OBJECTIVES: Primary symptoms of Ulcerative Colitis (UC) are well-known, however, similarities and differences among adults versus adolescents are not well-characterized. For this qualitative study, participants were asked to bring a collage representing their UC to the interview to help initiate discussion, as well as identify the most pertinent disease-related experiences. Such creative tasks are often used in qualitative research, but insights generated are not typically subject to systematic analysis.

METHODS: UC patients were recruited from clinical sites in the United States for in-depth, open-ended interviews. To begin, participants were asked to describe and explain the content of their collage. Collages and interview transcripts were coded using thematic analysis in Atlas.ti.

RESULTS: In total, 21 adults (20-70 years) and 14 adolescents (12-17 years) participated in interviews. Among adults, 53% were female, 66% were white, 24% had mild UC, 38% moderate and 38% severe. Among adolescents, 50% were female, 71% were white, 64% had mild UC, 29% moderate and 7% severe. Mean years since UC diagnosis was 9.3 and 3.0 for adults and adolescents, respectively. A total of 31 participants (n=17 adults, n=14 adolescents) brought a collage to the interview.

Analysis of the collages identified 11 symptoms and 18 impacts. An additional 5 symptoms were reported outside of the collage task, however the 11 represented in the collages were the most frequent/burdensome symptoms as described in the interviews. This indicates that content selected for the collages was most pertinent to participants. Collage content for adults and adolescents was comparable.

CONCLUSIONS: Creative methods, such as collage tasks, assist in facilitating discussions. Most symptoms identified in the collages were also frequently discussed in the interviews. However, traditional in-depth discussion is critical to ensure the complete range of symptoms are fully captured. Creative tasks provide a novel and complementary approach to support traditional qualitative research.