individuals who do not have the disease. At this point, it can be said that the theme of “emotional and psychological burden” is directly related to the unpredictability of the disease's flare-up periods. The literature indicates that IBD has a significant impact on physical and emotional well-being and creates serious difficulties in managing daily activities (Lesnovska et al., 2014; Zhou et al., 2024; Cho et al., 2018). The loneliness and feeling of misunderstanding that come with living with an invisible disease also carry the risk of stigmatization due to a lack of knowledge in society (Vernon Roberts et al., 2020; Muse et al., 2021). A study found that individuals with IBD reported feeling misunderstood by those around them, and that their illness was belittled or misinterpreted (Muse et al., 2021). Data collected under the theme of social and life restrictions show that when participants describe their experience of having IBS from their own perspective, they associate it with serious concerns such as suddenly needing to use the toilet and withdrawing from social settings. The literature also shows that this condition is a significant barrier that can lead to individuals becoming isolated from social life and negatively affecting their academic performance (Demirtaş, 2022; Ruan et al., 2020). Dietary restrictions and lifestyle changes related to the disease can trigger psychological exhaustion by making social interactions difficult for individuals (Lesnovska et al., 2014; Richard et al., 2020). In the coping and acceptance process, participants demonstrated a positive tendency to adapt to living under control and learn to live with difficulties. It is known that having accurate information about the disease is effective in developing positive attitudes; therefore, it increases proactive application skills and facilitates the adaptation process (Shao et al., 2023; Moradkhani, 2011; Li et al., 2025). In our study, participants also mentioned seeking support in managing the disease. The literature also indicates that social support from family and friends plays a critical role in alleviating negative emotions such as isolation and fear experienced by individuals and in improving patients' well-being and quality of life (Slonim Nevo et al., 2018; Kamp et al., 2019; Richard et al., 2020; Oliveira et al., 2007). Participants' frequently repeated expressions of anxiety, isolation, and fatigue suggest that healthy individuals perceive IBD not merely as a digestive system problem, but as a comprehensive struggle that permeates every aspect of life. In conclusion, the fact that the individuals in our study, despite not having IBD, showed results similar to those of qualitative research conducted with IBD patients is a fundamental indicator that empathy can be established through education, and therefore, the social stigma associated with IBD can be reduced. Conclusion This study, which examines young adults' knowledge, attitudes, and awareness regarding IBD, reveals the dynamics of approaches to this chronic condition among future decision-makers and healthcare professionals in society. Although the findings show that the majority of participants support IBD awareness initiatives and are open to learning more about the condition, the tendency toward social distancing and low advocacy among students in non-health fields suggests that lack of knowledge may contribute to stigma. In this context, increasing IBD awareness should be addressed as a shared responsibility of all academic disciplines, not just those in the health field. It should not be forgotten that the barriers to the social integration of individuals living with IBD can only be overcome with approaches based on accurate information and empathy. Therefore, it is believed that the implementation of systematic educational interventions across the university will break down misconceptions about the disease and create a more inclusive campus and community structure. Consequently, in order to increase the level of knowledge and positive attitudes towards IBD, the social dimensions of chronic diseases and methods of combating stigma should be conveyed to all disciplines through elective courses or awareness modules across the university. increasing activities organized by student communities at universities, disseminating accurate information through digital platforms, and developing awareness projects in public spaces through collaboration between local governments and universities. Declarations Ethics approval and consent to participate This research was conducted in accordance with the principles of the Helsinki Declaration, and official approval (Date/Number: 05/20/2026/178533) was obtained from the Scientific Research and Publication Ethics Committee of Artvin Çoruh University before proceeding to the implementation phase of the study. Prior to the data collection process, potential participants were informed in detail about the purpose and scope of the research and the confidentiality of the data. Conducted on a voluntary basis, the study obtained “Informed Oral Consent” from each participant and committed to keeping personal data anonymous. Emphasis was placed on the participants' right to withdraw from the study at any stage during the study period, and utmost sensitivity was shown in terms of protecting ethical principles. Consent for publication Not applicable. Availability of data and materials All data generated or analysed during this study are included in this published article. Competing interests The authors declare that they have no competing interests Funding This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. Authors' contributions A.T. conceptualized the study, collected the data and wrote the main manuscript text, Y.A. conceptualized the study, performed statistical analyses and Y.Y., provided mentorship, reviewed the article. All authors reviewed the manuscript. All authors reviewed, edited, and approved of the final manuscript and agreed to be accountable for its accuracy and integrity. Acknowledgements We would like to thank all participants in the study. References Agrawal, M., & Jess, T. (2022). Implications of the changing epidemiology of inflammatory bowel disease in a changing world. United European gastroenterology journal , 10 (10), 1113-1120. https://doi.org/10.1002/ueg2.12317. Alexakis, C., Nash, A., Lloyd, M., Brooks, F., Lindsay, J. O., & Poullis, A. (2015). Inflammatory bowel disease in young patients: challenges faced by black and minority ethnic communities in the UK. Health & social care in the community, 23(6), 665-672. https://doi.org/10.1111/hsc.12188. Alharbi, R., Almahmudi, F., Makhdoom, Y., Mosli, M. (2019). Knowledge and attitudes of primary healthcare physicians toward the diagnosis and management of inflammatory bowel disease following an educational intervention: A comparative analysis. Saudi J Gastroenterol, 25:277-85. https://doi.org/10.4103/sjg.SJG_169_19. Bernstein, C. N., Walld, R., & Marrie, R. A. (2020). Social determinants of outcomes in inflammatory bowel disease. Official journal of the American College of Gastroenterology|, 115 (12), 2036-2046. https://doi.org/10.14309/ajg.0000000000000794. Borowitz, S. M. (2023). The epidemiology of inflammatory bowel disease: Clues to pathogenesis?. Frontiers in pediatrics , 10 , (1103713), 1-5. https://doi.org/10.3389/fped.2022.1103713. Cho, R., Wickert, N. M., Klassen, A. F., Tsangaris, E., Marshall, J. K., & Brill, H. (2018). Identifying needs in young adults with inflammatory bowel disease: a qualitative study. Gastroenterology Nursing , 41 (1), 19-28. https://doi.org/10.1097/SGA.0000000000000288. Czuber-Dochan, W., Norton, C., Bredin, F., Darvell, M., Nathan, I., & Terry, H. (2014). Healthcare professionals' perceptions of fatigue experienced by people with IBD. Journal of Crohn's and Colitis , 8 (8), 835-844. https://doi.org/10.1016/j.crohns.2014.01.004. Demirtaş, A. (2022). The lived experiences of people with inflammatory bowel diseases: A phenomenological hermeneutic study. International journal of nursing practice , 28 (3), e12946. https://doi.org/10.1111/ijn.12946. Giri, S., Harindranath, S., Chandnani, S., Jena, A., Sharma, V., & Sebastian, S. (2025). Systematic Review: Stigma Associated With Inflammatory Bowel Disease. Alimentary Pharmacology & Therapeutics , 62 (11-12), 1066-1088. https://doi.org/10.1111/apt.70448. Groshek, J., Basil, M., Guo, L., Parker Ward, S., Farraye, F. A., & Reich, J. (2017). Media consumption and creation in attitudes toward and knowledge of inflammatory bowel disease: web-based survey. Journal of medical Internet research , 19 (12), e403. https://doi.org/10.2196/jmir.7624. Kamp, K. J., West, P., Holmstrom, A., Luo, Z., Wyatt, G., & Given, B. (2019). Systematic review of social support on psychological symptoms and self‐management behaviors among adults with inflammatory bowel disease. Journal of Nursing Scholarship , 51 (4), 380-389. https://doi.org/10.1111/jnu.12487. Lenti, M. V., Cococcia, S., Ghorayeb, J., Di Sabatino, A., & Selinger, C. P. (2020). Stigmatisation and resilience in inflammatory bowel disease. Internal and emergency medicine , 15 (2), 211-223. https://doi.org/10.1007/s11739-019-02268-0. Lesnovska, K. P., Börjeson, S., Hjortswang, H., & Frisman, G. H. (2014). What do patients need to know? Living with inflammatory bowel disease. Journal of clinical nursing , 23 (11-12), 1718-1725. https://doi.org/10.1111/jocn.12321. Li, Q., Xia, C., Chen, C., Jiang, Y., Jin, L., Zhang, J., ... & Chen, X. (2025). Knowledge, and attitude, and decisional conflict regarding biologics among patients with inflammatory bowel disease: a cross-sectional study. Frontiers in Medicine , 12 , 1604851. https://doi.org/10.3389/fmed.2025.1604851. Moradkhani, A., Kerwin, L., Dudley-Brown, S., & Tabibian, J. H. (2011). Disease-specific knowledge, coping, and adherence in patients with inflammatory bowel disease. Digestive diseases and sciences , 56 (10), 2972-2977. https://doi.org/10.1007/s10620-011-1714-y. Muse, K., Johnson, E., & David, A. L. (2021). A feeling of otherness: A qualitative research synthesis exploring the lived experiences of stigma in individuals with inflammatory bowel disease. International journal of environmental research and public health , 18 (15), 8038. https://doi.org/10.3390/ijerph18158038. Oliveira, S., Zaltman, C., Elia, C., Vargens, R., Leal, A., Barros, R., & Fogaça, H. (2007). Quality-of-life measurement in patients with inflammatory bowel disease receiving social support. Inflammatory bowel diseases , 13 (4), 470-474. https://doi.org/10.1002/ibd.20071. Polak, E. J., O'callaghan, F., & Oaten, M. (2020). Perceptions of IBD within patient and community samples: A systematic review. Psychology & Health , 35 (4), 425-448. https://doi.org/10.1080/08870446.2019.1662014. Ribaudi, E., Amato, S., Becherucci, G., Carillo, S., Covello, C., Mora, V., ... & Napolitano, D. (2025). Addressing Nutritional Knowledge Gaps in Inflammatory Bowel Disease: A Scoping Review. Nutrients , 17 (5), 833. https://doi.org/10.3390/nu17050833. Richard, L., Noller, G., Derrett, S., Sullivan, T., Doolan-Noble, F., McCombie, A., ... & Stokes, T. (2020). Patients’ accounts of living with and managing inflammatory bowel disease in rural Southern New Zealand: a qualitative study. BMJ open , 10 (11), e041789. https://doi.org/10.1136/bmjopen-2020-041789. Rohde, J. A., Wang, Y., Cutino, C. M., Dickson, B. K., Bernal, M. C., Bronda, S., ... & Farraye, F. A. (2018). Impact of disease disclosure on stigma: an experimental investigation of college students’ reactions to inflammatory bowel disease. Journal of Health Communication , 23 (1), 91-97. https://doi.org/10.1080/10810730.2017.1392653. Ruan, J., Wu, L., & Zhou, Y. (2020). Experiences of body image changes in Chinese patients living with inflammatory bowel disease: a descriptive qualitative study. Asian Nursing Research , 14 (4), 196-205. https://doi.org/10.1016/j.anr.2020.07.006. Shao, X. X., Fang, L. Y., Guo, X. R., Wang, W. Z., Shi, R. X., & Lin, D. P. (2023). Knowledge, attitude, and practice of patients living with inflammatory bowel disease: A cross-sectional study. World Journal of Gastroenterology , 29 (43), 5818. https://doi.org/10.3748/wjg.v29.i43.5818. Slonim-Nevo, V., Sarid, O., Friger, M., Schwartz, D., Sergienko, R., Pereg, A., ... & Odes, S. (2018). Effect of social support on psychological distress and disease activity in inflammatory bowel disease patients. Inflammatory bowel diseases , 24 (7), 1389-1400. https://doi.org/10.1093/ibd/izy041. Su, S., Marrie, R. A., & Bernstein, C. N. (2022). Factors associated with social participation in persons living with inflammatory bowel disease. Journal of the Canadian Association of Gastroenterology , 5 (2), 59-67. https://doi.org/10.1093/jcag/gwab022. Taft, T. H., Bedell, A., Naftaly, J., & Keefer, L. (2017). Stigmatization toward irritable bowel syndrome and inflammatory bowel disease in an online cohort. Neurogastroenterology & Motility , 29 (2), e12921. https://doi.org/10.1111/nmo.12921. Tan, M., Holloway, R. H., Lange, K., & Andrews, J. M. (2012). General practitioners' knowledge of and attitudes to inflammatory bowel disease. Internal medicine journal , 42 (7), 801-807. https://doi.org/10.1111/j.1445-5994.2011.02586.x. Vernon Roberts, A., Gearry, B., & Daya, A. S. (2020). The Level of Public Knowledge about Inflammatory Bowel Disease in Christchurch, New Zealand. Inflamm Intest Dis 2020;5:205–211. https://doi.org/10.1159/000510071. Yoon, H., Yang, S. K., So, H., Lee, K. E., Park, S. H., Jung, S. A., ... & Lee, D. H. (2019). Development, validation, and application of a novel tool to measure disease-related knowledge in patients with inflammatory bowel disease. The Korean journal of internal medicine , 34 (1), 81-89. https://doi.org/10.3904/kjim.2017.104. Zhou, Y., Qiao, R., Ding, T., Li, H., & Zhang, P. (2024). An uncertain future: perspectives of emerging adults with inflammatory bowel disease—a qualitative semistructured interview study in eastern China. BMJ open , 14 (11), e089213. https://doi.org/10.1136/bmjopen-2024-089213. Additional Declarations No competing interests reported. Supplementary Files Appendix1.pdf Cite Share Download PDF Status: Under Review Version 1 posted Reviewers agreed at journal 10 May, 2026 Reviewers agreed at journal 09 May, 2026 Reviews received at journal 13 Apr, 2026 Reviews received at journal 30 Mar, 2026 Reviewers agreed at journal 27 Mar, 2026 Reviewers agreed at journal 21 Mar, 2026 Reviewers invited by journal 17 Mar, 2026 Editor assigned by journal 16 Mar, 2026 Editor invited by journal 24 Feb, 2026 Submission checks completed at journal 23 Feb, 2026 First submitted to journal 23 Feb, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8918052","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":608356785,"identity":"6583167c-93ce-4537-aeb4-7ba14c9869f0","order_by":0,"name":"Amine Terzi","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABCElEQVRIiWNgGAWjYDCCA2DEwMDGwMD4AMpgYOAhUguzAQODAVyLBD4tMMAmAdLCQEgL3/Hegwd/MNhF80k3H6v4uedPYp90A+ODt20MdeYN2LVInjmXcECCITm3TeZY2s2eZwaJbTIHmA3ntjFIyBzArsXgRo7BAQMG5tw2iRyzGzwHDIzZJBLYpHmBWnC5zOD+G4MDCQz1QC353wr/QLSw/8ar5QaPwYEDDIdBtrAxA22RA9nCjE+L5Jkcg4MNBseBWtKMpWUOGAO1JDZLzjknITkDZ4idMf74o6I6d/6M5Icf3xyQ45GfkXzww5syG37cEQN2HgqPsYEBX0yOglEwCkbBKCAMAKoIU8T4U2lhAAAAAElFTkSuQmCC","orcid":"","institution":"Artvin Coruh University","correspondingAuthor":true,"prefix":"","firstName":"Amine","middleName":"","lastName":"Terzi","suffix":""},{"id":608356787,"identity":"588f142a-e009-4e25-94d3-8847ab2faea2","order_by":1,"name":"Yağmur Artan","email":"","orcid":"","institution":"Ardahan University","correspondingAuthor":false,"prefix":"","firstName":"Yağmur","middleName":"","lastName":"Artan","suffix":""},{"id":608356788,"identity":"c37c9a88-3ab2-4e85-baaf-596215f936cf","order_by":2,"name":"Yasemin Yıldırım","email":"","orcid":"","institution":"Ege University","correspondingAuthor":false,"prefix":"","firstName":"Yasemin","middleName":"","lastName":"Yıldırım","suffix":""}],"badges":[],"createdAt":"2026-02-19 15:09:01","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8918052/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8918052/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":105057200,"identity":"1a79dd70-9178-4ea6-b5ae-0e2b1579396f","added_by":"auto","created_at":"2026-03-20 11:58:38","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":245037,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eWord cloud of the most frequently used words in participant statements\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-8918052/v1/d7b6ad6bf0655490aae0b470.png"},{"id":105562898,"identity":"cc484f8b-cc25-4a34-999e-2d006d10ac4b","added_by":"auto","created_at":"2026-03-27 12:45:11","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2084779,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8918052/v1/9c82e369-4d24-4ec1-a275-a2a9f0628276.pdf"},{"id":105057201,"identity":"1d517d66-8382-451f-98c3-85cc1d4c5dde","added_by":"auto","created_at":"2026-03-20 11:58:38","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":214981,"visible":true,"origin":"","legend":"","description":"","filename":"Appendix1.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8918052/v1/349c153b2e4d85b6cb8b4590.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"The Silent Face of Inflammatory Bowel Diseases: A Mixed Method Study on Knowledge and Attitudes of Young Adults","fulltext":[{"header":"Introduction","content":"\u003cp\u003eInflammatory Bowel Diseases (IBD), comprising Crohn\u0026apos;s Disease and Ulcerative Colitis, are chronic gastrointestinal diseases with rapidly increasing global prevalence that threaten public health. These diseases severely undermine an individual\u0026apos;s quality of life with their characteristic cycles of remission and flare-ups (Agrawal \u0026amp; Jess, 2022; Borowitz, 2023). The fact that inflammatory bowel diseases are often diagnosed during young adulthood, when education, career, and social identity formation are at their peak, further complicates the management process (Alexakis et al., 2015; Ruan et al., 2020). Indeed, IBD is not only a physical ailment but can also be a debilitating process that directly disrupts a person\u0026apos;s daily routines and social functioning (Bernstein et al., 2020; Su et al., 2022).\u003c/p\u003e\n\u003cp\u003eInflammatory bowel diseases can be described as a \u0026ldquo;silent\u0026rdquo; disease due to the unpredictability of their symptoms and the fact that they cannot be detected from the outside. However, this silence is not only a clinical condition but also involves the suppression of patients\u0026apos; experiences, such as fear of defecation and incontinence, due to social taboos (Zhou et al., 2024; Lenti et al., 2020). Patients\u0026apos; avoidance of sharing certain symptoms and the difficulties they experience in social relationships can also fuel social stigma (Lenti et al., 2020; Rohde et al., 2018). A systematic review found that perceived stigma among individuals with IBD had a prevalence rate of 85.6% in adults and 87% in children (Giri et al., 2025). Social stigma not only worsens patients\u0026apos; psychological health but also limits their treatment compliance processes and their fundamental rights in public spaces. Consequently, individuals with the disease may experience social isolation due to the fear of their illness being discovered and the emergence of disease-related symptoms in society (Rohde et al., 2018; Muse et al., 2021). Therefore, the level of knowledge about IBD among the general public and, in particular, among university students who form the peer group, is of critical importance for the social integration of patients (Polak et al., 2020; Rohde et al., 2018). There may be a lack of knowledge on many topics related to inflammatory bowel diseases, and this situation may cause differences in attitudes towards the disease (Tan et al., 2012; Groshek et al., 2017; Ribaudi et al., 2025). In this context, although there are studies in the literature examining the perception and knowledge level of IBD (Tan et al., 2012; Groshek et al., 2017; Rohde et al., 2018), it can be said that there is a limited number of studies that address the underlying reasons for young adults\u0026apos; attitudes and the social origins of this silence from a holistic perspective. While quantitative methods are successful in reporting general trends, qualitative approaches are essential for understanding the deep traces of silence and stigma in individual lives (Zhou et al., 2024; Muse et al., 2021). Our study adopts a mixed-method approach to comprehensively examine young adults\u0026apos; knowledge levels and attitudes toward IBD. Thus, the aim is to reveal the silent face of the disease in society through both statistical generalizations and in-depth individual narratives.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cem\u003eStudy design\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThis study is a mixed-methods research conducted to assess the knowledge levels, attitudes, and perceptions of university students within the young adult population regarding IBD.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003ePopulation and Sample\u003c/p\u003e\n\u003cp\u003eThe study population consisted of university students aged 18\u0026ndash;30 studying in different faculties in a university where Black Sea Region, T\u0026uuml;rkiye. Participants were included in the study on a voluntary basis. No requirement to be studying in a health-related field was imposed for participation; thus, IBD awareness among students from different disciplines was evaluated comparatively. Purposive sampling was used to select the sample, and 461 participants were included in the study. Semi-structured interviews were conducted with 25 students. Research data were collected between June 1 and August 1, 2025.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eTools\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eResearch data were collected by reviewing the relevant literature (Tan et al., 2012; Rohde et al., 2018; Zhou et al., 2024; Muse et al., 2021; Polak et al., 2020; Yoon et al., 2019) and collected through the \u0026ldquo;Participant Information Form\u0026rdquo; and the \u0026ldquo;Semi-Structured Interview Form,\u0026rdquo; which enabled in-depth data collection.\u003c/p\u003e\n\u003cp\u003eParticipant Information Form: This measurement tool essentially consists of two main sections. The first section identified participants\u0026apos; socio-demographic variables such as age, gender, faculty of study, and health education status. The second section includes multiple-choice questions designed in line with the literature to objectively measure young adults\u0026apos; knowledge, awareness, and attitudes toward IBD (Suppl. File 1). The draft form was revised based on the results of a pilot study conducted with ten participants to test its content validity and comprehensibility, resulting in the final form.\u003c/p\u003e\n\u003cp\u003eSemi-Structured Interview Form: Participants were given approximately 15 minutes of information about inflammatory bowel diseases in order to collect qualitative data for the study. Following the briefing, participants were asked the question, \u0026ldquo;How would you describe having inflammatory bowel disease from your own perspective?\u0026rdquo; to reveal their individual interpretations of having the disease. During the form\u0026apos;s development process, content validity was ensured by consulting three different experts on the suitability of the questions for qualitative research techniques and the scope of the content. The form, shaped according to feedback from the expert panel, was included in the study protocol after its effectiveness was confirmed through pilot interviews with three participants.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eData analysis\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eAdvanced analytical techniques were utilized in the analysis of the quantitative and qualitative data obtained within the scope of the research. The statistical analysis of quantitative data was performed using SPSS (Statistical Package for the Social Sciences) v. 26.0 software. Descriptive statistics, including frequency, percentage distribution, minimum-maximum values, median, arithmetic mean, and standard deviation, were used to summarize the participants\u0026apos; descriptive characteristics and their level of knowledge about IBD. To examine the differences and relationships between variables, binary and multiple group comparisons were made according to the distribution characteristics of the data; a p \u0026lt; 0.05 value was taken as the criterion for statistical significance in the analyses.\u003c/p\u003e\n\u003cp\u003eThe data obtained from the qualitative phase of the study were subjected to content analysis using an inductive approach. In this process, the participants\u0026apos; responses to open-ended questions were examined line by line to identify units of meaning, and then these units were conceptualized to create codes with common characteristics. In the final stage, related codes were brought together to construct main themes representing the phenomenological framework of the study. The mixed-methods analysis was completed by synthesizing the generalizability of the quantitative findings with the in-depth insights provided by the qualitative data.\u003c/p\u003e"},{"header":"Results ","content":"\u003cp\u003eThe study included 461 students with a mean age of 21.87 years (SD = 4.32), the majority being female (62.9%). Among them, 40.3% were nursing students, 17.4% studied other health-related\u0026nbsp;\u003c/p\u003e\n\u003cp\u003edisciplines, and 42.3% were from non-health fields. Notably, only 24.1% had received any prior education or training on IBD, and a mere 11.3% reported knowing someone diagnosed with the condition (Table 1).\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 604px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e1\u003c/strong\u003e\u003cstrong\u003e. Demographic characteristics of participants (n=461)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 403px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 201px;\"\u003e\n \u003cp\u003e\u003cstrong\u003en(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 201px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSex\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 201px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFemale\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eMale\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 201px;\"\u003e\n \u003cp\u003e290 (62.9)\u003c/p\u003e\n \u003cp\u003e171 (37.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 201px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDisciplines\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 201px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNursing\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eOther health fields\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eNon-health fields\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 201px;\"\u003e\n \u003cp\u003e186 (40.3)\u003c/p\u003e\n \u003cp\u003e80 (17.4)\u003c/p\u003e\n \u003cp\u003e195 (42.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 201px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eClass\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 201px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e2\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e3\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e4\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 201px;\"\u003e\n \u003cp\u003e105 (22.8)\u003c/p\u003e\n \u003cp\u003e199 (43.2)\u003c/p\u003e\n \u003cp\u003e96 (20.8)\u003c/p\u003e\n \u003cp\u003e61 (13.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 201px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHave you ever received any training on IBD, or attended any seminars, congresses, or talks related to it?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 201px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 201px;\"\u003e\n \u003cp\u003e111 (24.1)\u003c/p\u003e\n \u003cp\u003e350 (75.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 201px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHas anyone in your family or close circle been diagnosed with IBD?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 201px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 201px;\"\u003e\n \u003cp\u003e52 (11.3)\u003c/p\u003e\n \u003cp\u003e409 (88.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 604px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge (years)(mean\u003cu\u003e+\u003c/u\u003eSD)=\u003c/strong\u003e21.87\u003cu\u003e+\u003c/u\u003e4.32\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eWhen asked about diseases classified under IBD, a higher proportion of nursing students accurately identified Crohn\u0026rsquo;s disease and ulcerative colitis compared to those from non-health fields (p \u0026lt; .001). However, misconceptions\u0026mdash;such as confusing IBD with irritable bowel disease or colon cancer\u0026mdash;were also significantly more prevalent among non-health students (p \u0026lt; .001) (Table 2).\u003c/p\u003e\n\u003cp\u003eParticipants\u0026rsquo; knowledge about the etiology of IBD varied markedly by field of study. While nursing students more frequently identified immune system disorders and genetics as main causes (p \u0026lt; .001), students from non-health fields exhibited higher levels of uncertainty. A similar trend was observed in identifying symptoms, with fatigue, abdominal pain, and bloody stool more accurately recognized by health field students (p \u0026lt; .001) (Table 2).\u003c/p\u003e\n\u003cp\u003eAwareness of diagnostic and treatment methods also differed significantly. Nursing students were more likely to correctly cite colonoscopy, imaging techniques, and pharmacological treatment as key elements in IBD management (p \u0026lt; .001). Interestingly, misconceptions about curability and the rarity of IBD were more common in non-health disciplines (p \u0026lt; .001) (Table 2).\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" align=\"\" width=\"130%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e2\u003c/strong\u003e\u003cstrong\u003e. IBD related knowledge of participants (n=461)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 47.6565%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eQuestions\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.5258%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal (n=461)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.3481%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNursing\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(n=186)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.131%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOther health fields (n=80)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.371%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNon-health fields (n=195)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.8513%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 47.6565%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eWhich of the following disease(s) is/are included under IBD?\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eCrohn disease\u003c/p\u003e\n \u003cp\u003eUlcerative colitis\u003c/p\u003e\n \u003cp\u003eConstipation\u003c/p\u003e\n \u003cp\u003eIrritable Bowel Disease\u003c/p\u003e\n \u003cp\u003eColon cancer\u003c/p\u003e\n \u003cp\u003eI have no idea\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.5258%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e239 (51.8)\u003c/p\u003e\n \u003cp\u003e295 (64.0)\u003c/p\u003e\n \u003cp\u003e134 (29.1)\u003c/p\u003e\n \u003cp\u003e193 (41.9)\u003c/p\u003e\n \u003cp\u003e135 (29.3)\u003c/p\u003e\n \u003cp\u003e91 (19.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.3481%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e151 (63.1)\u003c/p\u003e\n \u003cp\u003e167 (56.6)\u003c/p\u003e\n \u003cp\u003e54 (40.3)\u003c/p\u003e\n \u003cp\u003e109 (56.5)\u003c/p\u003e\n \u003cp\u003e63 (46.6)\u003c/p\u003e\n \u003cp\u003e9 (9.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.131%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e32 (13.4)\u003c/p\u003e\n \u003cp\u003e39 (13.2)\u003c/p\u003e\n \u003cp\u003e30 (22.4)\u003c/p\u003e\n \u003cp\u003e30 (15.5)\u003c/p\u003e\n \u003cp\u003e33 (24.5)\u003c/p\u003e\n \u003cp\u003e19 (20.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.371%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e56 (23.5)\u003c/p\u003e\n \u003cp\u003e89 (30.2)\u003c/p\u003e\n \u003cp\u003e50 (37.3)\u003c/p\u003e\n \u003cp\u003e54 (28.0)\u003c/p\u003e\n \u003cp\u003e39 (28.9)\u003c/p\u003e\n \u003cp\u003e63 (69.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.8513%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026gt;.05\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 47.6565%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eWhat is the main cause of IBD?\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eGenetic\u003c/p\u003e\n \u003cp\u003eEnvironmental factors\u003c/p\u003e\n \u003cp\u003eImmune system disorders\u003c/p\u003e\n \u003cp\u003eI have no idea\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.5258%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e142 (30.8)\u003c/p\u003e\n \u003cp\u003e62 (13.4)\u003c/p\u003e\n \u003cp\u003e190 (41.2)\u003c/p\u003e\n \u003cp\u003e67 (14.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.3481%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e93 (65.5)\u003c/p\u003e\n \u003cp\u003e27 (43.5)\u003c/p\u003e\n \u003cp\u003e60 (31.5)\u003c/p\u003e\n \u003cp\u003e6 (9.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.131%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e13 (14.0)\u003c/p\u003e\n \u003cp\u003e13 (21.0)\u003c/p\u003e\n \u003cp\u003e37 (19.5)\u003c/p\u003e\n \u003cp\u003e17 (25.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.371%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e36 (20.5)\u003c/p\u003e\n \u003cp\u003e22 (35.5)\u003c/p\u003e\n \u003cp\u003e93 (49.0)\u003c/p\u003e\n \u003cp\u003e44 (65.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.8513%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 47.6565%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eWhat is/are the most common symptom(s) of IBD?\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eAbdominal pain\u003c/p\u003e\n \u003cp\u003eDiarrhea\u003c/p\u003e\n \u003cp\u003eWeight loss\u003c/p\u003e\n \u003cp\u003eFatigue\u003c/p\u003e\n \u003cp\u003eUrgency to defecate\u003c/p\u003e\n \u003cp\u003eBloody stool\u003c/p\u003e\n \u003cp\u003eI have no idea\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.5258%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e267 (57.9)\u003c/p\u003e\n \u003cp\u003e268 (58.1)\u003c/p\u003e\n \u003cp\u003e185 (40.1)\u003c/p\u003e\n \u003cp\u003e143 (31.0)\u003c/p\u003e\n \u003cp\u003e181 (39.3)\u003c/p\u003e\n \u003cp\u003e257 (55.7)\u003c/p\u003e\n \u003cp\u003e84 (18.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.3481%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e142 (53.2)\u003c/p\u003e\n \u003cp\u003e141 (52.6)\u003c/p\u003e\n \u003cp\u003e98 (53.0)\u003c/p\u003e\n \u003cp\u003e74 (51.7)\u003c/p\u003e\n \u003cp\u003e101 (55.8)\u003c/p\u003e\n \u003cp\u003e123 (47.9)\u003c/p\u003e\n \u003cp\u003e10 (11.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.131%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e40 (15.0)\u003c/p\u003e\n \u003cp\u003e37 (13.8)\u003c/p\u003e\n \u003cp\u003e31 (16.8)\u003c/p\u003e\n \u003cp\u003e24 (16.8)\u003c/p\u003e\n \u003cp\u003e24 (13.3)\u003c/p\u003e\n \u003cp\u003e42 (16.3)\u003c/p\u003e\n \u003cp\u003e24 (28.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.371%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e85 (31.8)\u003c/p\u003e\n \u003cp\u003e90 (33.6)\u003c/p\u003e\n \u003cp\u003e56 (30.2)\u003c/p\u003e\n \u003cp\u003e45 (31.5)\u003c/p\u003e\n \u003cp\u003e56 (30.9)\u003c/p\u003e\n \u003cp\u003e92 (35.8)\u003c/p\u003e\n \u003cp\u003e50 (59.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.8513%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.005\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 47.6565%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDoes IBD affect any organs in the body other than the intestines?\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003cp\u003eI have no idea\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.5258%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e293 (63.6)\u003c/p\u003e\n \u003cp\u003e40 (8.7)\u003c/p\u003e\n \u003cp\u003e128 (27.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.3481%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e149 (50.8)\u003c/p\u003e\n \u003cp\u003e11 (27.5)\u003c/p\u003e\n \u003cp\u003e26 (20.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.131%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e51 (17.4)\u003c/p\u003e\n \u003cp\u003e12 (30.0)\u003c/p\u003e\n \u003cp\u003e17 (13.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.371%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e93(31.8)\u003c/p\u003e\n \u003cp\u003e17 (42.5)\u003c/p\u003e\n \u003cp\u003e85 (66.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.8513%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 47.6565%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCan stress trigger IBD flare-ups?\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003cp\u003eI have no idea\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.5258%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e354 (76.8)\u003c/p\u003e\n \u003cp\u003e27 (5.9)\u003c/p\u003e\n \u003cp\u003e80 (17.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.3481%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e171 (48.3)\u003c/p\u003e\n \u003cp\u003e7 (25.9)\u003c/p\u003e\n \u003cp\u003e8 (10.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.131%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e56 (15.8)\u003c/p\u003e\n \u003cp\u003e6 (22.2)\u003c/p\u003e\n \u003cp\u003e18 (22.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.371%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e127 (35.9)\u003c/p\u003e\n \u003cp\u003e14 (51.9)\u003c/p\u003e\n \u003cp\u003e54 (67.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.8513%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 47.6565%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDo you know how IBD is diagnosed?\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eBlood tests\u003c/p\u003e\n \u003cp\u003eEndoscopy/colonoscopy\u003c/p\u003e\n \u003cp\u003eImaging techniques (MRI, CT)\u003c/p\u003e\n \u003cp\u003eUltrasonography\u003c/p\u003e\n \u003cp\u003eI have no idea\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.5258%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e173 (37.5)\u003c/p\u003e\n \u003cp\u003e299 (64.9)\u003c/p\u003e\n \u003cp\u003e120 (26)\u003c/p\u003e\n \u003cp\u003e74 (16.1)\u003c/p\u003e\n \u003cp\u003e108 (23.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.3481%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e99 (57.2)\u003c/p\u003e\n \u003cp\u003e162 (54.2)\u003c/p\u003e\n \u003cp\u003e78 (65.0)\u003c/p\u003e\n \u003cp\u003e31 (41.9)\u003c/p\u003e\n \u003cp\u003e7 (6.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.131%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e26 (15.0)\u003c/p\u003e\n \u003cp\u003e48 (16.0)\u003c/p\u003e\n \u003cp\u003e18 (15.0)\u003c/p\u003e\n \u003cp\u003e15 (20.3)\u003c/p\u003e\n \u003cp\u003e24 (22.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.371%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e48 (27.8)\u003c/p\u003e\n \u003cp\u003e89 (27.8)\u003c/p\u003e\n \u003cp\u003e24 (20.0)\u003c/p\u003e\n \u003cp\u003e28 (37.8)\u003c/p\u003e\n \u003cp\u003e77 (71.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.8513%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026gt;.05\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 47.6565%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDo you know the treatment methods used for IBD?\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003ePharmacological treatment\u003c/p\u003e\n \u003cp\u003eDietary modification\u003c/p\u003e\n \u003cp\u003eSurgical treatment\u003c/p\u003e\n \u003cp\u003eComplementary and alternative medicine\u003c/p\u003e\n \u003cp\u003eI have no idea\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.5258%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e293 (63.6)\u003c/p\u003e\n \u003cp\u003e217 (47.1)\u003c/p\u003e\n \u003cp\u003e177 (38.4)\u003c/p\u003e\n \u003cp\u003e102 (22.1)\u003c/p\u003e\n \u003cp\u003e98 (21.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.3481%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e159 (54.2)\u003c/p\u003e\n \u003cp\u003e131 (60.4)\u003c/p\u003e\n \u003cp\u003e93 (52.5)\u003c/p\u003e\n \u003cp\u003e56 (54.9)\u003c/p\u003e\n \u003cp\u003e10 (10.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.131%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e49 (16.8)\u003c/p\u003e\n \u003cp\u003e32 (14.8)\u003c/p\u003e\n \u003cp\u003e31 (17.5)\u003c/p\u003e\n \u003cp\u003e16 (15.7)\u003c/p\u003e\n \u003cp\u003e18 (18.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.371%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e85 (29.0)\u003c/p\u003e\n \u003cp\u003e54 (24.8)\u003c/p\u003e\n \u003cp\u003e53 (30.0)\u003c/p\u003e\n \u003cp\u003e30 (29.4)\u003c/p\u003e\n \u003cp\u003e70 (71.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.8513%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.005\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 47.6565%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDo you think IBD is a disease that can be completely cured?\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003cp\u003eI have no idea\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.5258%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e160 (34.7)\u003c/p\u003e\n \u003cp\u003e164 (35.6)\u003c/p\u003e\n \u003cp\u003e137 (29.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.3481%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e80 (50.0)\u003c/p\u003e\n \u003cp\u003e82 (50.0)\u003c/p\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.131%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e21 (13.1)\u003c/p\u003e\n \u003cp\u003e29 (17.7)\u003c/p\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.371%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e59 (36.9)\u003c/p\u003e\n \u003cp\u003e53 (32.3)\u003c/p\u003e\n \u003cp\u003e83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.8513%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 47.6565%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDo you have any knowledge about the prevalence of IBD in the general population?\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eFrequently\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eOccasionaly\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eRarely\u003c/p\u003e\n \u003cp\u003eI have no idea\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9.5258%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e23 (5.0)\u003c/p\u003e\n \u003cp\u003e228 (49.5)\u003c/p\u003e\n \u003cp\u003e95 (20.6)\u003c/p\u003e\n \u003cp\u003e115 (24.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.3481%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e13 (56.5)\u003c/p\u003e\n \u003cp\u003e113 (49.6)\u003c/p\u003e\n \u003cp\u003e39 (41.0)\u003c/p\u003e\n \u003cp\u003e21 (18.3)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.131%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2 (8.7)\u003c/p\u003e\n \u003cp\u003e44 (19.3)\u003c/p\u003e\n \u003cp\u003e12 (12.6)\u003c/p\u003e\n \u003cp\u003e22 (19.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.371%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e8 (34.8)\u003c/p\u003e\n \u003cp\u003e71 (31.1)\u003c/p\u003e\n \u003cp\u003e44 (46.4)\u003c/p\u003e\n \u003cp\u003e72 (62.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.8513%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eRegarding social and psychological aspects, 54.4% believed they were informed about the daily challenges faced by individuals with IBD. However, detailed understanding of specific difficulties\u0026mdash;such as professional hindrances, psychological impacts, and social isolation\u0026mdash;was again more pronounced among those in health-related fields (p \u0026lt; .001) (Table 3).\u003c/p\u003e\n\u003cp\u003eParticipants also demonstrated varying perceptions about dietary implications. While a majority correctly identified spicy, fried, and processed foods as inappropriate for IBD patients, responses on items like gluten, citrus fruits, and dairy revealed knowledge gaps, particularly among non-health students (p \u0026lt; .001) (Table3 ).\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" align=\"\" width=\"130%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e3\u003c/strong\u003e\u003cstrong\u003e. Participants\u0026rsquo; Knowledge Regarding the Challenges Faced by Individuals with IBD and Their Dietary Considerations\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.3744%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eQuestions\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.9074%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal (n=461)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.44%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNursing\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(n=186)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.3935%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOther health fields (n=80)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.7895%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNon-health fields (n=195)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.0102%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.3744%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTo what extent are you informed about the major difficulties encountered by individuals living with IBD in their everyday lives?\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.9074%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e251 (54.4)\u003c/p\u003e\n \u003cp\u003e210 (45.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.44%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e155 (61.8)\u003c/p\u003e\n \u003cp\u003e31 (14.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.3935%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e33 (13.1)\u003c/p\u003e\n \u003cp\u003e47 (22.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.7895%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e63 (25.1)\u003c/p\u003e\n \u003cp\u003e132 (62.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.0102%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.3744%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eWhat are the potential difficulties individuals with IBD may encounter in their daily lives?\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003ePersistent urge to defecate\u003c/p\u003e\n \u003cp\u003eAbdominal pain and discomfort\u003c/p\u003e\n \u003cp\u003eFatigue and weakness\u003c/p\u003e\n \u003cp\u003eDietary restrictions\u003c/p\u003e\n \u003cp\u003eStress and anxiety\u003c/p\u003e\n \u003cp\u003eSleep disturbances\u003c/p\u003e\n \u003cp\u003eSocial isolation\u003c/p\u003e\n \u003cp\u003eChallenges in professional and academic life\u003c/p\u003e\n \u003cp\u003eEconomic challenges\u003c/p\u003e\n \u003cp\u003ePsychological impacts (depression, reduced self-esteem, etc.)\u003c/p\u003e\n \u003cp\u003eStruggles within intimate or social relationships\u003c/p\u003e\n \u003cp\u003eHealthcare appointments and clinical procedures\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.9074%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e374 (81.1)\u003c/p\u003e\n \u003cp\u003e369 (80.0)\u003c/p\u003e\n \u003cp\u003e266 (57.7)\u003c/p\u003e\n \u003cp\u003e211 (45.8)\u003c/p\u003e\n \u003cp\u003e293 (63.6)\u003c/p\u003e\n \u003cp\u003e219 (47.5)\u003c/p\u003e\n \u003cp\u003e199 (43.2)\u003c/p\u003e\n \u003cp\u003e195 (42.3)\u003c/p\u003e\n \u003cp\u003e94 (20.4)\u003c/p\u003e\n \u003cp\u003e232 (50.3)\u003c/p\u003e\n \u003cp\u003e153 (33.2)\u003c/p\u003e\n \u003cp\u003e149 (32.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.44%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e175 (46.8)\u003c/p\u003e\n \u003cp\u003e158 (42.9)\u003c/p\u003e\n \u003cp\u003e127 (47.8)\u003c/p\u003e\n \u003cp\u003e105 (49.8)\u003c/p\u003e\n \u003cp\u003e144 (49.1)\u003c/p\u003e\n \u003cp\u003e110 (50.2)\u003c/p\u003e\n \u003cp\u003e123 (61.8)\u003c/p\u003e\n \u003cp\u003e103 (52.8)\u003c/p\u003e\n \u003cp\u003e53 (56.4)\u003c/p\u003e\n \u003cp\u003e109 (47.0)\u003c/p\u003e\n \u003cp\u003e83 (54.2)\u003c/p\u003e\n \u003cp\u003e61 (41.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.3935%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e54 (14.4)\u003c/p\u003e\n \u003cp\u003e60 (16.3)\u003c/p\u003e\n \u003cp\u003e46 (17.3)\u003c/p\u003e\n \u003cp\u003e38 (18.0)\u003c/p\u003e\n \u003cp\u003e40 (13.7)\u003c/p\u003e\n \u003cp\u003e35 (16.0)\u003c/p\u003e\n \u003cp\u003e28 (14.0)\u003c/p\u003e\n \u003cp\u003e32 (16.4)\u003c/p\u003e\n \u003cp\u003e8 (8.5)\u003c/p\u003e\n \u003cp\u003e35 (15.1)\u003c/p\u003e\n \u003cp\u003e20 (13.1)\u003c/p\u003e\n \u003cp\u003e23 (15.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.7895%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e145 (38.8)\u003c/p\u003e\n \u003cp\u003e151 (41.0)\u003c/p\u003e\n \u003cp\u003e93 (34.9)\u003c/p\u003e\n \u003cp\u003e68 (32.2)\u003c/p\u003e\n \u003cp\u003e109 (37.2)\u003c/p\u003e\n \u003cp\u003e74 (33.8)\u003c/p\u003e\n \u003cp\u003e48 (24.2)\u003c/p\u003e\n \u003cp\u003e60 (30.8)\u003c/p\u003e\n \u003cp\u003e33 (35.1)\u003c/p\u003e\n \u003cp\u003e88 (37.9)\u003c/p\u003e\n \u003cp\u003e50 (32.7)\u003c/p\u003e\n \u003cp\u003e65 (43.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.0102%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026gt;.05\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.005\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.05\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026gt;.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.3744%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDo you have any knowledge about the dietary habits of individuals with IBD?\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.9074%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e195 (42.3)\u003c/p\u003e\n \u003cp\u003e266 (57.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.44%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e122 (62.6)\u003c/p\u003e\n \u003cp\u003e64 (24.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.3935%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e28 (14.4)\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e52 (19.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.7895%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e45 (23.1)\u003c/p\u003e\n \u003cp\u003e150 (56.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.0102%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.3744%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eWhich of the following foods do you consider potentially inappropriate or contraindicated for individuals living with inflammatory bowel disease (IBD)?\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eSpicy foods\u003c/p\u003e\n \u003cp\u003eFried foods\u003c/p\u003e\n \u003cp\u003eProcessed foods\u003c/p\u003e\n \u003cp\u003eDairy products\u003c/p\u003e\n \u003cp\u003eHigh-fiber foods\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eAlcohol\u003c/p\u003e\n \u003cp\u003eCarbonated beverages\u003c/p\u003e\n \u003cp\u003eProcessed meat products\u003c/p\u003e\n \u003cp\u003eCaffeinated beverages\u003c/p\u003e\n \u003cp\u003eCitrus fruits (e.g., oranges, lemons, grapefruits)\u003c/p\u003e\n \u003cp\u003eChocolate and sweets\u003c/p\u003e\n \u003cp\u003eFoods containing gluten\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.9074%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e390 (84.6)\u003c/p\u003e\n \u003cp\u003e366 (79.4)\u003c/p\u003e\n \u003cp\u003e312 (67.7)\u003c/p\u003e\n \u003cp\u003e146 (31.7)\u003c/p\u003e\n \u003cp\u003e140 (30.4)\u003c/p\u003e\n \u003cp\u003e328 (71.1)\u003c/p\u003e\n \u003cp\u003e308 (66.8)\u003c/p\u003e\n \u003cp\u003e256 (55.5)\u003c/p\u003e\n \u003cp\u003e235 (51.0)\u003c/p\u003e\n \u003cp\u003e230 (49.9)\u003c/p\u003e\n \u003cp\u003e176 (38.2)\u003c/p\u003e\n \u003cp\u003e166 (36.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.44%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e174 (44.6)\u003c/p\u003e\n \u003cp\u003e171 (46.7)\u003c/p\u003e\n \u003cp\u003e147 (47.1)\u003c/p\u003e\n \u003cp\u003e69 (47.3)\u003c/p\u003e\n \u003cp\u003e59 (42.1)\u003c/p\u003e\n \u003cp\u003e155 (47.3)\u003c/p\u003e\n \u003cp\u003e142 (46.1)\u003c/p\u003e\n \u003cp\u003e125 (48.8)\u003c/p\u003e\n \u003cp\u003e112 (47.7)\u003c/p\u003e\n \u003cp\u003e113 (49.1)\u003c/p\u003e\n \u003cp\u003e103 (58.5)\u003c/p\u003e\n \u003cp\u003e77 (46.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.3935%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e60 (15.4)\u003c/p\u003e\n \u003cp\u003e60 (16.4)\u003c/p\u003e\n \u003cp\u003e53 (17.0)\u003c/p\u003e\n \u003cp\u003e19 (13.0)\u003c/p\u003e\n \u003cp\u003e34 (24.3)\u003c/p\u003e\n \u003cp\u003e51 (15.5)\u003c/p\u003e\n \u003cp\u003e54 (17.5)\u003c/p\u003e\n \u003cp\u003e43 (16.8)\u003c/p\u003e\n \u003cp\u003e38 (16.2)\u003c/p\u003e\n \u003cp\u003e37 (16.1)\u003c/p\u003e\n \u003cp\u003e22 (12.5)\u003c/p\u003e\n \u003cp\u003e23 (13.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.7895%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e156 (40.0)\u003c/p\u003e\n \u003cp\u003e135 (36.9)\u003c/p\u003e\n \u003cp\u003e112 (35.9)\u003c/p\u003e\n \u003cp\u003e58 (39.7)\u003c/p\u003e\n \u003cp\u003e47 (33.6)\u003c/p\u003e\n \u003cp\u003e122 (37.2)\u003c/p\u003e\n \u003cp\u003e112 (36.4)\u003c/p\u003e\n \u003cp\u003e88 (34.4)\u003c/p\u003e\n \u003cp\u003e85 (36.1)\u003c/p\u003e\n \u003cp\u003e80 (34.8)\u003c/p\u003e\n \u003cp\u003e51 (29.0)\u003c/p\u003e\n \u003cp\u003e66 (39.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7.0102%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026gt;.05\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.05\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.005\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026gt;.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eAnalysis of students\u0026rsquo; attitudes toward IBD awareness revealed a moderate yet significant willingness to engage in advocacy efforts. While 44.0% expressed readiness to participate in awareness campaigns, this willingness was highest among nursing students (52.2%) and lowest among those in non-health fields (33.5%) (p \u0026lt; .001) (Table 4).\u003c/p\u003e\n\u003cp\u003eA substantial majority (82.0%) agreed that universities should enhance initiatives to raise awareness of chronic illnesses; however, this attitude did not significantly differ between academic disciplines (p \u0026gt; .05). Interestingly, although most participants (81.3%) reported they would feel comfortable sharing a classroom with someone diagnosed with IBD, discomfort was still evident in a minority\u0026mdash;especially among non-health students (29.8%)- a statistically significant difference (p \u0026lt; .005) (Table 4).\u003c/p\u003e\n\u003cp\u003eSupport for promoting the educational and social participation of individuals with chronic illnesses was notably high (88.7%), and over 70% indicated an interest in expanding their knowledge about IBD. Despite this interest, the preferred methods for accessing information\u0026mdash;online courses, seminars, or written sources\u0026mdash;did not significantly vary between groups (p \u0026gt; .05) (Table 4).\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" align=\"\" width=\"130%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e4\u003c/strong\u003e\u003cstrong\u003e. Participants\u0026rsquo; Attitudes Toward Awareness of IBD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.4962%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eQuestions\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.1336%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal (n=461)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003en (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.138%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNursing\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(n=186)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.34%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOther health fields (n=80)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.5172%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNon-health fields (n=195)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8.3403%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.4962%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eWould you consider participating in a campaign aimed at raising awareness about IBD?\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003cp\u003eUndecided\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.1336%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e203 (44.0)\u003c/p\u003e\n \u003cp\u003e91 (19.7)\u003c/p\u003e\n \u003cp\u003e167 (36.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.138%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e106 (52.2)\u003c/p\u003e\n \u003cp\u003e24 (26.4)\u003c/p\u003e\n \u003cp\u003e56 (33.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.34%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e29 (14.3)\u003c/p\u003e\n \u003cp\u003e27 (29.7)\u003c/p\u003e\n \u003cp\u003e24 (14.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.5172%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e68 (33.5)\u003c/p\u003e\n \u003cp\u003e40 (43.9)\u003c/p\u003e\n \u003cp\u003e87 (52.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8.3403%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.4962%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDo you believe that universities should enhance initiatives aimed at raising awareness of the challenges faced by individuals living with chronic illnesses?\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003cp\u003eUndecided\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.1336%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e378 (82.0)\u003c/p\u003e\n \u003cp\u003e45 (9.8)\u003c/p\u003e\n \u003cp\u003e38 (8.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.138%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e157 (41.5)\u003c/p\u003e\n \u003cp\u003e18 (40.0)\u003c/p\u003e\n \u003cp\u003e11 (28.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.34%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e62 (16.4)\u003c/p\u003e\n \u003cp\u003e12 (26.7)\u003c/p\u003e\n \u003cp\u003e6 (15.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.5172%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e159 (42.1)\u003c/p\u003e\n \u003cp\u003e15 (33.3)\u003c/p\u003e\n \u003cp\u003e21 (55.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8.3403%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026gt;.05\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.4962%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eWould you feel uncomfortable sharing a classroom with an individual diagnosed with IBD?\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003cp\u003eUndecided\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.1336%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e47 (10.2)\u003c/p\u003e\n \u003cp\u003e375 (81.3)\u003c/p\u003e\n \u003cp\u003e39 (8.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.138%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e25 (53.2)\u003c/p\u003e\n \u003cp\u003e155 (41.3)\u003c/p\u003e\n \u003cp\u003e6 (15.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.34%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e8 (17.0)\u003c/p\u003e\n \u003cp\u003e60 (16.0)\u003c/p\u003e\n \u003cp\u003e12 (30.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.5172%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e14 (29.8)\u003c/p\u003e\n \u003cp\u003e160 (42.7)\u003c/p\u003e\n \u003cp\u003e21 (53.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8.3403%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.005\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.4962%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDo you support the promotion of educational and social participation of individuals living with chronic illnesses?\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003cp\u003eUndecided\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.1336%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e409 (88.7)\u003c/p\u003e\n \u003cp\u003e24 (5.2)\u003c/p\u003e\n \u003cp\u003e28 (6.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.138%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e173 (42.3)\u003c/p\u003e\n \u003cp\u003e9 (37.5)\u003c/p\u003e\n \u003cp\u003e4 (14.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.34%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e67 (16.4)\u003c/p\u003e\n \u003cp\u003e5 (20.8)\u003c/p\u003e\n \u003cp\u003e8 (28.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.5172%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e169 (41.3)\u003c/p\u003e\n \u003cp\u003e10 (41.7)\u003c/p\u003e\n \u003cp\u003e16 (57.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8.3403%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026gt;.05\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.4962%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAre you interested in enhancing your knowledge about IBD?\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003cp\u003eUndecided\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.1336%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e328 (71.1)\u003c/p\u003e\n \u003cp\u003e70 (15.2)\u003c/p\u003e\n \u003cp\u003e63 (13.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.138%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e144 (43.9)\u003c/p\u003e\n \u003cp\u003e31 (44.3)\u003c/p\u003e\n \u003cp\u003e11 (17.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.34%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e48 (14.6)\u003c/p\u003e\n \u003cp\u003e15 (21.4)\u003c/p\u003e\n \u003cp\u003e17 (27.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.5172%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e136 (41.5)\u003c/p\u003e\n \u003cp\u003e24 (34.3)\u003c/p\u003e\n \u003cp\u003e35 (55.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8.3403%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;.001\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.4962%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eWhat methods would you utilize to obtain information about IBD?\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eOnline courses\u003c/p\u003e\n \u003cp\u003eSeminars and conferences\u003c/p\u003e\n \u003cp\u003eWritten sources (books, articles, etc)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.1336%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e121(26.2)\u003c/p\u003e\n \u003cp\u003e341 (74.0)\u003c/p\u003e\n \u003cp\u003e154 (33.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.138%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e58 (47.9)\u003c/p\u003e\n \u003cp\u003e148 (43.4)\u003c/p\u003e\n \u003cp\u003e68 (44.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.34%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e14 (11.6)\u003c/p\u003e\n \u003cp\u003e56 (16.4)\u003c/p\u003e\n \u003cp\u003e23 (14.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.5172%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e49 (40.5)\u003c/p\u003e\n \u003cp\u003e137 (40.2)\u003c/p\u003e\n \u003cp\u003e63 (40.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8.3403%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026gt;.05\u003c/p\u003e\n \u003cp\u003e\u0026gt;.05\u003c/p\u003e\n \u003cp\u003e\u0026gt;.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eWhen the qualitative data of the study were analyzed, three main themes and eight sub-themes emerged (Table 5).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"605\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 5. Data on Themes, Subthemes, and Participants\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMain Theme \u0026nbsp; \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSub-Theme \u0026nbsp; \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eRelevant Participant No. (Gender, age) \u0026nbsp; \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003en(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSample Participant Statements\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eEmotional and Psychological Burden\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eConstant Anxiety and Uncertainty\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1 (M, 21)\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e6 (F 19)\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e23 (F, 20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3 (%12)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026ldquo;Not knowing when the disease would flare up constantly worried me...\u0026rdquo; (K1), \u0026ldquo;The uncertainty about the future made me think...\u0026rdquo; (K6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePsychological Burnout and Difficulty\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10 (M, 20)\u003c/p\u003e\n \u003cp\u003e15 (F, 20)\u003c/p\u003e\n \u003cp\u003e21(F, 19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3 (%12)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026ldquo;During flare-ups, I felt physically and psychologically exhausted.\u0026rdquo; (K10), \u0026ldquo;Sometimes I would ask myself, \u0026lsquo;Why me?\u0026rsquo;\u0026rdquo; (K21)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eLoneliness and Misunderstanding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3 (F, 22)\u003c/p\u003e\n \u003cp\u003e12 (M, 22)\u003c/p\u003e\n \u003cp\u003e18 (M, 20)\u003c/p\u003e\n \u003cp\u003e20 (M, 19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4 (%16)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026ldquo;I was afraid that people would think I was \u0026lsquo;exaggerating\u0026rsquo;...\u0026rdquo; (K12), \u0026ldquo;I sometimes felt lonely because people find it difficult to understand invisible illnesses.\u0026rdquo; (K3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSocial and Life Restrictions\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSocial Withdrawal and Barriers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2 (M, 21)\u003c/p\u003e\n \u003cp\u003e11 (F, 21)\u003c/p\u003e\n \u003cp\u003e17 (M, 20)\u003c/p\u003e\n \u003cp\u003e19 (F, 20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4 (%16)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026ldquo;The thought of suddenly needing to use the bathroom at school or in crowded places would make me anxious.\u0026rdquo; (K2), \u0026ldquo;I would avoid social situations...\u0026rdquo; (K11)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePhysical and Academic Limitations\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7 (F, 21)\u003c/p\u003e\n \u003cp\u003e13 (F, 22)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2 (%8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026ldquo;I would feel sad that the constant feeling of fatigue might hold me back academically.\u0026rdquo; (K7), \u0026ldquo;I would feel stressed that it might affect my performance because there might be days when I couldn\u0026apos;t attend classes.\u0026rdquo; (K13)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eLifestyle Change\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5 (M, 23)\u003c/p\u003e\n \u003cp\u003e16 (M, 22)\u003c/p\u003e\n \u003cp\u003e24 (F, 21)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3 (%12)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026ldquo;I felt I would struggle in social settings due to dietary restrictions.\u0026rdquo; (K5), \u0026ldquo;I would have to live my life in a more planned and organized way.\u0026rdquo; (K24)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCoping and Acceptance\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePositive Adjustment and Empowerment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4 (F, 22)\u003c/p\u003e\n \u003cp\u003e9 (M, 20)\u003c/p\u003e\n \u003cp\u003e22 (M, 21)\u003c/p\u003e\n \u003cp\u003e25 (F, 23)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4 (%16)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026ldquo;Living under constant control would be exhausting, but I think I could adapt over time.\u0026rdquo; (K4), \u0026ldquo;Even if I faced difficulties, I believed I could learn to live with them.\u0026rdquo; (K25)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSearch for Support\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8 (F, 20)\u003c/p\u003e\n \u003cp\u003e14 (M, 21)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2 (%8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026ldquo;I would need emotional support from my family and friends.\u0026rdquo; (K8), \u0026ldquo;I would try to trust the healthcare team during the treatment process.\u0026rdquo; (K14)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eWhen the participants\u0026apos; responses to the semi-structured interview form were examined, the most frequently occurring words in the participants\u0026apos; statements were anxiety, isolation, fear, fatigue, adaptation, and acceptance (Figure 1).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eOur findings reveal that nursing students have a significantly higher level of knowledge regarding the definition, etiology, and symptom management of IBD compared to their peers studying in non-healthcare fields. Indeed, the study by Groshek et al. (2017) similarly shows that the public\u0026apos;s level of knowledge about IBD is low and that the disease is often confused with other gastrointestinal problems (Groshek et al., 2017).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe fact that nursing students successfully identified symptoms such as fatigue, abdominal pain, and bloody stools is a critical finding. Fatigue is a symptom that most significantly reduces the quality of life of IBD patients but is often neglected in clinical interviews (Czuber-Dochan et al., 2014). The low awareness of these specific symptoms among non-health students may be one of the factors contributing to the disease remaining \u0026ldquo;invisible\u0026rdquo; or \u0026ldquo;silent\u0026rdquo; in society. This silence increases the risk of stigmatization for patients as a result of symptoms being associated with social taboos (Taft et al., 2017; Rohde et al., 2018).\u003c/p\u003e\n\u003cp\u003eInterestingly, our study revealed misconceptions in non-healthcare disciplines that IBD has a curative treatment or that the disease is very rare. IBD is a chronic condition requiring lifelong management, and even primary care physicians may sometimes struggle with the complexity of this chronic management (Alharbi et al., 2019).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAlthough data from our study showed that more than half of the participants believed they were knowledgeable about the difficulties IBD patients face in daily life, in-depth analyses revealed that this self-perception did not always correspond to their actual level of knowledge. In particular, the significantly higher awareness among health sciences students in specific areas such as occupational barriers, psychological effects, and social isolation confirms the impact of clinical education in understanding the unseen aspects of this chronic condition.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIn the literature, IBD is defined as a process that threatens not only patients\u0026apos; physical health but also their social identity and professional development (Lesnovska et al., 2014). In this context, the fact that students in non-health fields have less understanding of this deep psychosocial burden can be considered a reflection of the perception of \u0026ldquo;invisible disability\u0026rdquo; in society (Taft et al., 2017).\u003c/p\u003e\n\u003cp\u003eAnother noteworthy finding of our study is the heterogeneous level of knowledge among participants regarding nutrition. While the vast majority of participants correctly identified that spicy, fried, and processed foods are unsuitable for IBD patients, confusion about specific foods such as gluten, citrus, and dairy products was particularly pronounced in the non-health group. Similarly, a recent review by Ribaudi et al. (2025) reports that there is a lack of evidence-based information and significant gaps in the general public\u0026apos;s knowledge about the IBD diet (Ribaudi et al., 2025). This uncertainty about nutrition is a significant factor contributing to patients\u0026apos; fear of eating in social settings and, consequently, leading to social isolation (Shao et al., 2023).\u003c/p\u003e\n\u003cp\u003eIn the context of psychosocial effects, health sciences students\u0026apos; better understanding of social isolation and psychological effects demonstrates that this group is more sensitive to the risk of stigma experienced by patients. IBD patients are frequently exposed to social stereotypes due to the nature of their symptoms, and this situation seriously undermines their quality of life (Groshek et al., 2017). As emphasized by Lenti et al. (2020), the perception of stigma in society reduces patients\u0026apos; psychological resilience and alienates them from society (Lenti et al., 2020).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAlthough the majority of students in the study stated that they felt comfortable sharing a classroom with an individual diagnosed with IBD, the discomfort felt by some students in non-health-related departments indicates that misconceptions about the disease create social distance. Rohde et al. (2018) found that university students\u0026apos; lack of knowledge about IBD not being contagious or controllable, combined with misconceptions, can fuel social distancing (Rohde et al. 2018). This is consistent with our findings.\u003c/p\u003e\n\u003cp\u003eMore than half of the participants want to learn more about IBD. The high desire for information is particularly important because it will increase individuals\u0026apos; knowledge about the disease, thereby increasing awareness and reducing social stigma. Polak et al. (2020) found that in both patient and community samples, the level of knowledge and awareness was inversely proportional to stigmatization (Polak et al., 2020).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eOur study reveals that participants\u0026apos; individual interpretations of IBD show that the disease is perceived not only as a physical condition but also as a deep psychological burden, even by individuals who do not have the disease. At this point, it can be said that the theme of \u0026ldquo;emotional and psychological burden\u0026rdquo; is directly related to the unpredictability of the disease\u0026apos;s flare-up periods. \u0026nbsp;The literature indicates that IBD has a significant impact on physical and emotional well-being and creates serious difficulties in managing daily activities (Lesnovska et al., 2014; Zhou et al., 2024; Cho et al., 2018). The loneliness and feeling of misunderstanding that come with living with an invisible disease also carry the risk of stigmatization due to a lack of knowledge in society (Vernon Roberts et al., 2020; Muse et al., 2021). A study found that individuals with IBD reported feeling misunderstood by those around them, and that their illness was belittled or misinterpreted (Muse et al., 2021).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eData collected under the theme of social and life restrictions show that when participants describe their experience of having IBS from their own perspective, they associate it with serious concerns such as suddenly needing to use the toilet and withdrawing from social settings. The literature also shows that this condition is a significant barrier that can lead to individuals becoming isolated from social life and negatively affecting their academic performance (Demirtaş, 2022; Ruan et al., 2020). Dietary restrictions and lifestyle changes related to the disease can trigger psychological exhaustion by making social interactions difficult for individuals (Lesnovska et al., 2014; Richard et al., 2020).\u003c/p\u003e\n\u003cp\u003eIn the coping and acceptance process, participants demonstrated a positive tendency to adapt to living under control and learn to live with difficulties. It is known that having accurate information about the disease is effective in developing positive attitudes; therefore, it increases proactive application skills and facilitates the adaptation process (Shao et al., 2023; Moradkhani, 2011; Li et al., 2025). In our study, participants also mentioned seeking support in managing the disease. The literature also indicates that social support from family and friends plays a critical role in alleviating negative emotions such as isolation and fear experienced by individuals and in improving patients\u0026apos; well-being and quality of life (Slonim Nevo et al., 2018; Kamp et al., 2019; Richard et al., 2020; Oliveira et al., 2007). Participants\u0026apos; frequently repeated expressions of anxiety, isolation, and fatigue suggest that healthy individuals perceive IBD not merely as a digestive system problem, but as a comprehensive struggle that permeates every aspect of life. In conclusion, the fact that the individuals in our study, despite not having IBD, showed results similar to those of qualitative research conducted with IBD patients is a fundamental indicator that empathy can be established through education, and therefore, the social stigma associated with IBD can be reduced.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study, which examines young adults\u0026apos; knowledge, attitudes, and awareness regarding IBD, reveals the dynamics of approaches to this chronic condition among future decision-makers and healthcare professionals in society. Although the findings show that the majority of participants support IBD awareness initiatives and are open to learning more about the condition, the tendency toward social distancing and low advocacy among students in non-health fields suggests that lack of knowledge may contribute to stigma. In this context, increasing IBD awareness should be addressed as a shared responsibility of all academic disciplines, not just those in the health field. It should not be forgotten that the barriers to the social integration of individuals living with IBD can only be overcome with approaches based on accurate information and empathy. \u0026nbsp;Therefore, it is believed that the implementation of systematic educational interventions across the university will break down misconceptions about the disease and create a more inclusive campus and community structure. Consequently, in order to increase the level of knowledge and positive attitudes towards IBD, the social dimensions of chronic diseases and methods of combating stigma should be conveyed to all disciplines through elective courses or awareness modules across the university. increasing activities organized by student communities at universities, disseminating accurate information through digital platforms, and developing awareness projects in public spaces through collaboration between local governments and universities.\u003c/p\u003e"},{"header":"Declarations ","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research was conducted in accordance with the principles of the Helsinki Declaration, and official approval (Date/Number: 05/20/2026/178533) was obtained from the Scientific Research and Publication Ethics Committee of Artvin \u0026Ccedil;oruh University before proceeding to the implementation phase of the study. Prior to the data collection process, potential participants were informed in detail about the purpose and scope of the research and the confidentiality of the data. Conducted on a voluntary basis, the study obtained \u0026ldquo;Informed Oral Consent\u0026rdquo; from each participant and committed to keeping personal data anonymous. Emphasis was placed on the participants\u0026apos; right to withdraw from the study at any stage during the study period, and utmost sensitivity was shown in terms of protecting ethical principles.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll data generated or analysed during this study are included in this published article.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA.T. conceptualized the study, collected the data and wrote the main manuscript text, \u0026nbsp;Y.A. conceptualized the study, performed statistical analyses and Y.Y., provided mentorship, reviewed the article. \u0026nbsp;All authors reviewed the manuscript. All authors reviewed, edited, and approved of the final manuscript and agreed to be accountable for its accuracy and integrity.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe would like to thank all participants in the study.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAgrawal, M., \u0026amp; Jess, T. (2022). Implications of the changing epidemiology of inflammatory bowel disease in a changing world. \u003cem\u003eUnited European gastroenterology journal\u003c/em\u003e, \u003cem\u003e10\u003c/em\u003e(10), 1113-1120. https://doi.org/10.1002/ueg2.12317. \u003c/li\u003e\n\u003cli\u003eAlexakis, C., Nash, A., Lloyd, M., Brooks, F., Lindsay, J. O., \u0026amp; Poullis, A. (2015). Inflammatory bowel disease in young patients: challenges faced by black and minority ethnic communities in the UK. 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Impact of disease disclosure on stigma: an experimental investigation of college students\u0026rsquo; reactions to inflammatory bowel disease. \u003cem\u003eJournal of Health Communication\u003c/em\u003e, \u003cem\u003e23\u003c/em\u003e(1), 91-97. https://doi.org/10.1080/10810730.2017.1392653. \u003c/li\u003e\n\u003cli\u003eRuan, J., Wu, L., \u0026amp; Zhou, Y. (2020). Experiences of body image changes in Chinese patients living with inflammatory bowel disease: a descriptive qualitative study. \u003cem\u003eAsian Nursing Research\u003c/em\u003e, \u003cem\u003e14\u003c/em\u003e(4), 196-205. https://doi.org/10.1016/j.anr.2020.07.006. \u003c/li\u003e\n\u003cli\u003eShao, X. X., Fang, L. Y., Guo, X. R., Wang, W. Z., Shi, R. X., \u0026amp; Lin, D. P. (2023). 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Development, validation, and application of a novel tool to measure disease-related knowledge in patients with inflammatory bowel disease. \u003cem\u003eThe Korean journal of internal medicine\u003c/em\u003e, \u003cem\u003e34\u003c/em\u003e(1), 81-89. https://doi.org/10.3904/kjim.2017.104. \u003c/li\u003e\n\u003cli\u003eZhou, Y., Qiao, R., Ding, T., Li, H., \u0026amp; Zhang, P. (2024). An uncertain future: perspectives of emerging adults with inflammatory bowel disease\u0026mdash;a qualitative semistructured interview study in eastern China. \u003cem\u003eBMJ open\u003c/em\u003e, \u003cem\u003e14\u003c/em\u003e(11), e089213. https://doi.org/10.1136/bmjopen-2024-089213. \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"inflammatory bowel disease, attitude, information","lastPublishedDoi":"10.21203/rs.3.rs-8918052/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8918052/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground: \u003c/strong\u003eInflammatory bowel disease is a chronic condition with increasing prevalence worldwide, particularly among young adults, profoundly affecting individuals' social lives, psychological well-being, and labor force participation. Lack of knowledge about these diseases in society leads to stigmatization of patients and disruptions in treatment processes. The attitudes of university students, who are the professionals of the future, are critical for building a more inclusive society.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eObjective: \u003c/strong\u003eThe aim of this study is to assess university students' knowledge, attitudes, and perceptions regarding inflammatory bowel diseases and to evaluate their level of awareness on this subject from the perspective of different academic disciplines.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e The study adopted a mixed-methods research design using both quantitative and qualitative data. The study sample comprised 461 students. Semi-structured interviews were conducted with 25 students. Research data were collected between June 1, 2025, and August 1, 2025. Data were collected using the Participant Information Form and the Semi-structured Interview Form. Quantitative data were evaluated using frequency, percentage distribution, arithmetic mean, and standard deviation values, as well as binary and multiple group comparisons. Qualitative data were evaluated using the inductive approach method.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e Participants' knowledge about the etiology of IBD showed significant differences depending on their field of study. Nursing students more frequently identified immune system disorders and genetics as the main causes (p \u0026lt; .001), while students from non-health fields showed a higher level of uncertainty. A similar trend was observed in the identification of symptoms; fatigue, abdominal pain, and bloody stools were more accurately recognized by students in the health field (p \u0026lt; .001). Nursing students were found to be more willing to participate in IBD awareness campaigns than students from other departments (p \u0026lt; .001). A significant social distance was revealed, with 29.8% of students from non-health-related departments stating that they felt uncomfortable sharing a classroom with someone diagnosed with IBD. When participants' individual interpretations of IBD were evaluated, the themes of “Emotional and Psychological Burden,” “Social and Life Restrictions,” and “Coping and Acceptance” came to the fore.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e The study shows that attitudes toward IBH vary significantly depending on the discipline in which education is received. While nursing students' high level of advocacy reflects the positive impact of professional education, the finding of social distance in non-health fields highlights the need for community-based education. Awareness programs and digital educational tools to be included in university curricula are thought to both fill clinical knowledge gaps and reduce the social stigma experienced by patients.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial number:\u003c/strong\u003eNot applicable.\u003c/p\u003e","manuscriptTitle":"The Silent Face of Inflammatory Bowel Diseases: A Mixed Method Study on Knowledge and Attitudes of Young Adults","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-03-20 11:58:33","doi":"10.21203/rs.3.rs-8918052/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewerAgreed","content":"108568524984028614357522269678500677162","date":"2026-05-10T17:29:29+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"225052530227191616526624186813290042667","date":"2026-05-09T11:08:28+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-13T17:32:01+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-30T21:58:03+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"175970280907394787368414241272869618256","date":"2026-03-27T10:59:02+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"31893565944379360673771962601885694149","date":"2026-03-21T06:36:30+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-03-17T20:21:36+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-03-16T09:55:35+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-02-25T03:28:27+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-02-23T07:43:19+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Medical Education","date":"2026-02-23T07:39:30+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"32a71ace-f59e-4613-ad7d-8a5be1283337","owner":[],"postedDate":"March 20th, 2026","published":true,"recentEditorialEvents":[{"type":"reviewerAgreed","content":"108568524984028614357522269678500677162","date":"2026-05-10T17:29:29+00:00","index":85,"fulltext":""},{"type":"reviewerAgreed","content":"225052530227191616526624186813290042667","date":"2026-05-09T11:08:28+00:00","index":84,"fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-03-20T11:58:33+00:00","versionOfRecord":[],"versionCreatedAt":"2026-03-20 11:58:33","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8918052","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8918052","identity":"rs-8918052","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}