Understanding the health and social care needs of people living with IBD: A meta-synthesis of the evidence

Table 3 Themes and concepts

1st order constructs	Ref.	2nd order constructs	Line of argument synthesis
Limitations/missing out on life events	[17,38,50-54]	Detained by disease (“pull”)	“Pushed and pulled: a compromised life”.Constant conflict between IBD and normal life results in a compromised life.Pushes to be normal but IBD pulls individual back.
Humiliation of incontinence	[17,50,51,53,54]	Fear of incontinence - unpredictability, humiliation
Social isolation	[17,38,50,51,53,54]	Behaviour due to fear of incontinence - avoidance
Unpredictability	[38,50-53]	Impact of behaviour - socially isolated, missing out on life events, limited life, relationship burden, feeling damaged
Powerlessness	[17,38,53,54]	Fatigue
Feeling damaged	[38,52-54]
Impact on relationships	[17,38,50-54]
Negative emotions	[17,50-54]
Stress	[38,51-54]
Fatigue	[38,50-53]
A disease for life	[38, 51-53]	Living in a world of disease
Fear of long term effects	[38, 51-53]
Invisible disease	[38,50,53,52]
Acceptance yet fight	[38,53,54]	Wrestling with life (“push”)
Knowing my body	[38,53,54]	Striving to thrive
Control	[38,51-54]
Maintaining normality	[38,50,52,53]

IBD: Inflammatory bowel disease.