Effects of problem-focused versus emotion-focused behavioral interventions on peptic ulcer recurrence: a 4-year retrospective cohort study.

Authors

Haiyan Peng, ShaoXue Li

Published in

Frontiers in medicine. Volume 13. Pages 1820736. Epub Jun 16, 2026.

Abstract

Peptic ulcer disease (PUD) exhibits high recurrence rates, and behavioral interventions targeting coping strategies may influence long-term outcomes. However, the differential associations of problem-focused versus emotion-focused structured interventions with ulcer recurrence remain unclear.
To evaluate the association between problem-focused versus emotion-focused behavioral interventions delivered during hospitalization and subsequent 4-year ulcer recurrence in patients with PUD.
This single-center retrospective cohort study included 167 patients hospitalized with PUD between January 2021 and March 2025. Based on documented structured interventions received during the index hospitalization, patients were classified into a problem-focused intervention group (n = 84; 6 monthly 90-min group sessions emphasizing problem identification, solution generation, goal-setting, and action planning) or an emotion-focused intervention group (n = 83; 6 monthly 90-min group sessions focusing on emotional awareness, relaxation training, mindfulness, and cognitive restructuring). Clinical outcomes and endoscopic findings were ascertained retrospectively from the electronic medical record over a 4-year period (January 2021 to March 2025). Baseline demographic and clinical characteristics were comparable between groups. Outcome assessors (endoscopists) were blinded to group assignment; patient blinding was not feasible given the behavioral intervention context.
Over the 4-year observation period, cumulative ulcer recurrence was significantly lower in the problem-focused group (19.05% vs. 37.35%; χ² = 7.243, P = 0.007). After multivariable adjustment for prespecified confounders (baseline ulcer diameter, NSAID use history, smoking status, H. pylori positivity, age, and gender), problem-focused intervention remained independently associated with reduced odds of recurrence (adjusted OR = 0.41, 95% CI: 0.22-0.76, P = 0.004). The problem-focused group also demonstrated higher intervention adherence (92.86% vs. 81.93%, P = 0.038), greater patient satisfaction (22.41 ± 2.30 vs. 19.75 ± 2.98, P < 0.001), and shorter median healing time (6.0 vs. 7.0 weeks, P = 0.022). No significant differences were observed in H. pylori reinfection rates or adverse events.
In this retrospective cohort, receipt of a structured problem-focused behavioral intervention during hospitalization was associated with lower ulcer recurrence and improved clinical outcomes over the 4-year observation period compared to an emotion-focused intervention. However, given the observational design, single-center setting, lack of participant blinding, and potential residual confounding, these findings should be interpreted as hypothesis-generating. Prospective randomized controlled trials are warranted to establish causality and evaluate generalizability before integration into routine clinical practice.

PMID:
42383062
Bibliographic data and abstract were imported from PubMed on 01 Jul 2026.

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